AAP Says No Amount of Alcohol Should be Considered Safe

[babyzebra]

I just heard about this report that was published by the AAP today. I don't have strong opinions about this either way since I don't drink alcohol anyway due to migraines, but I thought I would share for anyone who is interested. 




AAP Says No Amount of Alcohol Should be Considered Safe During Pregnancy 



A new clinical report from the American Academy of Pediatrics (AAP) identifies prenatal exposure to alcohol as the leading preventable cause of birth defects and intellectual and neurodevelopmental disabilities in children. The report, "Fetal Alcohol Spectrum Disorders," in the November 2015 issue of Pediatrics (published online Oct. 19) stresses that no amount of alcohol should be considered safe to drink during any trimester of pregnancy.

Fetal alcohol spectrum disorders (FASDs) is an all-encompassing term for the range of effects that can occur in someone whose mother drank alcohol during pregnancy. Neurocognitive and behavioral problems from prenatal alcohol exposure are lifelong, but early recognition, diagnosis and therapy for any FASD condition can improve a child's health.

Unfortunately, a lack of uniformly accepted diagnostic criteria for fetal alcohol-related disorders has critically limited efforts that could lessen the impact of FASDs, says Janet F. Williams, MD, FAAP, one of the report's lead authors.

"Even though fetal alcohol spectrum disorders are the most commonly identifiable causes of developmental delays and intellectual disabilities, they remain significantly under-recognized," said Dr. Williams.

Prenatal alcohol exposure is a frequent cause of structural or functional effects on the brain, heart, bones and spine, kidneys, vision and hearing. It's associated with a higher incidence of attention-deficit/hyperactivity disorder and specific learning disabilities such as difficulties with mathematics and language, visual-spatial functioning, impaired impulse control, information processing, memory skills, problem solving, abstract reasoning and auditory comprehension.

In surveys, about half of all childbearing age women in the United States report consuming alcohol within the past month, and nearly 8 percent of women said they continued to consume alcohol during pregnancy. A recent study found increased risk of infant growth retardation even when a pregnant woman's consumption was limited to 1 alcoholic drink per day (a 1.5-ounce shot of distilled spirits, 5 ounces of wine, or 12 ounces of beer).

First-trimester drinking, compared to no drinking, results in 12 times the odds of giving birth to a child with FASDs. First- and second-trimester drinking increased FASDs odds 61 times, and women who drink during all trimesters increased the likelihood of FASD odds by a factor of 65.

"The research suggests that the smartest choice for women who are pregnant is to just abstain from alcohol completely," said Dr. Williams.

The AAP offers several resources for on prenatal alcohol exposure, including an FASD Toolkit for physicians (http://www.aap.org/fasd) and a set of frequently asked questions for parents on Fetal Alcohol Syndrome Disorders (https://www.healthychildren.org/English/health-issues/conditions/chronic/Pages/Fetal-Alcohol-Spectrum-Disorders-FAQs-of-Parents-and-Families.aspx),
- See more at: www.aap.org/en-us/about-the-aap/aap-press-room/pages/AAP-Says-No-Amount-of-Alcohol-Should-be-Considered-Safe-During-Pregnancy.aspx#sthash.ScgcHKd1.dpuf

[frecklesnbrains]

Yep. Thanks for posting this! I think pregnant women get bombarded with so many things on the "no" list that we often don't get the details and/or data behind it. The recommendation against alcohol bears the most weight by far. No booze for me

[jaykemp]

My midwife suggested a half a glass of red wine at my last appointment with her so I could relax and allow my body to do its thing. I had been in prodromal labor for 7 weeks and needed relief. I didn't get a chance because I went into the labor 3 hours after I got home from my appointment.

[babyzebra]

jaykemp my OB recommended something similar for me too in my third trimester (although for a different reason). I know anecdotally some OBs advise women that it is fine to drink a small amount of alcohol after the first trimester (and it may be), although I am not familiar with the official stance of the ACOG. The report I heard this evening though seemed to suggest that this recommendation from the AAP differs from what OBs recommend.

[Andrea]

I have seen way too many babies with FASDs in my line of work to risk it.

[jaykemp]

Oct 19, 2015 18:49:05 GMT -5 babyzebra said:

jaykemp my OB recommended something similar for me too in my third trimester (although for a different reason). I know anecdotally some OBs advise women that it is fine to drink a small amount of alcohol after the first trimester (and it may be), although I am not familiar with the official stance of the ACOG. The report I heard this evening though seemed to suggest that this recommendation from the AAP differs from what OBs recommend.

I have a theory that none of these organizations talk to each other when they make recommendations. Either way, it's totally not a behavior I'd engage in until the very end and even then no more than a half a glass once in a blue moon. Mmmmm blue moon.

[Flair Underwood]

I think drinking alcohol is just a very selfish thing for pregnant women to do. I can turn off my judgement on 99% of issues - but this isn't one of them. I know some women don't feel that way, but, honestly, it's just alcohol. I'd rather abstain completely and would rather be safe then sorry.

[kittenslove]

I don't really care what others do. I mean, I don't want someone to get drunk every night, its not healthy, but if someone wants to have a glass every so often - for a toast, or to calm labor as suggested - I really don't care, its none of my business. I have a hard time with this report because it seems a little fear mongering - FASD is serious, but in Europe where women aren't shamed about drinking, they have a lower birth defect rate (or, at least according to some research I did during my first pregnancy.)

Seriously though, I have an aversion to alcohol right now. I'm so thirsty all the time, the idea of doing something to make me more sleepy and more thirsty is as about as appealing as putting a needle in my eye. Last pregnancy the smell on wine gave me heart burn. Ugh. I dont think I wanted a drink until 6 months after baby was here.

[frecklesnbrains]

Well the problem with ANY prenatal exposure is that it's actually impossible to determine what a safe amount is. Once a substance is shown to be harmful it's not possible to design a study to determine what a "safe" quantity is. It may in fact be that having half a glass of wine in the third trimester has absolutely no negative effects. However, because the harmful effects of alcohol are so well-documented (and not just full-blown fetal alcohol syndrome) it makes complete sense to me why boards make blanket recommendations like this, because there is no way to determine where the slippery slope begins.

(By the way, Europe may have a lower overall rate of birth defects - but that's a complex picture because many things contribute to birth defects. Actually FASD is typically a neurological disorder without birth defects. It's also impossible to compare rates of FASD in different countries because the awareness and diagnosis of the disorder varies so greatly).