Alcohol during pregnancy

Even small amounts of alcohol can harm an unborn baby's development, which can have lifelong impacts. There is no known safe time or amount of alcohol to drink during pregnancy.

The National Health and Medical Research Council (NHMRC) recommend that to reduce the risk of harm to their unborn child, women who are pregnant or planning a pregnancy should not drink alcohol.

It is also recommended for women who are breastfeeding, not drinking alcohol is safest for the baby.

Are you pregnant or planning a pregnancy? Do you have a friend or family member who is pregnant and looking for information about drinking alcohol during that time? This webpage contains answers to your questions on this topic.

Is there a safe amount of alcohol to drink while pregnant?

No. There is no known safe amount of alcohol to drink during pregnancy.1 Research suggests alcohol use, even at low levels, can impact the development of an unborn baby, resulting in lifelong consequences.12 The risk of harm to the unborn baby increases with the more alcohol, and the more frequently, the mother drinks.1

Does the placenta protect the baby from alcohol?

No. The placenta links the blood supply of the mother to the blood supply of the unborn baby and is essential for the growth of a healthy baby. This means if a woman drinks alcohol during pregnancy, the blood alcohol levels of the mother and the baby are similar.1 This happens because the mother does not break down the alcohol before it crosses the placenta, and the placenta does not reduce the amount of ethanol reaching the fetus.3 Because an unborn baby’s liver is not fully formed, the baby cannot process alcohol3 which means the unborn baby receives a similar concentration of alcohol as the mother. 14

Is there a safe time to drink alcohol when pregnant?

No. Alcohol can harm a developing baby at any time during pregnancy. This is because alcohol is a teratogen - an agent that can interrupt the development of an embryo or fetus.1 

A baby’s brain grows and develops throughout pregnancy, and alcohol can interfere with the chemicals necessary for normal brain development.1 The developing brain of a baby is more vulnerable to damage than the mature brain of an adult, and drinking alcohol at any time during pregnancy can impact the developing brain.14

What about an ‘occasional’ drink or a few sips when pregnant?

The NHMRC recommends that to reduce the risk of harm to their unborn child, women who are pregnant should not drink alcohol.

Any alcohol the mother drinks passes straight through the placenta to the developing baby,1 and while the mother might not feel the effects of a few sips or one drink, the baby does.

It may feel difficult to not drink alcohol during pregnancy, particularly if people aren’t aware of your pregnancy yet, but because there is no safe level of alcohol to drink during pregnancy, choosing not to drink removes the risk of any potential harm to the baby.

For tips about how to stay alcohol-free during pregnancy, click here.

How is alcohol harmful to unborn babies?

Alcohol is a teratogen, which means it can interrupt the normal development of an unborn baby.1 

Alcohol use when pregnant can cause a range of lifelong physical, mental and behavioural disabilities, known as Fetal Alcohol Spectrum Disorders (FASD).5 Alcohol exposure can also cause miscarriage, stillbirth, premature birth, and low birth weight.16

What is Fetal Alcohol Spectrum Disorder (FASD)?

Fetal Alcohol Spectrum Disorder (FASD) is an umbrella term used to describe a range of permanent and lifelong conditions that can result from a baby being exposed to alcohol during pregnancy.

The potential outcomes for a baby exposed to alcohol during pregnancy may fall along a continuum, ranging from mild to more severe.7 People with FASD will have strengths and difficulties in different areas, and this depends on the parts of the brain that have been most damaged by exposure to alcohol.8

Some problems people with FASD might experience can include:

  • Growth and birth defects, such as distinctive facial features,9 joint and limb abnormalities,7 heart and kidney defects, and growth problems.4
  • Intellectual problems, such as problems with memory and learning,7 difficulties with speech and language, cognitive deficits, difficulty with judgement,10 reasoning or understanding consequences of actions.11
  • Behavioural problems, such as hyperactivity and increased irritability,7 in addition to social and emotional issues.1112

FASD may not be seen at birth, and can often go unnoticed until childhood and adolescence when social and behavioural problems become more evident.4

People with FASD can have problems at school, difficulties gaining employment, social exclusion, mental health issues, alcohol and other drug use, and early and repeated engagement with the justice system.1314

What if alcohol was drunk before finding out about pregnancy?

