Fetal alcohol syndrome, risks?. And a general rant!

[Pinky333777]

I'm feeling guilty and having mixed feelings on consuming alcohol while pregnant.
Of course it's obviously best to avoid alcohol completely, but I think I've been ignoring or blocking out potential risks. Just so I can enjoy a glass of wine once a week.
How selfish of me.

I've just come off the phone with DP - who up until now has been okay with my occasional beverage - and he asked me if I were attending a friends party this weekend. Which I am. And he asked me if I will be drinking. I said I may have a glass, yes.
He's now of the opinion I should be completely avoiding alcohol.
I know deep down this is for the best and now feel guilty for having been drinking in the past.
I also selfishly feel sad this is another thing I can't do.
I'm being childish - I see that - I'm just feeling put out by all the 'can't dos and can't haves'
I tried to buy some clothes in a couple of shops recently. Neither had a maternity section. So I can't shop in normal shops.
I'm not allowed to ride my bike.
Or my scooter.
I can't do the escape rooms we hoped to do last weekend, or the Halloween celebrations at theme parks.
Can't enjoy my favourite cheese, or a cheeky cigarette.
I feel like a child always being told no and I want to strop about it 😃

Anyway, back on topic, sort of.
How much of a risk does a glass a week pose to an unborn baby?
Do you think I might have already caused damage??

I wish I had just quit completely and not been so niave and ignorant 😐
Anyone else struggling with this topic?

Pinky, totally get what you're saying. Also have moments when I get mega fed up of all things that you fancy but are off limits, which is normal. It doesn't mean that I'm not incredibly thankful for my healthy pregnancy (so far) or am any less equipped to deal with the challenges of motherhood brings!

I had a glass of champers to toast a best mates wedding but have otherwise been abstaining. A weekly glass is probably not going to cause any problems. I'm planning to allow myself a glass or two over the Xmas period and already bracing myself for judgement. My mother even abstained from wearing make up or any beauty products whilst pregnant, "just in case" and feels that I should do the same.

From what I can remember from a training session I had about FAS, a lot of the significant damage to the foetus is done in the first 12 week - a lot of women don't realise they are pregnant and carry on drinking several units, several times a week (or more) and don't realise the damage they have done until it is too late. Personally, I just didn't drink, it wasn't that much of a hardship for me and I just didn't feel like I needed it. If your drinking is bothering you, or your DP, then you should read up actual facts about it to reassure yourself and to show your DP to justify your decision/reassure him.

WRT life changing after you have a baby, umm yes of course it changes your life, how could it not? You won't be able to go away for city breaks at the weekend or have a lie in, your days out to theme parks will be very different as you'll have to factor in nappy changes and feeding and then after the first 6-12 months the baby won't want to go to those places and be stuck in a buggy all day because it will get bored, you will find yourself in parks and soft play centres and family restaurants with early bird menus rather than coffee shops, trendy bars and naice restaurants.

I find it bizarre when people refer to themselves as "big kids" as an excuse for being irresponsible or shunning responsibility rather than accepting it and adjusting their lives accordingly. I presume it's supposed to sound endearing and likeable but it just comes off as immature and selfish to me.

Who referred to themself as a big kid?

Oh Christ, it's 9 months. 9 bloody months! You're worried you might be doing damage so just stop. No stress for you (because the issue is obviously bothering you enough to MN about it), no stress for DH and a safe baby. It's really not that complicated.

I think we are all capable of deciding how best to grow our babies and what is a risk and what is not. Alcohol, soft cheese, cured meat, pate, bike riding, horse riding, running etc. All PERSONAL CHOICE. Not dangerous enough to be illegal. Not considered dangerous at all by many doctors and many countries. So it's personal choice.

I massively resented giving up all the fun things while pregnant. And the normal things like watching tv (flickering made me vomit) or going to church (incense made me vomit). Minimising very small risks for a hypothetical baby was hard.

By contrast i don't resent at all the things I have given up for my two wonderful actually existing children (sleep, alone time, partly my career) who I love deeply. Just because you find pregnancy restrictive doesn't mean you'll hate being a mother.

@PregnantBridesmaid the OP did in her first update...

