In every pregnancy, a woman starts out with a 3-5% chance of having a baby with a birth defect. This is called her background risk. This sheet talks about whether exposure to alcohol may increase the risk for birth defects over that background risk. This information should not take the place of medical care and advice from your health care provider.

What is alcohol?

Alcohol, drinking alcohol, ethanol and ethyl alcohol are all names for the ingredient in beer, wine, or hard liquor that gives an intoxicating effect to the drinker. The same amount of alcohol is found in a standard serving of beer, wine, or hard liquor. A standard serving is considered to be 12 ounces of beer, 4-5 ounces of wine, or 1.5 ounces of hard liquor.

Is there a safe amount of alcohol I can drink during pregnancy?

No, there is no safe level. Alcohol crosses the placenta easily and reaches the developing baby. Differences in genetics and metabolism of alcohol by both the mother and the developing baby lead to a wide range of risks. The risk may be different even in the same mother in different pregnancies.

Can drinking alcohol make it harder for me to get pregnant?

Yes. Some studies have shown an increase in fertility problems among women with heavy alcohol exposure. It is best to avoid alcohol while trying to get pregnant.

Can drinking alcohol cause a miscarriage?

Yes. Some studies reported higher rates of miscarriage and stillbirth with alcohol use during pregnancy.

Can drinking alcohol during my pregnancy cause a birth defect?

Yes. Drinking alcohol in pregnancy is a leading cause of intellectual disability. Drinking alcohol in pregnancy puts the developing baby at risk for Fetal Alcohol Syndrome (FAS). The features of FAS include a pattern of certain birth defects: small head and body size, specific facial features, and learning and behavioral problems. FAS is the most severe outcome of alcohol use during pregnancy. When a child has some but not all of the findings of FAS, health care providers may use other terms, such as Fetal Alcohol Spectrum Disorder (FASD) and Fetal Alcohol Effects (FAE). The risks from heavy alcohol use (5 or more drinks a days) and binge drinking (around 5 or more drinks on one occasion) have been well established. The risks for occasional use of lower amounts of alcohol are less clear.

Are there long term issues with FAS, FASD, and FAE?

Yes. These cause lifelong challenges, such as problems with learning and poor memory. People with FAS, FASD, and FAE can have a harder time understanding the consequences of their actions, have poor judgment, and difficulty with social relationships. Higher rates of dropping out of school, mental health problems, and alcohol or drug abuse have also been reported in these individuals.

I just found out I am 6 weeks pregnant and last weekend I had one beer. Will my baby have FASD?

While there is no known safe amount of alcohol, a single drink is unlikely to cause a problem. The best thing you can do for your baby is to avoid further use of alcohol during your pregnancy.

Is binge drinking on only some days of the week as risky as drinking alcohol everyday but at lower amounts?

Yes. Binge drinking provides the highest alcohol dose to the developing baby at one time. However, studies on alcohol use during pregnancy often calculate weekly averages, so the effects of certain patterns of drinking alcohol are not well studied.

Is it ok to drink after the first trimester?

No. Alcohol affects brain development. The baby’s brain develops throughout the entire pregnancy and continues to grow after birth. Drinking alcohol at any time in pregnancy increases the risk for the baby to have alcohol related brain damage. This means there is no safe period to drink when pregnant.

Can a baby go through withdrawal after birth?

Yes, if the mother has been drinking close to delivery. Symptoms can include tremors, increased muscle tone, restlessness and excessive crying.

How will I know if alcohol has hurt my baby?

If you are worried about the amount of alcohol you have drank during pregnancy, it is important to discuss this with your health care provider. Your health care provider may offer ultrasounds to look for birth defects and to watch the baby’s growth more closely. However, an ultrasound cannot see if alcohol has caused intellectual disabilities or learning difficulties.

Once your baby is born, tell your pediatrician about your alcohol use during pregnancy. Your baby can then be evaluated for effects of prenatal alcohol exposure. However, some of the problems caused by prenatal alcohol exposure, such as learning difficulties and behavioral problems, are more likely to be identified as your child gets older. Your child’s health care provider can continue to monitor your child over time.

Is there any hope for a baby who has been exposed to alcohol throughout pregnancy?

Yes. It is always recommended for a pregnant woman to stop her alcohol use, regardless of how far along in her pregnancy she is. The baby will benefit by no longer being exposed to alcohol. Though FAS/FASD cannot be cured, children with FAS/FASD benefit from an early diagnosis. The best outcomes happen with children who are diagnosed early. Being raised in a stable and nurturing home can lead to better outcomes. Services and support are available for children with alcohol related problems.

Can I drink alcohol while breastfeeding?

This should be avoided. Drinking alcohol can make it harder for your body to make milk, and alcohol gets into breast milk. The amount of alcohol in the milk is about the same level of alcohol in the woman’s bloodstream. Alcohol can pass back and forth from the bloodstream into the milk. Only time can reduce the amount of alcohol in the milk. Pumping and discarding, drinking water, taking caffeine, or exercising do not help your body to get rid of the alcohol faster. It takes about 2 to 2.5 hours for each standard drink to clear from breast milk. For each additional drink, a woman must wait another 2-2.5 hours per drink.

The infant brain continues to grow after birth. Effects on the baby from alcohol in breast milk are not well studied. However, some reports found that babies whose mothers drink alcohol while breastfeeding may eat less and/or have changes in their sleeping patterns. One study suggested problems with motor development following exposure to alcohol in breast milk, but other studies did not show the same results. Since breastfeeding has documented benefits for the baby, speak with your pediatrician about your specific alcohol intake before avoiding breastfeeding.

What if the father of the baby drinks alcohol?

There is no evidence to suggest that a father’s exposure to alcohol causes birth defects. In general, exposures that fathers have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures and Pregnancy at http://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/pdf/.
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