If a woman was drinking alcohol before finding out about pregnancy, it does not automatically mean the baby will be harmed.15

It’s important to know it’s never too late to stop drinking – every effort made to stop drinking alcohol, or reduce the amount of alcohol consumed, lowers the risk of harm to the unborn baby and benefits the mother’s health.

If you or someone you know is pregnant, or concerned that alcohol has been consumed in early pregnancy, try to stay alcohol-free, make an appointment to speak with your health care professional and try not to worry. Every pregnancy is different and there are a range of factors that play a role in determining the risk of harm to the baby.

Is there support for women who find it difficult to stop drinking alcohol during pregnancy?

Yes. We understand it can be difficult for some women to stop drinking alcohol during pregnancy.

If women are concerned or have trouble stopping drinking, it is recommended they contact their health care professional (doctor, midwife, obstetrician or community health nurse) for support and appropriate referral to services.

For information on strategies to avoid alcohol during pregnancy, click here.

What other things can women do to promote healthy pregnancies?

In addition to not drinking alcohol, there are lots of ways women can support their health and the development of their baby.

  • Regularly see your doctor, midwife, obstetrician or community health nurse to ensure mother and baby are monitored throughout pregnancy.
  • Modify your lifestyle to improve the health of your baby by taking folate, avoiding foods that have a higher risk of listeria infection, getting enough iodine and eating fish with lower levels of mercury.
  • Pregnant women are encouraged to do some sort of physical activity every day. Doctors can provide advice about the best sort of physical activity based on individual circumstances.
  • Pregnant women and their growing babies need extra nutrients, so follow advice from Eat for Health about healthy eating during pregnancy.
  • Looking after the mental health of a mother-to-be is just as important as looking after their physical health. Be sure to balance rest and activity and be mindful of stress levels. For more information about antenatal and postpartum mental health, visit Think Mental Health.
  • Avoid tobacco and other drug use. If you require support to do so, speak with your health care professional or the specialist Women and Newborn Drug and Alcohol Service (WANDAS) team at King Edward Memorial Hospital.
  • If you’re pregnant or planning pregnancy, talk to your doctor about your immunisation status. Pregnant women and newborn babies are at greater-risk of vaccine-preventable diseases.

Is any type of alcohol safer than another?

No. It doesn’t matter if it’s beer, wine or spirits. No type of alcohol is safe at any time during pregnancy.

Is it safe to drink alcohol when planning a pregnancy?

Many women are unaware they are pregnant up until the fourth to sixth week of pregnancy,16 during which time the developing baby is very sensitive to the effects of alcohol.1 As such, the NHMRC recommend women who are planning a pregnancy should not drink alcohol.

Has the evidence around alcohol use during pregnancy changed?

The evidence about the risk associated with alcohol use in pregnancy continues to emerge.

While no safe amount of alcohol for women to drink during pregnancy has been identified, because there is a risk of harm to the developing baby, the NHMRC’s new recommendation is that women who are pregnant or planning pregnancy should not drink alcohol.1  Read the plain English description of the evidence here.

Is it safe to drink alcohol when breastfeeding?

The NHMRC recommend for breastfeeding women, not drinking is safest for the baby.

For more information on alcohol use and breastfeeding, click here.

Looking for more information?

If you would like more information about alcohol use for women who are pregnant, planning a pregnancy or breastfeeding, contact your GP or other health care professional.

Do you or someone you know need help?

If you or someone you know you know needs help or support in relation to their alcohol or other drug use, including during pregnancy, the Alcohol and Drug Support Line is a confidential, non-judgemental telephone counselling, information and referral service. The phone service is free of charge and available 24/7 by calling (08) 9442 5000 or 1800 198 024 (toll-free for country callers).

