How Much Alcohol Can a Woman Safely Drink During Pregnancy?

Animal research shows that on the cellular level, as little as one dose of alcohol can reduce brain cell adhesion and cause neurological deficits. Human research has been limited, for ethical/legal reasons, and studies conducted on children exposed prenatally to low levels of alcohol have been contradictory. The following are statements from credible sources that unequivocally warn that the only safe level of alcohol during pregnancy is ZERO.
National Organization on Fetal Alcohol Syndrome:

"No safe time. No safe amount. No safe alcohol. Period."

[NOFAS Cover Page]

National Institute on Alcohol Abuse and Alcoholism:

"While it is apparent that children who meet the criteria for FAS are born only to those mothers who consume large amounts of alcohol during pregnancy, studies have reported neurobehavioral deficits and intrauterine growth retardation in infants born to mothers who reported themselves to be moderate alcohol consumers during pregnancy."

"Clinicians, however, must offer advice to their patients based upon the best available scientific evidence. Although some clinicians believe that recommending total abstention for pregnant women may subject them to unwarranted guilt about drinking small amounts of alcohol, most accept the need for clinical caution. Because we do not know at what point alcohol damage begins, it is prudent to recommend that pregnant women abstain from alcohol."

[NIAAA US Dept of Health & Human Services, Alcohol Alert No.13, July 1991]

Centers for Disease Control and Prevention:

"Public health concern over the use of alcohol during pregnancy was first signaled in 1981 by the release of a public health advisory from the Office of the Surgeon General warning women who were pregnant or planning to become pregnant to abstain from alcohol use because of the potential risks to the fetus. Since that time the U.S. Department of Health and Human Services issued additional advisories in 1990 and 1995 reiterating that women who are pregnant or planning to become pregnant should not drink alcohol."

[National Center on Birth Defects and Developmental Disabilities: FAS Prevention Activities ]

March of Dimes:

"Research shows that even small amounts of alcohol can increase the risks of birth defects. So the safest choice is not to drink at all during your pregnancy."

"In fact, it's best to stop drinking before you try to become pregnant. Three weeks after you conceive, your baby's important organs are already forming. But you may not even know you're pregnant yet. During that time, alcohol could affect your baby's developing brain and body. So if you are thinking about getting pregnant, you should stop drinking before trying to conceive."

[March of Dimes, Alcohol and Pregnancy: Make the Right Choice]

More from the March of Dimes:

"No level of alcohol use during pregnancy has been proven safe. The March of Dimes recommends that a pregnant woman does not drink any alcohol - including beer, wine, wine coolers and hard liquor - throughout her pregnancy and while nursing.

"Drinking while pregnant can cause fetal alcohol syndrome, a lifelong condition that can include mental retardation, facial abnormalities, stunted growth, and learning disorders. It can also increase the risk of miscarriage, low birthweight, stillbirth and death in early infancy. When a pregnant woman drinks, alcohol passes swiftly through the placenta to her fetus. In the unborn babyís immature body, alcohol is broken down much more slowly than in an adultís body. As a result, the alcohol level of the fetusís blood can be even higher and can remain elevated longer than that of the motherís blood."

March of Dimes: Drinking During Pregnancy

United States Institute of Medicine (1996):

"Universal prevention intervention strives to ensure that all members of society understand that drinking alcohol can have hazardous consequences, particularly during pregnancy. The universal prevention message for FAS is a conservative one that encourages abstinence prior to conception and throughout pregnancy as the safest alternative."

[Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment]

Mayo Clinic:

"When you drink alcohol, it enters your bloodstream and can reach your developing fetus by crossing the placenta. Because a fetus metabolizes alcohol more slowly than an adult does, your developing baby's blood alcohol concentrations are higher than those in your body. The presence of alcohol can impair optimal nutrition for your baby's developing tissues and organs and can damage brain cells."

"Consider giving up alcohol during your childbearing years if you're sexually active and you're having unprotected sex. Nearly half of all pregnancies are unplanned."

[ Fetal Alcohol Syndrome]

Queens University in Belfast (1999):

"The behavioural effects observed indicate maternal alcohol consumption has influenced, possibly permanently, the functioning of the brain and CNS of the fetus and infant. These effects are observed at low levels of maternal alcohol consumption (5-6 units per week) and this raises questions regarding the 'safe' level of alcohol during pregnancy."

