<p>For all its joy, pregnancy is hard work. The long-term prospects of family and new life are exhilarating, but the process itself doesn’t always feel so wonderful: fatigue, nausea, discomfort, and more are on the menu for the foreseeable future, and taken off are hazards like extra cups of coffee, smoking, and alcohol.</p> <p>Giving up alcohol for such a long period can be tough for some women. Birthdays, reunions, work gatherings, and whatnot are often filled with people imbibing the sauce, so it’s difficult to resist. You may ask yourself, “What harm could one little glass of wine do?”</p> <p>A fair question, and the truth is that we don’t know for sure. What we do know is that alcohol damages a developing fetus: all sorts of organs from the eyes through the heart and kidneys may be affected; worse still, the brain may be impacted, affecting the behavior and abilities of the child. The more alcohol involved, the greater the severity of the damage.</p> <p>Most research has focused on expectant mothers who consume moderate to heavy amounts of alcohol, which left an open question as to whether small amounts create an effect. Given the gravity of the consequences and the fact that there is a scale of severity depending on how much you drink, the bottom line from healthcare organizations all over the country was that there is no safe level of alcohol for pregnant women.</p> <p>That suspicion is being substantiated by more and more research exploring the effects of small amounts of alcohol on the developing fetus. We now have evidence that even small amounts may produce less severe but nonetheless real effects.</p> <p>That may be disappointing news to some who were hoping to have one for their anniversary, but understanding the science behind this issue may help you to appreciate why the sacrifice is worth it. </p> <h2>How does alcohol affect my unborn baby?</h2> <p>It’s common knowledge that whatever you consume while pregnant is bound to be shared with the soon-to-be human hanging around inside. Alcohol passes from your blood through the placenta to your baby, and unfortunately for them, the liver is one of the last organs to develop (it doesn’t fully mature until the final stages of pregnancy).</p> <p>Simply put, your baby is not able to process alcohol well, so exposure to it can be extremely damaging. Alcohol can destroy cells in various parts of the fetus, causing physical abnormalities. It messes with nerve cell development and functionality; impacts blood flow (and therefore the fetus’ oxygen and nutrient supply); and creates toxic byproducts that accumulate in the baby’s brain, causing damage.</p> <p>The CDC’s list of physical, behavioral, and intellectual disabilities that a child exposed to alcohol in the womb may develop include the following:</p> <ul> <li>Abnormal facial features (e.g., a smooth ridge between the nose and upper lip) </li> <li>Shorter height than average and low body weight</li> <li>Small head</li> <li>Hyperactivity, attention issues, and poor memory</li> <li>Low IQ and learning disabilities (commonly with math in school)</li> <li>Speech delays</li> <li>Vision/hearing issues</li> <li>Poor judgment and reasoning skills</li> </ul> <p>Outside of developmental harm that can be lifelong, it also raises the risk of miscarriage, premature births, and low birth weight.</p> <figure><img alt="" height="640" src="https://cdn.storymd.com/optimized/koXbEGIEq8/thumbnail.jpg" width="565" /> <figcaption>Male Baby with the FAS-syndrome. <em>Source: Teresa Kellerman</em></figcaption> </figure> <h2>Fetal alcohol spectrum disorder</h2> <p>Fetal alcohol spectrum disorder (FASD) encompasses a scale from the least to the greatest effects on the child, and fetal alcohol syndrome (FAS) is the most severe. FAS babies possess distinct facial features like small eyes, a thin upper lip, and flat skin between the nose and mouth. That rare glass of wine at a party is not likely to cause FAS; it’s more associated with expectant mothers who drink to at least a moderate degree.</p> <p>People with FAS may have problems with learning, memory, communication, attention, vision, and hearing. They may have all these issues or only some. School can be an extremely tough experience as they typically struggle to get along with others. All FASDs last a lifetime as there is no cure, but the silver lining is that, with early treatment, we can improve a child’s development.