Baby, Can I have a drink?

Doctors and their female patients of child-bearing age need to start talking about alcohol consumption

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Until now, a doctor wouldn’t usually ask a woman having a routine pap smear how many drinks she enjoyed that week. But new national guidelines recommend that alcohol consumption become a regular topic of conversation between female patients of child-bearing age and their physicians. “We’re not here to moralize or be pejorative,” says Dr. Vyta Senikas, associate executive vice-president of the Society of Obstetricians and Gynaecologists of Canada, and a co-author of the report. “This is a question of awareness and harm reduction.”

The guidelines, published in the August edition of the Journal of Obstetrics and Gynaecology of Canada, recommend that doctors ask women who are or could become pregnant about their drinking habits, and record that information in their charts. Previous guidelines focused on diagnosing cases of fetal alcohol spectrum disorder, which affects as many as three in every 1,000 births, and results in neurological and behavioural problems.

Given that half of pregnancies are unintended, and that most Canadian women imbibe, comfortable dialogue is critical, say experts. Unfortunately, many physicians admit that they don’t broach the subject for fear of shaming their patients. That’s why the guidelines offer doctors suggestions on how to ask about alcohol consumption in a “supportive” and “motivational” way.

The guidelines also aim to alleviate the anxiety women experience after learning they’re pregnant—and realize they’ve had a few drinks. “We’re fairly comfortable saying there’s no need to terminate, and chances are there hasn’t been an effect,” explains Senikas. In fact, the guidelines take into account that some studies show “low level” alcohol consumption doesn’t have a negative impact. The trouble is defining how much is too much. “The most prudent choice,” says Senikas, “is to abstain.”




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Baby, Can I have a drink?

  1. Sorry, but this is a load of bunk. I totally support the notion that abstaining from drinking while trying to conceive or during pregnancy is wise, but the facts don't support the level of concern I keep seeing about this issue.

    "…A large study examined 400,000 women in the U.S., all of whom had consumed alcohol during pregnancy. Not a single case of fetal alcohol syndrome occurred and no adverse effects on children were found when consumption was under 8.5 drinks per week…"

    "…An analysis of seven major medical research studies involving over 130,000 pregnancies suggests that consuming two to 14 drinks per week does not increase the risk of giving birth to a child with either malformations or fetal alcohol syndrome…."

    "…There is even little evidence that occasional binge drinking during pregnancy seriously harms the fetus, according to an analysis of medical research published during the 35 year period between 1970 and 2005 involving over 3,500 articles. Binge drinking was defined as consuming five or more alcoholic drinks per occasion…."
    http://www2.potsdam.edu/hansondj/FetalAlcoholSynd

    • Thank you for these quotations supporting one side of this discussion and including a link for the third quotation. In order to see whether these studies truly support this please include references for all your quotations that hopefully come from peer-riewed publications. Unsubstanciated or possibility evaluation of these statements undermines your thoughts and arguments. I would like to look at the studies you cite. Thank you

      • A reasonable request, but if you scroll down under the link provided you'll note all the quotes come from different parts of the same article. Each has a footnote that points to the relavent study from which the quotes are derived.

        Keep in mind too that I'm not advocating irresponsible behaviour. Personally I think it best to abstain during pregnancy and even during the first six months of breastfeeding.

        That said, I think it's important that we don't stress women out over this and that we don't demonize moderate drinkers when in actuality there are no facts to support the harm concern for those moderate drinkers.

    • Phil
      If this is the case then why am I raising 4 grandchildren all with fetal alcahol syndrom, when their mother had a few while pregnant?
      Why are there more and more cases of FASD in this world instead of less? The only safe way is no alcahol when trying to have children.
      These studies did not follow threw long enough, most cases of mild FAS only really manifest after the child is 6 years of age and most are labeled ADHD or very active or learning disabled . Most are misdiagnosed and a large amount of them are labeled BAD kids.
      Wake up ….. our kids arent bad they are ill and we all need to practise safe drinking.

      • I adopted three FASD kids. If they are so normal, why can't I get a babysitter so I can go to work? Daily calls from schools, friends laugh at them and call them names (and they still have feelings!), police involvement, inappropriate behaviour, learning disabilities…the list goes on. The people doing these studies don't walk the walk!!! I dare them!!!!

