What is the best advice for women in regards to alcohol use during pregnancy?

According to the Surgeon General, there is no acceptable threshold or safe level of alcohol consumption while pregnant. Their recommendation is to not consume any alcohol whatsoever while pregnant. And yet a recent survey has shown that 10-15% of pregnant American women reported recently consuming alcohol, and a staggering 30% of pregnant American women admitted to drinking at some point during their pregnancies. Even low to moderate levels of alcohol consumption (namely 2 standard drinks/day) increases the risk of spontaneous abortion and stillbirths. Long-term effects of low-to-moderate alcohol consumption are lengthy. They can include stunted growth in the first year of life, poor cognitive development and poor behavioural development.

So why are women still drinking while pregnant? What are the risk factors associated with the use of alcohol during pregnancy?

Women are at increased risk of harmful drinking during pregnancy if they have pre-existing risk factors present in their lives such as heavy drinking prior to being pregnant, use other substances commonly misused with alcohol such as tobacco and cocaine, limited access to prenatal and postnatal services, living in stressful environments or being exposed to drug and/or alcohol use by a partner. Statistics have shown that women with lower education levels, lower socioeconomic status, and inadequate nutrition are significantly more at risk of harmful drinking during pregnancy.

What are some examples of personal and interpersonal barriers that prevent women from disclosing alcohol use while pregnant?

Some examples of personal barriers women face when wanting to tell someone they are drinking while pregnant include a fear of feeling shame, guilt and being subjected to obvious societal stigmas attached to mothers misusing substances while pregnant. Some interpersonal barriers include the dismissal and lack of support from family and the fear of losing her children and/or baby to a partner or child welfare services.

How much is too much? What are the risks associated with heavy or binge drinking while pregnant?

Heavy drinking is defined as more than 2 standard drinks/day. Binge drinking is defined as 5 standard drinks/day or more. As the number of consumed drinks rise, so do the associated risks and health factors during pregnancy. But recent findings have shown that even low levels of alcohol use while pregnant can lead to Fetal Alcohol Spectrum Disorder (FASD), fetal alcohol syndrome (FAS) and other alcohol-related neurological and physiological effects.

What is Fetal Alcohol Syndrome (FAS)?

Over time a pattern of physical and mental defects developed amongst babies exposed to high levels of alcohol consumption during pregnancy. This pattern of psychological, behavioural and physiological damage is now referred to as Fetal Alcohol Syndrome (FAS). FAS babies are chiefly effected by permanent central nervous system damage, which is centralized in the brain. This can lead to a plethora of negative neurological and behavioural effects including poor memory skills, impulsive behaviours, attention deficits and mental retardation. Children with FAS often are predisposed to drug and substance addiction and mental health problems. Physiologically, children with FAS experience stunted growth and distinct facial abnormalities characterized by and associated with prenatal alcohol consumption. These facial features can include a thin upper lip, small eye openings and a smooth philtrum (the groove located between the upper lip and nose).

What is Fetal Alcohol Spectrum Disorder (FASD)?

FASD refers to babies who have a spectrum of permanent birth defects (including physical, behavioural and cognitive effects) as a result of prenatal alcohol exposure. Approximately 1% of children are believed to have FASD. FASD is an “umbrella” term developed to include several subtypes of conditions resulting from prenatal alcohol exposure including Fetal Alcohol Syndrome (FAS), Partial Fetal Alcohol Syndrome (PFAS), Alcohol-Related Neurodevelopmental Disorder (ARND), Alcohol Related Birth Defects (ARBD) and Fetal Alcohol Effect (FAE).

What are some other effects associated with these conditions as a result of prenatal alcohol exposure?

Alcohol-related birth defects (ARBD) can include skeletal, renal, ocular, auditory and cardiac malformations. Some examples of Alcohol-Related Neurodevelopmental Deficits (ARND) can include structural brain abnormalities, impaired motor skills, poor hand-eye coordination, impaired judgment skills and learning difficulties.

What about drinking alcohol while breastfeeding?

Just like consuming alcohol while pregnant, there is no safe level of alcohol consumption while breastfeeding. Every ounce of alcohol a mother consumes is passed into her breast milk. Although somewhat diluted, it still poses significant and sometimes irreversible health risks to the baby. Maternal alcohol consumption decreases milk flow and results in a slew of neonatal problems including malnutrition, altered sleeping patterns, and impaired motor development. If breastfeeding it is recommended that mothers abstain completely from drinking alcohol. If alcohol is drunk, it is recommended that women delay breastfeeding until the alcohol has cleared their system and no alcohol is present in their breastmilk. A good tool to use for milk screening purposes is our product, Milkscreen. 

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