Monday 20 November 2017

Dear Dr Nina: I'm pregnant and fear I may have harmed the baby by drinking

Babies born with FAS may be born prematurely.
Babies born with FAS may be born prematurely.
It is unclear whether there is any safe level of alcohol in pregnancy

Nina Byrnes

Our resident GP Nina Byrnes answers your medical questions.

Q. I am 11-weeks pregnant and I am absolutely terrified that I may have caused irreparable damage to my baby. I am happy to be expecting, but it wasn't a planned baby. The thing is, I didn't find out I was pregnant until I was eight weeks pregnant and in the six weeks between conception and finding out, I had four very boozy weekends. I am talking at least a bottle of wine and about three or four cocktails each time. I would also have had a glass or two of wine three of the other nights in each of the six weeks.

There has been a lot in the media recently about foetal alcohol syndrome and I am terrified that I will have a baby with learning difficulties as a result. I am so worried that I'm not sure if I can continue with the pregnancy. Can you help?

A. Congratulations on your pregnancy. This is a very precious time. Up to one in two pregnancies are unplanned so you are not alone. It is great that you are looking forward to motherhood and your focus should be on your physical and mental health moving forwards.

You still have another 29 weeks to go and leading a healthy lifestyle in that time will reap huge benefits for you and your baby.

I can fully understand why you are concerned about drinking alcohol in the first eight weeks. There is no known safe limit of drinking in pregnancy and the official advice is to avoid alcohol during this time. The reasoning behind this is that we know that any alcohol does cross the placenta. A baby's exposure to alcohol can lead to foetal alcohol syndrome (FAS).

Babies born with FAS may be born prematurely. They may not grow as well as they should and can be underweight. In childhood they may be slower to have language skills and may have learning difficulties and difficulties with attention and memory. They may be more prone to hyperactivity. Those with FAS can have physical signs including a thin upper lip, small eyes or a flattened groove between upper lip and nose. FAS is most likely in those who have been drinking heavily in pregnancy.

It is unclear whether there is any safe level of alcohol in pregnancy. There have been conflicting studies. A Danish study done in 2012 suggested small amounts of alcohol didn't cause any damage. More recently a Finnish study contradicted this stating alcohol in the first few weeks could have an adverse effect. This study was however done on mice so any predictions in humans are estimated.

It wouldn't be ethical to undertake a randomized controlled study looking at alcohol use in pregnant mothers so any evidence we do have will always be observational in nature meaning there may be other factors, beyond the studies control, affecting results.

There is no point beating yourself up for what you did before you knew you were pregnant. Do talk to your obstetrician about your concerns but if you are an otherwise healthy person and you don't drink heavily on a regular basis it is very unlikely that those nights out did major harm. The important thing now is to focus on your wellbeing for the rest of your pregnancy.

Avoid alcohol moving forwards. Eat well including lots of healthy unprocessed foods that are rich in iron, folate, vitamin C and minerals. Ensure five portions of dairy a day and plenty of vitamin D to absorb it. Keep healthy snacks such as nuts to hand. Keep caffeine to a minimum and drink plenty water.

Get plenty of exercise. Being physically fit will help you through pregnancy labour and beyond. Don't smoke and don't let others smoke around you. This will harm your baby. Most importantly mind your mental health. Pregnancy and motherhood brings great joy but can also be a time of stress and anxiety. Don't let things get on top of you. If you feel overwhelmed talk to someone you trust. Be reassured, it is most likely you will welcome a healthy bouncing baby into the world.

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