This sheet is about exposure to alcohol in pregnancy and while breastfeeding. This information is based on available published literature. It should not take the place of medical care and advice from your healthcare provider.
What is alcohol?
Alcohol, ethanol, and ethyl alcohol are all names for the ingredient in beer, malt liquor, wine, and spirits (“hard liquor”) that can cause intoxication (including feeling “buzzed” or drunk). Standard servings of beer (12 ounces), malt liquor (8 ounces), wine (5 ounces), and spirits (1.5 ounces) all contain about the same amount of alcohol, although exact amounts can vary. For females, having 8 or more drinks per week is considered heavy drinking (for males, 15 or more drinks per week). Having 4 or more drinks on one occasion (about 2-3 hours) is binge drinking for females (5 or more drinks on one occasion for males).
It is recommended not to drink any amount of alcohol at any time in pregnancy or if you might be pregnant. Alcohol can affect a pregnancy even before a person knows they are pregnant. If a person who is pregnant is using alcohol, it is recommended they stop as soon as possible, no matter how far along they are in their pregnancy. The baby will still benefit from no longer being exposed to alcohol. If you are pregnant or might get pregnant and cannot stop drinking, talk with your healthcare provider as soon as possible. They can go over what resources are available to help you stop.
Is any amount of alcohol okay to drink during pregnancy?
Any amount of alcohol could be harmful to a pregnancy. Alcohol easily crosses the placenta and reaches the developing baby. The chance that a baby will be affected by alcohol can depend on many factors, including genetics, nutrition, and alcohol metabolism (how the body processes alcohol) of both the person who is pregnant and the developing baby. The risks may be different for the same person in different pregnancies.
I drink alcohol. Can it make it harder for me to get pregnant?
Some studies have shown an increase in problems with fertility (ability to get pregnant) with heavy alcohol use.
Does drinking alcohol increase the chance of miscarriage?
Miscarriage is common and can occur in any pregnancy for many different reasons. Studies have reported higher rates of miscarriage among those who drink alcohol during pregnancy.
Does drinking alcohol increase the chance of birth defects?
Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. Drinking alcohol in pregnancy can cause Fetal Alcohol Spectrum Disorder (FASD). FASD includes a range of effects related to alcohol exposure in pregnancy, from physical birth defects (including defects of the heart, kidneys, and bones) to changes in brain development. These effects can range from mild to severe. Depending on the specific effects or combination of effects, healthcare providers use different terms to describe different kinds of FASD.
The most severe form of FASD is Fetal Alcohol Syndrome (FAS). Children with FAS have a pattern of birth defects that includes specific facial features, a smaller head and body size, and effects on brain development that can cause significant challenges in learning and behavior.
The chances of a baby having FAS/FASD from heavy drinking and binge drinking in pregnancy have been well established. The risks from occasional use of lower amounts of alcohol are less clear.
Does drinking alcohol in pregnancy increase the chance of other pregnancy-related problems?
Studies have reported higher rates of stillbirth among people who drink alcohol during pregnancy. Drinking alcohol may also increase the chance of preterm delivery (delivery before 37 weeks of pregnancy) and cause the baby to grow smaller than expected.
Does drinking alcohol during pregnancy affect future behavior or learning for the child?
Drinking alcohol in pregnancy affects brain development and is a leading cause of intellectual disability. A baby’s brain develops throughout pregnancy, so drinking alcohol at any time in pregnancy increases the chance for the baby to have intellectual disabilities and learning problems. People with FASD can also have behavioral problems, such as poor judgment, not understanding the consequences of their actions, and trouble with social relationships. These problems can create lifelong challenges for people who are affected and their families.
I just found out I am pregnant and last weekend I had one beer. Will my baby have FASD?
Having a single serving of alcohol one time is much less concerning than heavy or binge drinking and is considered less likely to cause alcohol-related problems for the baby. However, it is recommended that you avoid further use of alcohol during your pregnancy.
Does binge drinking only on some days carry the same risk as drinking lower amounts every day?
Binge drinking exposes the developing baby to the highest amount of alcohol at one time and is known to increase risks to the pregnancy. The effects of other specific patterns of alcohol use in pregnancy are not as well understood because some studies look at weekly averages while others look at daily use.
If I keep drinking alcohol, will it cause withdrawal symptoms in my baby after birth?
The use of alcohol during pregnancy can cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal. Babies have a higher chance of going through withdrawal if they have been exposed to alcohol close to delivery. Symptoms of withdrawal can include involuntary shaking movements (tremors), increased muscle tone, restlessness, and excessive crying.
Are there tests that can help me know if alcohol has affected my baby?
Talk with your healthcare provider about your alcohol use and the best ways to monitor your baby’s growth and development during pregnancy. Ultrasounds can look for some birth defects and follow the baby’s growth. There are no screenings or tests available during pregnancy that can tell if alcohol has caused intellectual disabilities or learning problems, or if it will affect future behavior for the child.
It is suggested that you also talk to your baby’s healthcare provider about your alcohol use during pregnancy. They can evaluate your child after being born for any effects from alcohol and continue to monitor for learning and behavioral issues as the child gets older. Although FASD cannot be cured, children can benefit from an early diagnosis. Your child’s healthcare provider can talk with you about services and support that are available for families and children with problems related to alcohol exposure in pregnancy.
Breastfeeding while drinking alcohol:
Alcohol easily gets into breast milk. The amount of alcohol in a person’s breast milk is about the same as in their blood. Alcohol can pass back and forth between the bloodstream and the breast milk. Only time can lower the amount of alcohol in the blood and breast milk. Pumping and discarding milk, drinking water, taking caffeine, or exercising do not help the body get rid of alcohol faster. It takes about 2 to 2.5 hours for each standard drink to clear from breast milk. For each additional drink, a person must wait another 2-2.5 hours per drink. If needed, the person may pump during this time to stay comfortable and keep up their milk supply. Discarding this pumped milk will help avoid exposing the baby to any alcohol in the milk. Drinking alcohol can also make it harder for the body to make milk.
The infant brain continues to grow after birth. Effects on the baby’s development from alcohol in breast milk are not well studied. One study suggested problems with motor development following exposure to alcohol in breast milk, but other studies did not show the same results. Some reports found that babies exposed to alcohol through breast milk may eat less and/or have changes in their sleeping patterns. If you suspect that the baby has any symptoms, contact the child’s healthcare provider.
Consuming more than one drink per day is not recommended while breastfeeding. However, since breastfeeding has known benefits for the baby, talk with your baby’s healthcare provider about how much and how often you drink so they can help you weigh the risks and benefits of continuing to breastfeed. Be sure to talk to your healthcare provider about all your breastfeeding questions.
If a male drinks alcohol, could it affect fertility or increase the chance of birth defects?
Some studies have shown that drinking alcohol lowers male fertility (ability to get partner pregnant). Male exposure to alcohol is not known to increase the chance for birth defects above the background risk. In general, exposures that fathers or sperm donors have are unlikely to increase the risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.
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OTIS/MotherToBaby encourages inclusive and person-centered language. While our name still contains a reference to mothers, we are updating our resources with more inclusive terms. Use of the term mother or maternal refers to a person who is pregnant. Use of the term father or paternal refers to a person who contributes sperm.