[Hepper, P.G. Report on Prenatal Exposure to Alcohol, 1999]

Wayne State University Research:

"Sixteen percent of the children born in the United States are exposed prenatally to alcohol, making alcohol the most common neurobehavioral teratogen. Whereas the earliest reports of neurobehavioral toxicity related to drinking during pregnancy were described among children of alcoholic mothers, more recent research suggested deleterious outcomes for children who are exposed prenatally to moderate amounts of alcohol. Jacobson and Jacobson, in their review of prenatal alcohol exposure and neurobehavioral development, suggested that even the smallest dose may adversely affect the fetus."

"Maternal alcohol consumption even at low levels was adversely related to child behavior; a dose-response relationship was also identified. The effect was observed at average levels of exposure of as low as 1 drink per week. Although effects on mean scores for Externalizing and Aggressive behaviors were observed at low levels of prenatal alcohol exposure, effects on Delinquent behavior and Total Problem Scores were observed at moderate/heavy levels of exposure. Children with any prenatal alcohol exposure were 3.2 times as likely to have Delinquent behavior scores in the clinical range compared with nonexposed children. The relationship between prenatal alcohol exposure and adverse childhood behavior outcome persisted after controlling for other factors associated with adverse behavioral outcomes. Clinicians are often asked by pregnant women if small amounts of alcohol intake are acceptable during pregnancy. These data suggest that no alcohol during pregnancy remains the best medical advice."

[Pediatrics Vol. 108 No. 2 August 2001, p. e34]

Center for Science in the Public Interest:

"A recent survey illustrated the need for physician education on "how much" alcohol consumption is "too much" during pregnancy. 41% of physicians placed the threshold for FAS at one to three drinks per day while 38% placed the threshold at one or fewer drinks per day.17 Both opinions directly contradict the Surgeon General's advice that women not consume any alcoholic beverages during pregnancy because of the risk of birth defects."

[CPSI Booze News Fact Sheet: Fetal Alcohol Syndrome]

Vanderbilt University School of Medicine:

"Laboratory studies suggest that a single drinking binge by a pregnant woman can damage for life the brain of her unborn child."

"Drinking in late pregnancy is really unsafe for the brain... One glass of wine at dinner is unlikely to cause the damage, but we cannot say that any added intake would be safe... The most prudent policy would be to have no alcohol during pregnancy."

[Science News, Vol. 158, No. 2, July 8, 2000, p. 28]

American Academy of Pediatrics (1993):

"Fetal alcohol syndrome is one of the most common identifiable causes of mental retardation, with a worldwide incidence estimated to be 1.9 per 1000 livebirths. However, when children with less severe manifestations of the syndrome (FAE) are included, the estimated incidence may be as great as 1 in 300 livebirths. Evidence indicates, however, that physicians may not consistently inquire about alcohol use during pregnancy or recognize the full spectrum of the effects of prenatal exposure."

"There is no established 'safe dose' of alcohol for pregnant women."

"The consumption of at least one to two drinks a day was associated with a substantially increased risk of giving birth to a growth-retarded baby."

"While there is remaining controversy about the association between maternal consumption of smaller amounts of alcohol and possible damage to the fetus, current data do not support the concept that any amount of alcohol is safe for all pregnant women."

"Since there is no known safe amount of alcohol consumption during pregnancy, the Academy recommends abstinence from alcohol for women who are pregnant or who are planning a pregnancy."

[Schydlower M et al, Committee on Substance Abuse and Committee on Children With Disabilities, Fetal Alcohol Syndrome and Fetal Alcohol Effects. Pediatrics, Vol 91, No.5 May 1993, pp.1004-1006]

American Academy of Pediatrics (1998):

"FAS is the leading cause of mental retardation in newborns."

"There is no safe level of alcohol consumption during pregnancy."

"Even one drink risks the health of an unborn baby."

"Pregnant? Don't Drink. Period."

[American Academy of Pediatrics, Fetal Alcohol Syndrome: 10 Things You Need to Know

American Academy of Pediatrics (2000):

"Because there is no known safe amount of alcohol consumption during pregnancy, the Academy recommends abstinence from alcohol for women who are pregnant or who are planning a pregnancy."

"The Academy supports federal legislation that would require the inclusion of health and safety messages in all print and broadcast alcohol advertisements based on the US Surgeon General's warning: 'Drinking during pregnancy may cause mental retardation and other birth defects. Avoid alcohol during pregnancy.'"

[Pediatrics, Volume 106, Number 02, August 2000, pp 358-361]

List compiled by Teresa Kellerman
FAS Community Resource Center
Last Update: August 12, 2003

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