I don't understand all of those saying adamantly that it is absolutely fine to drink one small glass of wine. It probably is fine and many many do and are fine. But research is not there to bully mothers as someone suggested, but to try to understand what is safest. You can ignore it if you like and your baby will probably be fine. But the advice is that it is safest not to drink at all. FAS is also spectrum like and there are some thoughts that some children have cognitive difficulties associated with it, without full facial features or obvious difficulties etc. And that there may be critical periods where even small amounts of alcohol may do harm.
I'm really not saying that pregnant mothers need to feel guilty for their choices, but its better to know the possible risks in order to make that choice. It is not only alcoholic binge drinkers who have babies who may have been impacted on by alcohol in pregnancy. We are early in understanding all this but research into areas like is there to understand and help prevent and treat difficulties. To dismiss it as just pushing an agenda is really ignorant.

I don't understand all of those saying adamantly that it is absolutely fine to drink one small glass of wine

Because it categorically is. Science, logic, all human experience and common sense all agree. It IS fine. We know this.
Anyone who says otherwise is lying or wrong.

So messy, you think the nhs advice that there is no proven safe amount of alcohol is there just because researchers like to lie?

I'm no expert on the dangers of alcohol in pregnancy, but I do think your "I'm stroppy because I'm fed up with being told what I can/can't do!" attitude is a bit weird. It's 9 months out of your whole life, and nobody made you decide to have a baby! I used to drink loads a fair bit before having dc but didn't have any problem giving up while I was pregnant. Thinking "Ooh I can't wait to have a lovely glass of wine after dc is born " is perfectly natural. Carrying on drinking because you want to rebel against 'the rules' is childish.

Actual scientist here.

This is a tricky question. Because all of the following statements are true.

1. Women have bodily autonomy and policing their behaviour while pregnant is a slippery slope.
2. Ethanol is a teratogen
3. There is no defined safe level of consumption
4. The best data we have so far shows no effect in LIGHT drinkers
5. Roughly 2-4% of the population are born affected by ethanol.

All those points are true, and some of them are contradictory.

My take on it is this: we all metabolise alcohol differently. A foetus doesn’t metabolise it that well, and is constantly exposed for longer due to the womb environment (excrete into amniotic fluid, ingest amniotic fluid etc.)

I suspect (and I have a PhD which involved a lot of embryology) that the foetus is very sensitive to alcohol at a few key points and moderately sensitive at others. Unfortunately we don’t really know when.

There’s also the ethical issue - public health need to make a recommendation that is evidence based and also ‘doable’ by the population. I understand why the advice is how it is and I think it’s sensible.

You can’t enforce a behaviour on pregnant women - they have bodily autonomy. I suspect there are a lot of women fretting needlessly over having had a light beer st a bbq while women with serious problems can’t access the help they need.

At the same time, a few % of the population of babies are born affected by ethanol each year. That’s a lot - some y figures put it up to five percent. Remember fas is a spectrum disorder, as there are a lot of children born subtly affected.

So this isn’t a cut and dried issue. Public health is often a compromise.

I didn’t drink during pregnancy- I had hg and the thought repulsed me. I wouldn’t have drunk even if I wasn’t, even though I know that logically a single small one with food is unlikely to harm. I’m also aware that people are crap at judging how many units they take in.

You can ride your bike, unless there’s s specific reason you have for not doing it?

Don’t smoke - that’s absolutely 100% negative for both of you.

Interesting post Anatidae, thank you. I hadn’t realised the proportion of DC with FAS was so high.

The FAS “lobby”, including many biological and adoptive parents of DC with FAS, is perhaps understandably promoting the “no alcohol is safe” message.

I wonder what proportion of DC with FAS have mothers who drank only a small number of units.

From patientinfo.co.uk

“It is not known exactly how much alcohol is safe in pregnancy. Heavy drinking and binge drinking are more likely to cause damage to the baby.

Not every mother who drinks heavily in pregnancy has a baby with FAS. So there seem to be other factors that make it more likely to happen. These may include:

The genetic 'makeup' of the mother and baby. (This is the coding system inside each cell of our bodies. We inherit it from our parents. It makes us who we are and makes each of us different.)
How healthy the mother is.
How good the mother's diet is.
Whether the mother is stressed.
The mother's age.
Whether the mother smokes or not.”

“In the UK, it is not known exactly how common FAS is. This is because it is difficult to diagnose. Also, there is no system for reporting it. FAS is one of the most common reasons for children to have mental or behavioural problems, other than gene abnormalities.

