“Did that night out hurt my baby?” A common question among women who fall pregnant unexpectedly is whether drinking that happened shortly beforehand could have caused foetal alcohol syndrome. Put simply, “Has a heavy night of drinking harmed the baby I now know I’m expecting?” The answer is usually “It’s unlikely if it was just one night, but because there is no established safe level of alcohol consumption in pregnancy, we recommend you stop drinking until after you give birth and limit it while breastfeeding.” Prenatal alcohol syndrome is an incorrectly used term for foetal alcohol syndrome (FAS), which is one of a range of foetal alcohol spectrum disorders caused by maternal drinking. We do not wish this article to sound sexist. However, the unique relationship between a mother’s body and a baby that grows within it makes the impact of her lifestyle and behaviours profound, and her alcohol consumption is directly responsible for foetal alcohol syndrome and any other foetal alcohol spectrum disorder. This is neither gender’s fault; it’s just how human biology works.

FAS has a variety of symptoms that can affect a child physically, cognitively, behaviourally, and emotionally. The extent to which they do this is unpredictable but is known to depend on the amount and regularity of alcohol consumption in pregnancy. FAS is typically diagnosed by physical characteristics, including:

A smooth philtrum
Short stature
Small head
Small eye opening
Low nasal bridge
Thin upper lip
Flat midface

The term foetal alcohol spectrum disorders (FASDs) refers to a wide variety of health, developmental, and behavioural problems a baby can experience when exposed to alcohol in the womb. These problems can appear at any point in childhood and last a lifetime. Examples of potential foetal alcohol spectrum disorders include:

ADHD
Vision and hearing problems
Intellectual disabilities
Sleep problems
Sucking problems in babies
Growth delays
Speech and language delays
Bone, cardiac, and renal problems
Slow cognitive processing
Memory problems

It is important to note that, with the exception of FAS, these issues can be caused by other things, and without a documented history of alcohol use in pregnancy, a FASD cannot be confirmed. Again, there is no safe established level of alcohol in pregnancy, and it’s completely unethical to perform tests in this area, so we cannot specify what range of consumption risks which problems. It is safe to assume that the higher the consumption, the more severe and far-ranging the problems.

Are there cures for foetal alcohol spectrum disorders?

There is no cure for foetal alcohol syndrome or the other foetal alcohol spectrum disorders, though multidisciplinary support involving medication, physiotherapy, glasses, hearing aids, special education, occupational therapy, and other assistance can help with management.

How do we know that all of these problems are attributable to alcohol exposure?

Observational research is informative. It’s true that completely accurate data on this topic is challenging because we don’t know that all alcohol consumption in pregnancy is reported or identified. Social stigma, mental health problems, education, and a variety of other factors can create communication issues between parents and their healthcare providers. Much of the research we have is based on animal studies, which can be problematic. However, there is consensus among both international governments and healthcare authorities that there is strong enough evidence of alcohol’s disastrous effects of growing young to merit public health warnings for humans. The most important thing to take from the evidence available is that because we don’t know of any safe level of alcohol in pregnancy, it’s best to abstain completely.

For more advice on taking care of yourself in pregnancy, labour, and birth, check out Unii’s Antenatal Course, with prenatal video episodes taught by senior NHS midwives, an award-winning obstetrician and gynaecologist, and six other leading healthcare experts. Coming soon to unii.com.

Antenatal Class Questions: What is prenatal alcohol syndrome (foetal alcohol syndrome)?

There is no safe level of alcohol consumption in pregnancy.