Is It Safe to Drink During Pregnancy?

Is It Safe to Drink During Pregnancy?

Conflicting information can be confusing for to-be moms.

Are you counting the days until you hear the pitter patter of little feet? Congratulations! The choices you make over the upcoming months—for example, whether to have an occasional glass of wine—can have a big effect on the long-term health of your baby.

As a physician and mom of two, Darria Long Gillespie, MD, senior vice president of Clinical Strategy at Sharecare, grappled with this choice herself. She chose not to drink any alcohol during her pregnancies. “I’ve looked at a lot of research and my take on it is that while there may be some safe amount of alcohol you could consume in pregnancy, the reality is, there is no one threshold that we can say is “safe.” Plus, it can vary from woman to woman, and even from pregnancy to pregnancy. The potential harms of alcohol in pregnancy are too great, and it’s not worth the risk. It’s better to abstain.”

Dr. Gillespie’s thinking is consistent with most health organizations’ recommendations. The US Centers for Disease Control and Prevention (CDC) says there is no known safe amount of alcohol during pregnancy or while trying to get pregnant. The American College of Obstetrics and Gynecology says it’s bests not to drink at all when pregnant and the American Academy of Pediatrics (AAP) says no amount of alcohol consumption is safe during any trimester of pregnancy.

What’s the harm?
When you drink alcohol, it crosses the umbilical cord to your developing baby. So, in effect, your baby drinks too. Alcohol can interfere in the development of the brain and other organs. It can also cause miscarriage, still-birth or life-long disabilities. According to the AAP, prenatal exposure to alcohol is the top preventable cause of birth defects and intellectual and neurological developmental disabilities in children.

Fetal alcohol spectrum disorders, or FASD, refers to the group of effects that may occur in women who drink during pregnancy, and can range from mild to severe. However, fetal alcohol syndrome (the most severe subset of FASD) may result from even small quantities of alcohol consumption.

A 2018 study in the Journal of the American Medical Association suggests FASD could affect between 3.1 and 9.9 percent of American children—up to ten times more common than previously thought. To reach their conclusions, researchers evaluated more than 6,600 first graders for FASD in four communities across the US; their mothers were interviewed, as well. The authors found that 222 of the children had FASD. What’s more, just two of them were diagnosed before the study, suggesting it's being vastly underreported.

Furthermore, alcohol does not contribute to your increased nutritional demands, Gillespie says. “When you’re pregnant, you still have to watch your calorie intake. You need lots of nutrition to feed a baby, and alcohol is just empty calories.”

You’re also more likely to fall when you’re pregnant, and drinking alcohol just increases that risk. “When you’re pregnant, your balance is ‘off’,” Gillespie says. “Your ligaments are more loose and flexible because your body is preparing to deliver a baby. You also have an additional 20 pounds strapped to your front, which all combines to make you much more likely to fall when you’re pregnant. You don’t want to put yourself in any situation where you may be slightly intoxicated and further increase your risk of falling.”

Despite the risks, the CDC says one in 10 pregnant women in the US reports drinking at least one alcoholic beverage in the past 30 days and about one-third of those who do consume alcohol, binge drink.

If you’re actively trying to get pregnant, you should also abstain from drinking, says Gillespie. “The first trimester is so crucial in your baby’s development. That’s the point at which ingesting alcohol is probably going to have the biggest consequences. However, many women don’t know they are pregnant until the middle of the first trimester.”

The CDC recommends that women who are sexually active and not using birth control also avoid alcohol for the same reason. About half of all pregnancies are unplanned, so if you became pregnant, you could unknowingly expose a developing fetus to the potential harms of alcohol.

What about when you’re nursing?
“If you want to have a glass of wine or two when you’re nursing, that’s fine,” says Gillespie. You have two choices: pump and dump your breast milk (alcohol goes straight into your milk) and feed your baby a bottle. Or, if your baby does not need to eat right away, wait several hours until your body has metabolized the alcohol and then nurse.

Bottom line
Gillespie acknowledges it can be hard to completely abstain when you’re pregnant. However, she says, “As a mom, you want what’s best for your child. The risks of drinking alcohol, even small amounts, just aren’t worth it.” She found that drinking mocktails during pregnancy was a good compromise. “A Shirley Temple is not the same as a glass of wine, of course, but you can indulge your inner seven-year-old while enjoying the festivities and not put your developing baby at risk.”

Medically reviewed in February 2018.

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