Articles

Key takeaways

• No amount of alcohol is safe to drink during pregnancy.
• Drinking alcohol during pregnancy can lead to long-term health problems for your baby.
• Avoid alcohol completely while pregnant, and follow safety guidelines if drinking while breastfeeding.
• Support is available if you need help to stop drinking.

The effects of alcohol during pregnancy

Avoiding alcohol during pregnancy is the safest choice. There is no proven safe amount of alcohol you can drink during pregnancy. If you drink alcohol, some of it will pass through the placenta to your baby.

Your baby cannot process alcohol like an adult because their liver is not fully developed. Alcohol remains in your baby's body for several hours after it has left your bloodstream. The more you drink, the greater the risk of harm to your baby.

Drinking alcohol during pregnancy can increase your risk of:

• Miscarriage
• Stillbirth
• Premature birth
• Having an underweight baby
• Your baby not growing as expected in the womb (foetal growth restriction).

Alcohol can damage your baby's developing cells. This can affect how their brain and organs develop. It can also make your baby more prone to illness in infancy and childhood.

Foetal Alcohol Spectrum Disorder (FASD)

Drinking alcohol during pregnancy can cause a range of lifelong conditions that affect your baby's development (known as foetal alcohol spectrum disorder, or FASD). About 3 in every 100 children and young people in the UK have FASD.

FASD can cause problems with:

• Learning and behaviour
• Joints, bones, and muscles
• Some organs
• Managing emotions and developing social skills
• Hyperactivity and impulse control
• Communication, such as problems with speech
• Sensory difficulties – like being sensitive to certain lights, sounds, or touch.

Foetal alcohol syndrome (FAS) is a more severe form of FASD. The severity of FASD is linked to how much and how often you drink alcohol during pregnancy.

Stopping drinking alcohol at any point during pregnancy can be beneficial. Even if you have been drinking alcohol, stopping at any point during your pregnancy is one of the best things you can do for your baby. It will protect them from any further harm and help give them the best possible start.

Navigating an alcohol-free pregnancy

It is best not to drink alcohol at all if you are pregnant. This will keep any risk to your baby to a minimum. Remind yourself that you are doing this for your baby's health and safety.

Getting support from others

Tell your partner, family, and friends about the possible effects of alcohol on your baby. Ask them to support you when you choose not to drink.

Your partner can also support an alcohol-free pregnancy by not drinking alcohol around you. They can help you by also trying activities that do not involve alcohol, like going for a walk.

It can help to be around other people who are not drinking alcohol. You might find a "sober-buddy" who is also avoiding alcohol.

Social situations

You might be tempted to drink alcohol out of habit in social settings. Try changing how you socialise. You could go to a cafe or do an activity like a (prenatal) yoga class.

If you go to parties, take your own non-alcoholic drinks. People do not always havenon-alcoholic options.

Non-alcoholic alternatives

There are many non-alcoholic drinks available, including:

• Mocktails – cocktails that do not contain alcohol. You can ask a bartender to make an alcohol-free version of your favourite.
• Sparkling water – with ice and lemon.
• Iced fruit teas – check the label to ensure they are caffeine-free and safe for pregnancy.
• Traditional still lemonade
• Milkshakes – made with skimmed or semi-skimmed milk.
• Non-alcoholic wine and beer – check the label as some can contain tiny amounts of alcohol.

Water is the best choice for hydration. You can also try sugar-free squash, decaf tea and coffee, or fruit juice. Limit fruit juice or smoothies to 150ml per day and drink them with meals to protect your teeth.

Medical help

If you have difficulty stopping drinking alcohol, talk to a midwife, doctor, or pharmacist. They can offer confidential help and support.

Acamprosate is a medicine that can help reduce alcohol cravings. It may be recommended during pregnancy to help you stop drinking.

There is limited information on taking acamprosate during pregnancy. However, the benefits of taking this medicine to help you stop drinking alcohol may be greater than any possible risks. Your doctor will talk this through with you and help you decide on the best way to avoid alcohol.

Alcohol and breastfeeding: what you need to know

Alcohol passes freely into your breast milk. The level of alcohol in your breast milk will be similar to the level in your blood. An occasional drink is unlikely to harm your baby, especially if you wait at least 2 hours before feeding.

Regularly drinking above recommended limits can be harmful to you and your baby.

Excessive alcohol can decrease your milk supply. It may also cause sleep, growth, and developmental problems for your baby. High levels of alcohol in your milk may lead to drowsiness, deep sleep, and weakness in your baby.

Recommendations for drinking alcohol while breastfeeding

To keep health risks from alcohol low, it is safest not to drink more than 14 units a week. If you drink 14 units per week, spread your drinking evenly over 3 or more days. Have several drink-free days each week if you want to cut down.

One unit of alcohol is equal to:

• A small glass of wine (125ml)
• Half a pint of beer
• A single measure of a spirit (25ml)

An occasional drink is unlikely to harm your baby. This means 1 or 2 units, once or twice a week.

It takes about 2 to 3 hours for one glass of wine or beer to leave your system. The more you drink, the longer it takes.

If your baby is under 3 months old, it will take them longer to process alcohol. This is because their liver is still developing.

Planning for a drink

If you plan to have a social alcoholic drink, try to avoid breastfeeding for 2 to 3 hours after every alcoholic drink you have. This allows time for the alcohol to leave your breast milk. You should make sure breastfeeding is well established before trying this.

You could express some milk before a social event. Then you can feed your baby with the expressed milk after the event.

Your breasts may become uncomfortably full if you leave long gaps between feeds. You may need to express for comfort.

You do not need to express breast milk to clear it of alcohol. As your blood alcohol levels fall, the level of alcohol in your breast milk will also decrease.

Important safety warning

If you drink any alcohol, do not bed share with your baby. Also, do not fall asleep on a sofa or chair with your baby.

Doing this increases the risk of the sudden, unexplained death of a baby (sudden infant death syndrome, or SIDS). If you drink alcohol heavily, another adult who has not had any alcohol should care for your baby.

Finding support to reduce or stop drinking alcohol

It is important to talk to your midwife or doctor if you are worried about your drinking. They can offer you the right help and information. You can speak to one of the following professionals:

• Your midwife
• A doctor who specialises in pregnancy and birth (obstetrician)
• A practice nurse
• Your GP
• A health visitor

They will support you directly or advise you on local counselling or support services. Talking to your midwife is often the first step to getting the right support for you and your baby.

Free and confidential helplines are available:

• Drinkline – call 0300 123 1110.
• Wales Drugs and Alcohol helpline (DAN 24/7) – call 0808 808 2234 or text DAN to 81066.
• Addiction Northern Ireland – provides support and treatment, call 02890 664 434.