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Alcohol use during pregnancy and breastfeeding

Consuming alcohol during pregnancy can harm your developing fetus and alcohol consumption when breastfeeding can harm your baby. The minimum amount of alcohol intake which can harm the fetus is not known, so for women who are planning a pregnancy; pregnant; or breastfeeding, avoiding alcohol consumption is the safest option.

Alcohol rapidly enters the blood stream and its effects on many organs and body systems are felt within minutes after consumption. Females are more susceptible to its effects due to their smaller body mass and higher proportion of body fat.

It is well documented that misuse of alcohol can lead to many health and social problems including vomiting and dehydration; anxiety and depression; injury (or death) from accidents, falls, attacks; relationship problems; gastrointestinal and liver disease; financial and other social problems; cardiac disease; and memory loss.

Alcohol during pregnancy

Women who consume alcohol during pregnancy may have poor appetites and nutritional intake. These and other health and lifestyle issues can adversely affect a woman’s health and pregnancy.

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Alcohol readily crosses the placenta. It can cause birth abnormalities, is toxic to the fetus and can damage the developing brain. Exposure of the fetus to alcohol may result in many kinds of harmful effects, which are known as fetal alcohol spectrum disorder (FASD). In addition, high-level and/or frequent intake of alcohol during pregnancy increases the risk of miscarriage, stillbirth and premature birth, and may reduce the growth rate of the developing fetus. Babies may not grow normally or may be born early and can continue to be affected during childhood—with children having learning difficulties and behavioural and socialisation problems.

The level of risk from alcohol use to the developing fetus or a breastfeeding baby is highest when there is high, frequent maternal alcohol intake and likely to be low if a woman has consumed only small amounts of alcohol (such as one or two drinks per week) before she knew she was pregnant or during pregnancy. Low levels of maternal alcohol consumption are more likely to be related to neurodevelopmental abnormalities rather than prematurity, miscarriage, stillbirth or reduced birth weight. Because everyone is different, the risk varies considerably from one person to another.

All of these effects can be prevented by avoiding alcohol during pregnancy.

Antenatal care

Regular antenatal care is important to ensure you are healthy, and that your baby is developing and growing well. If your baby appears to be small, a growth ultrasound and monitoring may be organised by your doctor or midwife. Ask for help if you have anxiety or mood disorders, and a social worker can provide practical assistance for social matters as required.

After the birth of your baby

If you have continued to drink alcohol during your pregnancy, your baby may need to stay in hospital longer than usual to ensure they are settled, feeding well and gaining weight. Some babies exposed to heavy alcohol use throughout pregnancy may experience alcohol withdrawal symptoms and require supportive care and treatment.

If your doctor or midwife has concerns regarding your baby’s health, they will refer your baby to a paediatrician (baby doctor). Child health nurses are available in the community to talk to you about any concerns you may have regarding your baby’s growth and development.

Do not put your baby to sleep in your bed, particularly if you have been drinking alcohol. The risk of sudden infant death syndrome (SIDS) or a sleeping accident is increased under these, and other unsafe baby sleeping conditions.

If you plan to drink alcohol or have been drinking, always ensure there is a trusted adult who is not affected by alcohol or drugs available to care for your baby.

Alcohol use during breastfeeding

Evidence indicates that alcohol consumption during breastfeeding may adversely affect lactation, infant behaviour (e.g. feeding) and psychomotor development of your baby. Australian and international guidelines recommend breastfeeding your baby for the first six months of their life so it is advisable to avoid alcohol in the first month after delivery until breastfeeding is well established. Not drinking alcohol is the safest option.

After breastfeeding is established alcohol intake should be limited to less than two standard drinks in any one day and alcohol consumption should be avoided immediately before breastfeeding. Women who wish to drink alcohol could consider expressing milk in advance.

Stopping alcohol use

If you drink alcohol every day you may be at risk of having withdrawal symptoms when you try to stop. Your midwife or doctor can refer you to a specialist service for assessment for alcohol detoxification. We recommend an inpatient, medicated withdrawal treatment to reduce potential problems for you and your unborn baby.

If you are not at risk of withdrawing from alcohol, but are finding it hard to stop drinking, speak with your midwife or doctor who can refer you to a specialist service. You may also find the following suggestions helpful as you work towards abstinence. Stop or start reducing your alcohol intake immediately and keep a diary of when you drink alcohol. This may help you to see where you can avoid drinking situations. Substitute alcohol with non-alcoholic beverages, including water and avoid people and places linked with your alcohol consumption. Use other (positive) ways to cope with everyday stress and learn relaxation techniques. Delay that first drink, and use a phrase such as “I will think about it later”. Distract yourself with other, pleasurable activities and be assertive—say “no” if you don’t want to drink. We recommend abstaining but if you must drink an alcohol beverage, choose one that has low alcohol content. Sip it slowly over one or more hours and try hard not to have a second drink.

Preventing relapse

Congratulations on your efforts if you have stopped your alcohol intake. While this is a great achievement, you may still find it hard to say no to alcohol and you may be struggling to stay sober. Friends or family may offer you alcohol or you may be craving a drink. If you are at risk of relapsing, ask your doctor for a referral to an alcohol and drug counsellor. Counselling may help you to explore personal issues and make positive changes, learn new ways to manage stress, develop strategies to reduce or stop drinking, or obtain a referral to support services.

Further support and information

Mater Mothers’ Hospital Drug and Alcohol Service 07 3163 2417 or email champ@mater.org.au

Alcohol and drug information service (ADIS) 07 3837 5989 or free call 1800 177833

Mater acknowledges consumer consultation in the development of this patient information.
Mater Doc Num: PI-CLN-430029
Last modified 08/8/2017.
Consumers were consulted in the development of this patient information.
Last consumer engagement date: 18/1/2014
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