There are big differences in how much people drink in different countries, and even between areas in the same country. Because of this, how often babies are born with FAS varies between places. In the USA it is estimated to occur in 2 to 15 of every 10,000 births. Other alcohol damage without the full syndrome of FAS happens much more commonly. It is thought between 2 and 5 of every one hundred schoolchildren may be affected in some way.

In Italy FAS is thought to happen in up to 62 in every 1,000 births. In parts of South Africa it may be as often as 89 in every 1,000 births.”

Surely the point is that if we cannot be absolutely sure what the effects will be, the only truly safe answer is not to drink alcohol at all. What you have to ask yourself is why drinking a few glasses of wine is so important to you that it's not worth giving it up for that short period of your life in order to guarantee that alcohol won't affect your baby. Why on earth would you take the chance, unless you are an alcoholic and can't stop drinking?

Bodily autonomy and (probable) low risk for light consumption. Plenty of us without an alcohol problem found it difficult or did not wish to give up alcohol completely when pregnant. And the social pressure on pregnant women not to do lots of things is wearing.

I understand why the no alcohol message is promoted. I didn’t drink at all during pregnancy and that if I’m honest is down to my past work.
I’ve seen enough embryology and know enough about how difficult retrospective observational studies are to trust one over the other.

Having said that... we can’t police women’s bodies, we can only make evidence based policy and provide comprehensive alcohol help services.

So messy, you think the nhs advice that there is no proven safe amount of alcohol is there just because researchers like to lie?

The guidelines are not about science, they are about money. It's not researchers who make up the guidelines or write the nhs website.

We know for an absolute fact that a single glass of wine a week cannot cause FAS. We know that. You know that. Why do we pretend this is news to anyone?

In the UK, it is not known exactly how common FAS is. This is because it is difficult to diagnose. Also, there is no system for reporting it. FAS is one of the most common reasons for children to have mental or behavioural problems, other than gene abnormalities

come on now, don't be silly. You cannot say on the one hand that we don't know how common something is or have any way of reporting it, and then also say it is one of the most common reasons for mental/behavior problems.
You can't assert the latter if you beleive the former to be true.

Also, the latter is not true anyway.

I asked a consultant about this, because I didn't realise I was pregnant until I came home from a very boozy holiday and was worried. He said that, in a 40 year career, he'd only ever seen one case of foetal alcohol syndrome- and that was in an alcoholic mother drinking a bottle of spirits a day.

Absolute certainty about anything doesn't exist. Life is about taking calculated risks. Do your research and make your own informed decisions.

We know for an absolute fact that a single glass of wine a week cannot cause FAS.

I hate to be pedantic (actually no I love it which is why I’m a scientist) but we dont know that. We cannot know that and we cannot investigate it because to do so in a manner which would give us a concrete answer would endanger foetuses, and research like that just doesn’t happen (thank goodness.)

What we can say is that based on current best knowledge, on a population level, light alcohol consumption does not appear to cause deleterious effects.

What happens on an individual level is more complex. Some people are exquisitely sensitive to ethanol. Some have odd alcohol dehydrogenase mutations. Some may metabolise it oddly in other ways. We cannot ever say ‘one glass a week has zero effect on everyone in all circumstances.’ The actual consumption level in mothers of Babies born with FASD varies considerably. There are obviously many genetic pathways involved and it’s just very very complicated.

FASD is a common cause of behavioural and structural abnormality in children. It’s also very difficult to diagnose the milder variants. The full blown FaS has a series of facies (facial abnormalities) which seem to overlay structural brain abnormalities (the developing brain and face are closely interlinked.) so FAS isn’t too hard to diagnose but FASD is harder. It’s a spectrum.

Researchers don’t write the nhs guidelines directly, you’re right about that (they’d be a lot fucking blunter in many things I can tell you if we did...)

The actual consumption level in mothers of Babies born with FASD varies considerably. There are obviously many genetic pathways involved and it’s just very very complicated
FASD has never been diagnosed in a case where a woman actually drank one glass of wine a week.
Never.

I don't know why people don't just abstain from drinking alcohol for 9 months if they're even a tiny bit worried about whether it could be affecting their baby. It really isn't that hard to not drink alcohol. To be honest, it's a good habit to get into if you're going to be spending a lot of time on your own with a newborn baby.

Messy I’m curious where you get your certainty from? Just repeating it’s impossible and has never happened etc doesn’t answer the question.