Alcohol and Pregnancy: Is 'A Little Bit' Safe?

Find out what experts say about whether light drinking is risky when you’re pregnant.

From the WebMD Archives

If you're pregnant and wondering if it's OK to indulge in the occasional small glass of merlot or to sip a little champagne on New Year’s Eve, the advice you receive may be confusing.

Some doctors recommend that you completely avoid alcohol when you’re expecting; others say that occasional light drinking is unlikely to harm your baby.

Chances are your friends are divided on this, too. One might confide that she enjoyed the occasional beer during her pregnancy and feels her child turned out fine, while another sees this as taking an unnecessary risk.

For decades, researchers have known that heavy drinking during pregnancy can cause birth defects. But the potential effects of small amounts of alcohol on a developing baby are not well understood.

Whatever the risks, many moms-to-be are choosing not to totally give up alcohol. A recent CDC study found that about one in eight pregnant women in the U.S. report drinking at least one alcoholic beverage in the past month.

Here’s what doctors say pregnant women should keep in mind when deciding whether to drink lightly or to steer clear of alcohol altogether.

How Much Is Too Much?

“The problem with drinking alcohol during your pregnancy is that there is no amount that has been proven to be safe,” says Jacques Moritz, MD, director of gynecology at St. Luke’s-Roosevelt Hospital in New York.

David Garry, DO, associate professor of clinical obstetrics and gynecology at the Albert Einstein College of Medicine and chair of the Fetal Alcohol Spectrum Disorders Task Force for the American College of Obstetricians and Gynecologists District II/NY, agrees. He says that researchers don’t know enough about the potential effects of drinking alcohol at particular times during the pregnancy to be able to say that any time is really safe.

It’s also difficult to predict the impact of drinking on any given pregnancy because some women have higher levels of the enzyme that breaks down alcohol.

“If a pregnant woman with low levels of this enzyme drinks, her baby may be more susceptible to harm because the alcohol may circulate in her body for a longer period of time,” Garry tells WebMD.

Continued

Because there are so many unknowns, the CDC, the U.S. Surgeon General, the American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics advise pregnant women not to drink alcohol at all.

They note, on their web sites, that pregnant women who drink alcohol risk giving birth to a child with a fetal alcohol spectrum disorder (FASD). These conditions range from mild to severe and include speech and language delays, learning disabilities, abnormal facial features, small head size, and many other problems.

More Research Is Needed

Although heavy drinking can obviously be harmful, the risks of light and moderate drinking aren’t as clear.

Some women may have been reassured by a study that was published in October 2010 in the Journal of Epidemiology and Community Health.

In that study, researchers in the U.K. reported that the 5-year-old children of women who drank up to one to two alcoholic drinks per week or per occasion while pregnant were not at an increased risk of behavioral or cognitive problems. The authors noted, however, that it’s possible that developmental problems linked to maternal drinking could emerge later in childhood. They are planning a follow-up study to monitor the children as they grow older.

An Ongoing Debate

Many doctors agree with the stance of the CDC and Surgeon General and recommend that their pregnant patients avoid drinking.

“The way I see it is: If you wouldn’t give a 2-month-old a glass of wine, then why would you drink a glass of wine when you’re pregnant?” Garry says.

Carol Archie, MD, associate clinical professor of obstetrics and gynecology at the David Geffen School of Medicine at UCLA, is concerned that even small amounts of alcohol can affect a developing baby’s brain.

“We know that alcohol impacts brain cells and that the baby’s brain is constantly developing throughout the entire pregnancy,” she says. “So I would say to a pregnant mother that it’s probably best to abstain from all alcohol.”

Other doctors feel that pregnant women shouldn’t worry about having a small drink every once in a while.

“I’ve always told my patients that I think it’s a personal decision and there isn’t evidence that light drinking is dangerous,” says Marjorie Greenfield, MD, professor of obstetrics and gynecology at Case Western Reserve University School of Medicine in Cleveland and author of The Working Woman’s Pregnancy Book. “About one to two drinks per week is probably OK. But never consume more than two at a time or drink to the point of inebriation,” she says. Moritz also says she thinks “a celebratory glass of alcohol is more than likely fine -- for example, if someone is giving a toast on a holiday or at a birthday party.”

Continued

Playing it Safe

Ultimately, it’s up to each mom-to-be to consult with her doctor and decide if she’ll have the occasional small drink. Those who opt to give up alcohol may miss unwinding with a cocktail, but Archie thinks they won’t regret being cautious.

“In the life of you and your child, it’s such a small amount of time and the sacrifice is not so great. It’s definitely not the biggest sacrifice you’ll make when raising your child,” she says. “I think it’s the appropriate amount of caution to bring to something that’s so miraculous and beautiful.”

Experts say that women with certain risk factors should be especially careful about avoiding alcohol while pregnant. You probably should not drink, for example, if you have liver disease, a history of addiction, or are on any medications that may conflict with alcohol, such as antidepressants.

And if you’re concerned that you are drinking too much and feel that you cannot stop -- during your pregnancy or at any other time -- talk with your doctor. He or she can refer you for counseling or treatment.

WebMD Feature Reviewed by Laura J. Martin, MD on June 22, 2012

Sources

SOURCES:

National Institutes of Health: “Fetal Alcohol Spectrum Disorders.”

World Health Organization’s Health Evidence Network: “Is low-dose alcohol exposure during pregnancy harmful?”

CDC, Morbidity and Mortality Weekly Report, May 22, 2009; vol 58: pp 529-532.

Jacques Moritz, MD, director of gynecology, St. Luke’s-Roosevelt Hospital.

David Garry, DO, associate professor of clinical obstetrics and gynecology, Albert Einstein College of Medicine; director of obstetrics, Jacobi Medical Center; chair, Fetal Alcohol Spectrum Disorders Task Force for the American College of Obstetricians and Gynecologists District II/NY.

CDC: “Facts about FASDs.”

News Release, U.S. Department of Health & Human Services Office of the Surgeon General.

News Release, American College of Obstetricians and Gynecologists.

The American Academy of Pediatrics Committee on Substance Abuse and Committee on Children With Disabilities. Pediatrics, August 2000; vol 106: pp 358-361.

Kelly, Y. Journal of Epidemiology and Community Health, Oct. 5, 2010, online edition.

Yvonne Kelly, PhD, senior lecturer in the department of epidemiology and public health, University College London.

Carol Archie, MD, associate clinical professor of obstetrics and gynecology, David Geffen School of Medicine at UCLA.

Marjorie Greenfield, MD, professor of obstetrics and gynecology, Case Western Reserve University School of Medicine; author, The Working Woman’s Pregnancy Book.

© 2010 WebMD, LLC. All rights reserved.

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