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How Much Christmas Punch
Is Allowed for Pregnant Women?

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

This article originally appeared on page 19 in the December 13-14, 2003 issue of
The Mississauga News under the feature: Health & Wellness, Doctor's Corner.
Portrait of Dr. Peter W. Kujtan, supplied 2005
Dr. Peter W. Kujtan

Alcohol intake is not recommended during pregnancy anymore. The reason is a syndrome called Fetal Alcohol Syndrome (FAS). FAS is a group of physical and mental problems which can develop in some unborn babies when their mothers drink too much alcohol during pregnancy. These include low birth weight, slower development, skeletal deformities, facial abnormalities, organ deformities and central nervous system problems. We see varying degrees of mental retardation, learning disabilities, irritability, hyperactivity, and poor coordination. The true frequency of occurrence is unknown, but is thought to affect one child out of every 3000 births. There is also a newer entity called Fetal Alcohol Effects (FEA). It is milder than FAS and probably more common. FAS is more commonly associated with binge drinking and with alcoholism, but there has been the rare case in lighter alcohol users. The risks increase with ingesting more than 1oz of pure alcohol daily and with binge drinking.

Some women worry about the amount of alcohol consumed before they realized that they were pregnant, and there is no testing that can be done in pregnancy to reassure them. If during this time they drank more than three drinks a day, then the risk is increased. FAS is a difficult entity to diagnose. It often takes months to years of careful and repeated observation by the same health care team to even entertain the notion.

The decision to ingest alcohol during pregnancy should not be a difficult one. The unborn fetus feels the effects of alcohol as soon as the mother does. There are many exposures during pregnancy that are considered a balanced risk. Ingesting an antibiotic to treat a urinary infection is an example. The infection could have more dire consequences than using the drug to cure it. Similarly, choosing to use anti-vomiting medication to ensure fetal nutrition is maintained is another good example. But there is no circumstance where regular alcohol consumption out balances a negative consequence of pregnancy. Drinking alcohol is a social choice made by the mother. There is no good medical reason for it. We know that alcohol is produced in our gut during digestion of food. It is a small quantity and has little effect.

In the end, having that one glass of spiked Christmas Punch is a relative risk just as wearing your seat belt is. There is no certain evidence that one drink will cause any deleterious effects. My advice is to become aware of the risks and then decide for yourself. The medical pendulum has now swung to advocating total abstinence from alcohol during pregnancy.

Related resources:

Fetal alcohol spectrum disorder from Wikipedia, the free encyclopedia.
Fetal Alcohol Spectrum Disorders (FASDs) from Centers for Disease Control and Prevention (CDC). Facts about FASDs, Cause and Prevention, Signs and Symptoms, Types of FASDs, Diagnosis, Treatment, Get help.
Fetal Alcohol Syndrome from HealthLine. What is fetal alcohol syndrome? What are the causes of fetal alcohol syndrome? What are the symptoms of fetal alcohol syndrome? How is fetal alcohol syndrome diagnosed? What are the treatments for fetal alcohol syndrome? How can I prevent fetal alcohol syndrome?
FASLink: Fetal Alcohol Disorders Society from faslink.org. The FASlink Collection is an extensive compilation of key articles about FASD. Fetal Alcohol Spectrum Disorders (FASD), Fetal Alcohol Syndrome (FAS), Fetal Alcohol Effects (FAE), Partial Fetal Alcohol Syndrome (pFAS), Alcohol Related Neurodevelopmental Disorders (ARND), Static Encephalopathy Alcohol Exposed (SEAE) and Alcohol Related Birth Defects (ARBD) are all names for a spectrum of disorders caused when a pregnant woman consumes alcohol. FASD is 100% preventable.
Fetal alcohol syndrome from Mayo Clinic. Symptoms & causes. Diagnosis & treatment.
Fetal Alcohol Syndrome Fact Sheet from ADA - Division of Alcohol and Drug Abuse.
Fetal alcohol syndrome from MEDLINE Plus with more information on FAS plus an illustration of the
Simian crease or Single palmar crease.

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