Alcohol and drug use in pregnancy: Keeping you and your baby safe

Many women and birthing people naturally lose interest in alcohol early in pregnancy, but for others, giving up drinking can be more challenging.

There is no known safe level, no safe amount and no safe type of alcohol during pregnancy. The UK Chief Medical Officers (CMO) advise that the safest approach is to avoid alcohol completely if you are pregnant or trying for a baby. Drinking alcohol at any stage of pregnancy can increase the risk of miscarriage, premature birth, and fetal alcohol spectrum disorder (FASD), which can cause lifelong learning and developmental difficulties for your child.

If you are finding it difficult to stop drinking, support is available. Speak to your midwife, GP, or local support services Barnsley Recovery Steps for confidential advice and help.

For more information on alcohol and pregnancy, visit the National Organisation for FASD.

Using illegal or street drugs during pregnancy, including cannabis, ecstasy, cocaine and heroin, could have a serious effect on your unborn baby.

If you regularly use drugs, it's important to tackle this now you're pregnant.

Illegal drugs in pregnancy

How does alcohol affect my baby in pregnancy?

• Anything you drink, including alcohol, passes to your baby through the placenta.
• It stays in the fluid that surrounds your baby (amniotic fluid) for a while. After you stop drinking your baby can still get affected.
• Your baby is too small to be able to process any alcohol.
• It can affect the way your baby’s brain and body develop and this can cause disabilities. The disorder name for this is “Fetal Alcohol Spectrum Disorder” (FASD).
• Alcohol has the most impact on neuro-behavioural problems to your unborn baby. This could include behaviour problems and anxiety.
• All babies with FASD will have damage to their brain and the rest of their central nervous system.
• Your baby develops gradually over 9 months. Alcohol can cause physical conditions such as heart problems or bone deformities.
• There are over 400 conditions linked to FASD.

What is Fetal Alcohol Spectrum Disorder?

It is a disorder that is caused through your baby being exposed to alcohol.

• Each person with FASD is affected differently.
• It affects behaviour, the brain and the body.
• It is a lifelong condition.
• Early diagnosis and support are key to helping live with the disorder.

What will my midwife ask me about alcohol in pregnancy and why?

• Your midwife (or doctor) will explain the risks of any alcohol in pregnancy to help you make healthy decisions.
• They will ask how much alcohol you drink and offer support if you feel you need it.
• This is then recorded in your pregnancy notes/ record.
• This is asked in line with national guidance.

I’ve had some alcohol in pregnancy (or before I knew I was pregnant) and worried what to do

• Avoid drinking further alcohol.
• The risk of harm to your baby is likely to be low if you have drunk only small amounts of alcohol before you knew you were pregnant.
• If you are drinking heavily, stopping suddenly or significantly reducing how much you drink suddenly it can be unsafe. If you suffer symptoms such as shaking, sweating or feeling sick and anxious before the first drink of the day, then you should seek medical advice before stopping drinking completely. Please speak to your midwife or GP, or contact your local specialist service to discuss going alcohol free safely (see the back page for further details).

The Facts:

• Alcohol can pass into your breastmilk and then into your baby when you feed them.
• The amount of alcohol in your breastmilk is the same amount that is in your blood.
• Alcohol in breastmilk peaks 30 to 60 minutes after you have had the drink, and 60 to 90 minutes if you have eaten.
• When alcohol is gone from your blood it is also gone from your milk.
• It takes 2 to 3 hours to eliminate 1 unit of alcohol from your blood and milk.
• The amount of time it takes to eliminate the alcohol increases as the amount of alcohol drank increases.
• Co-sleeping with your baby is very dangerous if you or anyone in the bed has had any alcohol. 

What this means:

• You should not drink heavily or regularly without considering how you can limit your baby’s exposure to the alcohol (remember your health is important too).
• An occasional drink is unlikely to harm your baby, especially if you wait 2 hours after having a drink before feeding.
• As alcohol is not “trapped” in breastmilk there is no need to pump and throw away breastmilk.
• However you choose to feed your baby, if you drink any alcohol do not bed share with your baby or fall asleep with your baby on the sofa or chair.
• Breastfeeding does not stop you from getting pregnant. If you are not using anything to stop pregnancy or want to have a baby, it’s safest not to drink alcohol.

If you are worried about your child/baby, please contact your GP, Health Visitor or Midwife.

Does every baby get FASD if the Mum has alcohol in pregnancy?

It is not possible to tell which babies will be affected. This is why the advice is to not drink any alcohol so that there is no risk. There is no safe time, type, or amount of alcohol that you can drink when your pregnant. If you have been drinking alcohol, the most important thing to do is stop.

How can I tell if my baby/child has FASD?

In most cases it is difficult to tell at birth if your baby has FASD. Sometimes there are some facial features that indicate FASD.

Some behaviour problems can happen in childhood:

• FASD can sometimes be mis-diagnosed as ADHD.
• Some children affected will have slower than usual development.
• The following can be some things that your child may struggle with:
  • Emotions
  • Learning
  • Social relationships
  • Concentration
  • Memory
  • Being impulsive
  • Hyperactivity