      • you are exactly right, this is what my nutrition professor said too. Women shouldn't be taking ANY risk with alcohol when pregnant. Abstinence is the best way to protect your kids. I mean…people are risking their children's entire lives with their stupid behavior. Safety first

    • But it's still better not to take the risk right? I mean the life of your own child is at stake
      they can drink all they want afterwards anyway

  2. "…There is even evidence that light drinking during pregnancy may be beneficial to children. A study of 12,495 three-year-old children found that those born to mothers who drank light amounts of alcohol (beer, wine or spirits) during pregnancy had fewer conduct, emotional and peer problems than did those born to abstaining mothers or those who drank heavily while pregnant.

    The research used a nationally representative sample of infants born in the United Kingdom and utilized the U.K. Millennium Cohort Study, a project following the health of children born between 2000 and 2002 in England, Northern Ireland, Scotland and Wales.

    Boys born to light drinkers had 40% fewer conduct problems, were 30% less likely to suffer hyperactivity, and received higher scores on tests of vocabulary and of ability to identify colors, shapes, letters and numbers than did those born to abstainers.

    Girls born to light drinkers were 30 percent less likely to have emotional symptoms and peer problems compared with those born to abstainers during pregnancy…"
    http://www2.potsdam.edu/hansondj/FetalAlcoholSynd

    • These stats are interesting, but they only show positive correlations, not any causation.

      • Oh very true, but I think it underlines the degree to which our actual knowledge and the social rhetoric of the medical establishment have parted ways.

        Scaring people with an opinion dressed up as fact isn't cool. In fact it's manipulation of the highest order and will eventually backfire horribly.

        • Next straw man that needs to come down is the saturated fat myth. I spent 25 years drinking skim milk because I though milk fat was bad for me. Turns out that was WAY overstated. Eggs and beef were also demonized with almost no research to back it up. I'm back to 2% and enjoying my milk again (I drink at least 2 litres a day). My cholesteral is fine.

          • Agreed. Whether one puts fat on around the organs or other dangerous places is actually more related to the amount of insulin the body produces in response to eating.

            So if your meals are carb balanced and high in fibre you're very unlikely to put on fat in these areas, and your cholesterol is not highly impacted either.

            Personally I think we should all be more concerned with the salt in our diets than anything else.

  3. Having read the article Phil is alluding to and having done some further research…the real message here is "don't freak out if you find out your pregnant and you've had a drink or two". However, the experts don't really know how much is okay so why drink at all…do your baby a favour and don't imbibe. Alcohol hardly adds nutrients or anything else valuable to the mother's diet.

  4. Yes well I should clarify that from my perspective, if you can't go nine months without a drink, perhaps you have a problem you should look into. Then again, based on the actual facts, I can see why europeans don't concern themselves overly much.

    Ultimately my beef is using this possibility as a tactic to scare people into healthy life choices with bogus information.

    In my opinion, if you abuse the public trust by exagerating the case for or against something, you diminish the impact of your words in the future.

    The last thing we need is to undermine the credibility of our medical associations, but that's what this does in my opinion.

  5. As a researcher into prenatal alcohol use, I am only too aware of the shortcomings of these studies despite what should have been rigorous peer reviews. You will find the harm to babies was assessed without the use of cross disciplinary diagnostic tools. Most used inadequate analyses such as the tick box lists. Moreover, many children do not display any of the fetal alcohol spectrum disorders (FASD) until attaining puberty. Therefore it is most important to read the complete publication and question what are clearly misdiagnoses.

  6. In the U.S., the Surgeon General has warned there in no KNOWN safe amount. We just don't know what a safe amount is. Why chance it? I do agree that if a woman drank a few drinks before she knew she was pregnant, it shouldn't be freak out time; however, after she finds out she's pregnant, it really would be best to abstain and not take changes.

  7. As a parent of 4 children affected by exposure to alcohol I find these comments quite alarming. All 4 of my kids were affected in different ways, developmental delays, sensory disorders and tics and severe regulation issues that cause a ton of problems for school, community and his success. Infants are affected differently, some very mildly and some very profoundly, you have no idea which child will be affected and how the damage will present. I have been a foster parent for many years and have seen how alcohol exposure in utero can cause damage to a persons brain, many kids diagnosed with ADHD, conduct disorder, bipolar disorder and learning disabilities were children born of mothers who consumed alcohol. Studies show that many of our prison populations were alcohol exposed in utero, many of the kids in group homes and people with mental health disorders were also exposed. The canadian bar association recognizes this is a problem for many people convicted of crimes. We cannot simply ignore this issue. There are too many people out there who are struggling with the effects of alcohol exposure. I struggle daily to acquire the supports and understanding needed to help my children be successful.

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