Alcohol ban advised for pregnancy

Advice on drinking during pregnancy is tightening up

Women should not drink any alcohol during pregnancy, NHS adviser the National Institute for Health and Clinical Excellence (NICE) has said.

It says if they must drink, they should not do so in the first three months and should limit consumption to one or two units once or twice a week afterwards.

It brings NICE in line with government advice and replaces previous guidance saying small daily amounts were fine.

However, NICE concedes there is no evidence to support the change.

Not everyone agrees with such a tough approach, but research into the impact of alcohol is patchy.

The Royal College of Obstetricians and Gynaecologists said there was no evidence that a couple of units once or twice a week would do any harm to the baby - but could not categorically rule out any risk.

Unfortunately not all women are getting the support they need at the moment Dr Gillian Leng NICE deputy chief executive Q&A: Alcohol and pregnancy

NICE, which is responsible for the promotion of good health in England, Wales and Northern Ireland, decided to tighten its guidance partly because of concern that people are now drinking more than in the past.

Previous draft guidance suggested women could drink a unit of alcohol a day once they were past the first three months of pregnancy.

NICE deputy chief executive Dr Gillian Leng said people, and in particular women, were drinking more and the NHS advisory body wanted to send a "clear message".

"I think it reinforces the advice which came out last year. Women should be advised not to drink."

See table of alcohol units

The Department of Health in England revised its guidance last year, calling for no drinking while pregnant or while trying to get pregnant.

Professor Sir Liam Donaldson, Chief Medical Officer for England, welcomed the new guidance from NICE, stressing that it was particularly important not to drink at the beginning of pregnancy, when the risk of miscarriage was highest.

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Drinking heavily in pregnancy can cause foetal alcohol syndrome, which can leave children with features like small heads, widely spaced eyes and behavioural or learning problems.

A spokeswoman for the National Childbirth Trust said the group agreed women should limit their drinking during pregnancy, but warned it was important to "put things into perspective".

"Pregnant women who have had a few drinks often worry a great deal about whether they have harmed their baby. On balance, for instance, it is believed that if a light, infrequent drinker, in general good health, drinks to the point of drunkenness on one occasion, the risk to her baby is small."

Supplements

NICE also made a number of other recommendations for the care of women in England and Wales who were pregnant or planning to get pregnant.

It said vitamin D and folic acid supplements should be offered by health staff to help ward off conditions such as rickets and spina bifida.

And screening for sickle cell diseases by week 10 and Down's syndrome between 11 and 14 weeks using the most up-to-date methods should be available.

Officials also called for local health bosses to ensure peer support schemes where mothers encourage new parents to breastfeed are set up.

Much of what NICE is recommending is already happening although provision is patchy and officials said they wanted to make sure women got "gold standard" care.

Dr Leng added: "Unfortunately not all women are getting the support they need at the moment."

NICE also called for improvements in the care of pregnant women with diabetes.

About 20,000 pregnancies each year are affected by diabetes and, therefore, carry higher risk of miscarriage, birth defects and still birth.

The guidance said women should get access to advice and support, in particular to achieve good blood sugar control, before they get pregnant.

During pregnancy, access to specialist multi-disciplinary teams of doctors, nurses and midwives was essential, it added.

UNITS FOR ALCOHOLIC DRINKS

Drink	Volume	Strength	Units
Normal beer/lager/cider
half pint	284ml	4	1
large can/bottle	440ml	4.50%	2
Strong beer/lager/cider
half pint	284ml	6.50%	2
large can/bottle	440ml	6.50%	3
Table wine
small glass	125ml	12.50%	1.5
medium glass	175ml	12.50%	2
large glass	250ml	12.50%	3
bottle	750ml	12.50%	9
Spirits
single shot	25ml	40.00%	1
bottle	750ml	40.00%	30
Alcopops
bottle	275ml	5.00%	1.5
Office for National Statistics

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