Live Chat is also free of charge and available for Western Australian during select hours via the Alcohol.Think Again website.

1

National Health and Medical Research Council. (2020).  Australian Guidelines to Reduce Health Risks from Drinking Alcohol. Commonwealth of Australia, Canberra.

2

Lees, B., Mewton, L., Jacobus, J., Valadez, E., Stapinski, L., Teesson, M., Tapert, S., & Squeglia, L. (2020). Association of prenatal alcohol exposure with psychological, behavioral, and neurodevelopmental outcomes in children from the adolescent brain cognitive development study. American Journal of Psychiatry, 1-13.

3

Burd, L., Blair, J., & Dropps, K. (2012). Prenatal alcohol exposure, blood alcohol concentrations and alcohol elimination rates for the mother, fetus and newborn. Journal of Perinatology, 32, 652-659.

4

Reibel, T., & Giglia, R. (2016). WA Health AUDIT-C Learning Guide. Telethon Kids Institute, University of Western Australia, under contract with the WA Department.

5

Crawford-Williams, F., Fielder, A., Mikocka-Walus, A., Esterman, A., & Steen, M. (2016). A public health intervention to change knowledge, attitudes and behaviour regarding alcohol consumption in pregnancy. Evidence Based Midwifery, 14(1), 4-10.

6

Peadon, E., O’Leary, C., Bower, C., & Elliot, E. (2007). Impacts of alcohol use in pregnancy: the role of the GP. Australian Family Physician, 36(11).

7

Crawford-Williams, F., Fielder, A., Mikocka-Walus, & A., Esterman, A. (2015). A critical review of public health interventions aimed at reducing alcohol consumption and/or increasing knowledge among pregnant women.

8

Lange, S., Probst, C., Gmel, G., Rehm, J., Burd, L., & Popova, S. (2017). Global prevalence of fetal alcohol spectrum disorder among children and youth: a systematic review and meta-analysis. JAMA Pediatrics, 171(1),948-956.

9

Muggli, E., Matthews, H., Penington, A., Claes, P., O’Leary, C., Forster, D., … & Halliday, J. (2017). Association between prenatal alcohol exposure and craniofacial shape of children at 12 months of age. JAMA Pediatrics. 

10

Astley, S., Olson, H., Kerns, K., Brooks, A., Aylward, E., Coggins, T., … & Richards, T. (2009). Neuropsychological and behavioral outcomes from a comphrensive magnetic resonance study of children with fetal alcohol spectrum disorder. Canadian Society of Pharmacology and Therapeutics, 16(1), 178-201.

11

Mattson, S., Schoenfeld, A., & Riley, E. (n.d.). Teratogenic effects of alcohol on brain and behaviour. National Institute on Alcohol Abuse and Alcoholism.  

12

Sood, B., Delaney-Black, V., Covington, C., Nordstrom-Klee, B., Ager, J., Templin, T., Janisse, K., Martier, S., & Sokol, R. (2001). Prenatal alcohol exposure and childhood behavior at age 6 to 7 years: I. Dose-response effect. Pediatrics, 108(2), 1-9.

13

Bower, C., Watkins, R., Mutch, R., Marriott, R., Freeman, J., Kippin, N., … & Giglia, R. (2018). Fetal alcohol spectrum disorder and youth justice: a prevalence study among young people sentenced to detention in Western Australia. BMJ Open, 8.

14

Symons, M., Pedruzzi, R., Bruce, K., & Milne, E. (2018). A systematic review of prevention interventions to reduce prenatal alcohol exposure and fetal alcohol spectrum disorder in indigenous communities. BMC Public Health, 18(1227).

15

National Health and Medical Research Council. (2020). Guidelines: Practical Information.

16

Peadon, E., O’Leary, C., Bower, C., & Elliot, E. (2011). Impacts of alcohol use in pregnancy: The role of the GP. Australian Family Physician, 36(11), 935-939.

Page last updated: 03 February 2021

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