While Others May Whine About You Passing On The Wine, Your Baby Will Give Thanks This Holiday

While Others May Whine About You Passing On The Wine, Your Baby Will Give Thanks This Holiday

By Nadia Mohamedi, OTIS Teratogen Information Specialist

Last weekend, as I was out to dinner with friends, something caught my eye just outside the window near our table. I couldn’t help but notice a few orange leaves drift down to the colorful tree trunks. The conversation around me was quickly replaced by the excitement of my thoughts. I began to anticipate one of my favorite parts of Thanksgiving – the autumn-inspired alcoholic drinks.  I quickly found my thoughts taking me on a delicious journey of hot spiked cider by the fire, placing glasses of dark red wine on an elegant spread, and sipping a pumpkin cocktail in a near-comatose state on the couch.

Just as quickly as my journey began, my daydream came to a screeching halt as I was surprised to hear, “come on, one drink is not going to hurt you” aimed at my friend, Sara. Sara was three months pregnant. Amidst the orders of wine and beer, her order of sprite with a lemon stood out and the company at the table did not want her to miss out on the fun. I looked at her increasingly anxious face as phrases flew at her like, “I hear you have to drink like more than 4 drinks per day every day to be worried about affecting your baby” and “my mother drank throughout pregnancy and I’m fine.” Our waiter quickly excused himself. I had conversations with Sara before she was pregnant about alcohol, so I knew that she had the information to defend herself. However, that doesn’t always make dealing with the perils of peer pressure any easier. I could tell she was extremely uncomfortable. Given my lack of shyness about discussing birth defects at dinner, I chimed in with the information I’ve acquired as a counselor, which I will also share here with you.

 At the Organization of Teratology Information Specialists (OTIS), I have had the privilege of working with Dr. Kenneth Lyons Jones, one of two doctors who first identified Fetal Alcohol Syndrome (FAS) in 1972. His talks have been extremely informative and eye-opening. First, I was astounded to hear that drinking alcohol during pregnancy is the #1 cause of mental retardation in the United States. In fact, there are more children that have neurodevelopmental problems due to their mothers drinking alcohol in pregnancy than there are children with autism in the U.S. Unfortunately, there is no known way to prevent autism, however an alcohol-related neurodevelopmental problem or FAS is 100% preventable by abstaining from alcohol in pregnancy.

A diagnosis of FAS means that a child prenatally exposed to alcohol has exhibited all three of the following criteria: poor growth, neurodevelopmental problems (such as intellectual, behavioral or social deficiencies), and facial anomalies like a long, smooth upper lip.  Other birth defects have been associated with FAS like heart and limb abnormalities. Women who drink 4-8 servings of alcohol per day during pregnancy have about a 44% chance of having a child with FAS while women who drink 2-4 drinks per day throughout the first trimester have about an 11% chance of having a child with FAS. Binge drinking (5 or more drinks in one day) may be the most harmful for the baby since the liver may not be able to metabolize everything, exposing the fetus to more alcohol.

So, what’s wrong with having one drink once in a while? Unfortunately, FAS is just the tip of the iceberg, representing the most extreme cases of prenatal alcohol exposure. Fetal Alcohol Spectrum Disorders or FASD is the term used to describe the range of effects seen in children whose mothers drank alcohol in pregnancy. The most common outcome seen in alcohol-affected children is neurodevelopmental deficiencies, supporting the theory that alcohol directly affects the fetus’ brain development. Because the fetus’ brain is developing during all three trimesters, there is no safe period during pregnancy for alcohol consumption.  Furthermore, after more than 30 years of research, researchers have not found a level of drinking during pregnancy under which they can say confidently that the developing baby would not be affected. In fact, some studies have shown that mothers who drank as little as less than one drink per day in pregnancy had babies that exhibited signs of lower mental development.

Other reasons for the lack of a safety threshold are: 

1. Every single person (and fetus) in the world has a different genetic susceptibility to alcohol.  So, in Dr. Jones’ words, “any recommendation of a low amount of alcohol for a woman to drink could be safe for some and devastating for others.”
2. The different patterns of drinking are not well studied in pregnancy.
3. Some neurodevelopmental problems caused by prenatal alcohol exposure may not present themselves until later in the child’s life, such as when they enter school. More long-term studies are needed to measure these effects.

By now, our table was pretty hushed and, I have to admit, a little melancholy. In my defense, once I get started, my scientific nerdiness is hard to contain. But just as the orange leaves brighten up otherwise gloomy fall days, the mood brightened when we all decided that the non-alcoholic “Sparkler (sparkling apple cider, ginger and cinnamon)” on the drink menu sounded just as delicious as our previous pumpkin martini orders. Sara shot me a smile that read “thank you” and the lively conversation resumed.

Although facing the extended family this holiday season may seem daunting without a little vino, pregnant women should be proud that with every sip they take of soda, virgin Sex on the Beach or Shirley temples in replace of alcohol, they are NOT increasing their baby’s risk for mental retardation, alcohol-related birth defects, or life-long learning and behavioral problems. This holiday season, I’ll be supporting Sara and other pregnant moms by accompanying them at the kiddie table, making delicious fruity drinks and emphasizing the fact that nine short months of abstaining from alcohol are really just a small sacrifice in the grand scheme of things. Now THAT’S something to raise your glass of “Sparkler” to this Thanksgiving. Cheers!

Nadia Mohamedi is a certified teratogen information specialist and also serves as a research assistant/interviewer for OTIS studies in San Diego, CA. She holds a BA in neurobiology and a minor in psychology from Harvard College. In addition to her work with OTIS, Nadia has worked for the Alcohol and Drug Abuse Treatment Program at McLean Hospital as well as served as a teacher’s assistant at a school for children with disabilities in Lima, Peru.

OTIS is a North American non-profit dedicated to providing accurate evidence-based information about exposures during pregnancy and lactation. Questions or concerns about alcohol during pregnancy or breastfeeding can be directed to OTIS counselors at (866) 626-OTIS (6847) or online at OTISPregnancy.org.

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