Alcohol In Pregnancy And While Breastfeeding

Researchers have found that the new mothers took an average of an extra day more to recover from the birth in hospital than non-drinkers. And they were less likely to have formed a strong attachment to their child three months later, experts at Robert Gordon University in Aberdeen found.

The guidance on this has converged, and it’s simpler than the debate suggests.

No amount of alcohol has been established as safe in pregnancy, and no stage of pregnancy has been established as safe.

Health authorities therefore advise not drinking at all. Alcohol crosses the placenta freely, and a foetus can’t process it as an adult can.

Studies of low-level drinking give mixed results, but the absence of proven harm at low doses isn’t the same as proof of safety, and the harm at higher doses isn’t in dispute.

What the risks are

Alcohol in pregnancy can affect the developing brain, producing lifelong effects on learning, attention, memory, impulse control and behaviour, and in some cases physical and growth effects too. These are permanent, and the behavioural difficulties are often not recognised for what they’re until school age or later.

Binge drinking is particularly harmful, because it delivers a high concentration at once. Several drinks on one occasion is more dangerous than the same total spread out. That’s important, because “I only drink at weekends” is sometimes offered as the safer pattern and is the opposite.

If you drank before you knew

This is very common, and it isn’t a reason to panic.

Around half of pregnancies are unplanned, and a great many women have drunk normally in the first weeks without knowing. The majority of babies in this situation are entirely fine.

Tell your doctor the truth: how much, and when. You won’t be judged, and it’s information they need. And stop now: the benefit of stopping applies at any point in a pregnancy.

Anxiety and guilt about this are extremely common. Raise them with your obstetrician instead of holding on to them alone for eight months.

While breastfeeding

Different rules, and more manageable.

Alcohol passes into breast milk at roughly the level in your blood, and leaves it the same way: as your blood level falls, so does the milk.
Time is the only thing that clears it. Roughly two hours per standard drink before feeding.
“Pump and dump” doesn’t speed this up. It relieves engorgement and lets you keep to a schedule; it doesn’t remove alcohol from your body or from the milk still being made. This is widely misunderstood.
An occasional single drink, taken just after a feed, is generally considered compatible with breastfeeding.
Newborns and premature babies clear alcohol far more slowly, so caution should be greater in the early weeks.

Never share a bed with a baby after drinking. Alcohol substantially increases the risk of sudden infant death when co-sleeping, because it affects how easily you rouse. This applies to both parents, and it applies to falling asleep on a sofa too.

If you’ve had a drink, someone else does the night, or the baby sleeps in their own cot.

If stopping is difficult

If cutting out alcohol is hard, that’s a medical matter, not a moral one, and it’s treatable.

Tell your doctor. They’ve heard it, and the alternative, concealing it and continuing, is much worse for everyone.
Don’t stop abruptly on your own if you’re drinking heavily and daily. Withdrawal can be dangerous and needs medical supervision.
Support is available through addiction services and your polyclinic or GP, and a referral is a normal thing to ask for.

Declining a drink invites questions, especially before you’ve announced a pregnancy. Easy lines: “I’m on antibiotics”, “I’m driving”, “not tonight”, or simply holding a glass of something. You owe nobody an explanation, and a hostess who presses isn’t owed one either.

Frequently asked questions

Is any amount of alcohol safe in pregnancy?

No amount has been established as safe, and no stage of pregnancy has been established as safe, so health authorities advise not drinking at all. Studies of low-level drinking give mixed results, but absence of proven harm at low doses isn’t proof of safety.

I drank before I knew I was pregnant. What now?

This is very common, around half of pregnancies are unplanned, and the majority of babies in this situation are fine. Tell your doctor how much and when, and stop now, since the benefit of stopping applies at any point in a pregnancy.

Is occasional drinking worse than regular small amounts?

Binge drinking is particularly harmful because it delivers a high concentration at once, so several drinks on one occasion is more dangerous than the same total spread out. “I only drink at weekends” isn’t the safer pattern.

Can I drink while breastfeeding?

An occasional single drink taken just after a feed is generally considered compatible. Alcohol passes into milk at roughly your blood level and clears as that falls. Allow around two hours per standard drink before feeding. Be more cautious in the early weeks, since newborns clear alcohol far more slowly.

Does pumping and dumping remove alcohol from milk?

No. It relieves engorgement and helps you keep to a schedule, but it doesn’t clear alcohol from your body or from the milk still being produced. Only time does that.

What if I find it hard to stop drinking?

That’s a medical matter, not a moral one, and it’s treatable. Tell your doctor. Concealing it and continuing is much worse. If you drink heavily and daily, don’t stop abruptly on your own, as withdrawal can be dangerous and needs supervision.

What to remember

No established safe amount, no established safe stage. The advice is none.

If you drank before you knew, that’s common, most babies are fine, and being straight with your doctor is the right move.

Breastfeeding is more forgiving: roughly two hours per drink, and pumping and dumping doesn’t speed it up.

And never bed-share after drinking. That one isn’t a small risk.