</p> <p>The CDC estimates that there is around 1 case of FAS per 1,000 live births in the US. The frequency of all FASDs could be as high as 1–5 out of every 100 children in the US and Western Europe. A 2022 report from the CDC states that around 1 in 7 pregnant people had reported that they are currently drinking, and 1 in 20 reported that they went binge drinking within the last 30 days.</p> <h2>New research illustrates the harms of even small levels of alcohol</h2> <p>In recent years, researchers have been finding that milder, more subtle damage can manifest from small amounts of alcohol consumed during pregnancy. </p> <p>In a 2015 study of 31,000 pregnancies by the American Academy of Pediatrics, researchers found a heightened risk of growth problems when mothers had one drink a day. Because some behavioral and learning issues don’t become apparent until years after birth, it’s quite likely that just small amounts of alcohol can have an impact.</p> <p>Going more in-depth, a 2020 systematic review of 23 papers confirmed that alcohol consumption during pregnancy leads to kids with inhibited cognitive functions, as well as an increased risk of lower birth weight.</p> <p>The team behind the paper claimed that theirs was the first time that an analysis compared results on the effect of alcohol during pregnancy from a number of different study designs. This helped to control for variables that may skew the results, thereby allowing researchers to better isolate the effect of alcohol alone. </p> <p>A separate piece of research looking into the kind of messaging that these mothers are receiving has raised concern over those who have skin in the game. The researchers of this 2019 study examined information on alcohol industry-funded sites and found routine omissions or misrepresentations of the evidence for the risks of drinking during pregnancy.</p> <figure><img alt="" height="494" src="https://cdn.storymd.com/optimized/kAvlrLUed1/thumbnail.png" width="640" /> <figcaption>Fetal Alcohol Spectrum Disorders (FASD). <em>Source: SAMHSA from Rockville</em></figcaption> </figure> <h2>Staying off alcohol</h2> <p>Alarming figures about the use and abuse of alcohol during pregnancy aside, most women do give up alcohol once they learn that they are pregnant or are planning to become so. </p> <p>If you just found out that you’re pregnant after already having drunk earlier on in the pregnancy, you should stop immediately. The likelihood of having inflicted damage is low, but it is something worth bringing up with your doctor if you are concerned.</p> <p>Nine months may feel like a long time, but it is not forever. The sacrifices you make now will pay lifelong dividends in the form of good health for your child. Having said that, not everyone finds giving up the drink so easy, and there are resources endorsed by the CDC to help you on your journey:</p> <ul> <li> <p><strong><a data-tabindex-counter="1" data-tabindex-value="none" href="https://findtreatment.samhsa.gov/" tabindex="-1" target="_blank">Substance Abuse and Mental Health Services Administration (SAMHSA) Treatment Locator.</a></strong><strong><strong> </strong></strong>This tool helps people to find drug and alcohol treatment programs local to their area.</p> </li> <li> <p><strong><a data-tabindex-counter="1" data-tabindex-value="none" href="https://www.niaaa.nih.gov/" tabindex="-1">National Institute on Alcohol Abuse and Alcoholism (NIAAA).</a> </strong>Their navigator tool will help you or a relative to find treatment for an alcohol dependency.</p> </li> <li> <p><strong><a data-tabindex-counter="1" data-tabindex-value="none" href="https://www.aa.org/" tabindex="-1">Alcoholics Anonymous (AA).</a> </strong>A support group organization dedicated to helping people to share their experiences and find the strength to overcome their alcoholism. Check out their website to find an AA program local to you.</p> </li> </ul> <h2>More on Alcohol and Pregnancy</h2><ul><li><a href="https://soulivity.storymd.com/journal/wlaxl7p0em-alcohol-use-during-pregnancy" target="_blank">Alcohol Use During Pregnancy</a></li><li><a href="https://soulivity.storymd.com/journal/vm9nx54tgw-fetal-alcohol-spectrum-disorders" target="_blank">Fetal Alcohol Spectrum Disorders (FASDs)</a></li><li><a href="https://soulivity.storymd.com/journal/5mre6o6tzw-women-and-alcohol" target="_blank">How Alcohol Abuse Affects Women</a></li></ul>