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Jan 27, 2009

There's no evidence that drinking small amounts of alcohol in pregnancy harms babies, according to doctors advising the government on antenatal care. But they say you cannot rule out the risk completely.

What do we know already?

Alcohol in the bloodstream of a pregnant woman can cross the placenta to her unborn baby. We know that drinking large amounts of alcohol can harm the growing baby. In cases where the mother drinks a lot throughout pregnancy, it can cause fetal alcohol syndrome, where the baby is born with a smaller head and has problems developing. But we don't know for sure how much alcohol is safe.

The current guidelines from the Department of Health say women should avoid drinking any alcohol during their pregnancy. But some doctors disagree with this advice. They say drinking small amounts of alcohol is unlikely to cause any harm.

What does the new report say?

A group of doctors and other experts are putting together guidelines for the NHS about how women should be cared for during their pregnancy. These guidelines will include advice on whether pregnant women should drink alcohol.

The group has published an early version of the guidelines. It says pregnant women should drink less than one standard alcoholic drink a day and if possible avoid alcohol completely in the first three months of pregnancy. A standard alcoholic drink (1.5 UK units or 12 grams of alcohol) is the same as one small glass of wine or half a pint of ordinary-strength beer or lager. The early version of the guidelines also says women should be warned that binge drinking (more than five standard drinks on one occasion) may be particularly harmful while pregnant.

The group has reviewed all the available research about alcohol in pregnancy. They say there is no clear evidence that drinking less than one standard alcoholic drink a day in pregnancy can harm babies, but the risk can't be ruled out completely.

Anyone can comment on the draft guideline, until 29 October. The group will take account of all the comments before publishing a final version of the guideline, in March next year. You can find the draft guideline on the website http://www.nice.org.uk/page.aspx?o=451448.

Where does the report come from?

The draft guideline was written by a group including GPs, obstetricians, researchers, midwives and patient representatives. It is published by the National Institute for Health and Clinical Excellence, which was set up to advise the government on healthcare.

What does this mean for me?

If you are pregnant or planning a pregnancy, you probably already have a long list of 'dos' and 'don'ts' to remember. It can be confusing when the experts don't agree about what's safe.

The advice from the government is simple, and hasn't changed. It says women should not drink any alcohol in pregnancy. This new report is not the final version of advice about pregnancy. The final version won't be published until next year.

But the new report is based on good-quality evidence. So if you think it is too restrictive to avoid any alcohol in pregnancy, you could use the new report as a guide. If you follow this, you'll need to drink less than one standard drink a day. A standard drink is one small glass of wine, or half a pint of ordinary-strength beer or lager. Drinking less than one a day means you don't have a drink every day. The report warns that more than five standard drinks on one occasion can be harmful.

The report also says women should avoid alcohol completely in the first three months of pregnancy. That's because the risk to the baby might be highest at that time. The report says there may be a slightly increased risk of miscarriage from drinking even small amounts of alcohol. Miscarriage is most common in the first three months.

What should I do now?

If you are pregnant, or planning a pregnancy, deciding about whether to drink alcohol is just one of many things to think about. If you are confused about what is or isn't safe for you and your baby, speak to your GP or midwife. They should be able to give you all the information you need, in booklets you can keep at home for reference.