Alcohol and Pregnancy: Risks, Alcoholism, Treatment

To drink or not to drink while pregnant is a subject that has long been debated and one surrounded by much controversy. Due to stigma and fear of shame, many women are reluctant to even ask the question. Others see no problem in taking an occasional drink. Unclear guidelines and mixed information don’t help people to decide what’s best. Most health organisations, including the HSE, will advise women to avoid alcohol during pregnancy. For a good reason. There are many risks associated with doing so. However, around 63% of women in Ireland admit to having some alcohol while pregnant, making it the highest rate in the world.

At Smarmore Castle we are clear in our advice that alcohol is best avoided altogether during pregnancy. Although an occasional drink may do no harm, alcohol is known to break down inhibitions, and the risk that one drink might lead to several more is best not taken.

Drinking during pregnancy is more likely among younger women and those living in affluent socio-economic environments.

If so many women are doing it, you might ask if it’s really that harmful. The short answer is that there is no extensive evidence that moderate drinking does damage to the unborn child. However, there are limited studies on this topic, and each one comes out with a conclusion opposite to the one before it.

One minute it’s ok, the next it’s not. At one time, alcohol use was even encouraged. Then it was forbidden. However, the risks still exist and should be known. As long as you are knowledgeable about and understand the risks, you are free to make your own decision.

So, Can I Drink Alcohol When I’m Pregnant?

The answer to this question depends on how much you drink, but the decision to do so or not is entirely up to you. It is one thing to have an occasional small drink, but the risk of doing damage increases with additional consumption.

In Ireland, a woman cannot be held criminally liable for the effects on her unborn child of substances consumed in pregnancy. But in other countries, such as the USA, they may be subject to prosecution.

If you have a maximum of two units of alcohol a week, which is classified as light drinking, the risks are quite low. Having more than that increases the chance of complications. Drinking during the first trimester increases them even more.

Binge drinking should be avoided at all costs, as that can lead to FAS (foetal alcohol syndrome) and other severe development issues, along with complications for the mother. To avoid FAS, the HSE recommends not to go above the low-drinking guidelines, and decrease or eliminate use as much as possible.

Keep in mind that a unit is half a pint of beer, a medium (175mL) glass of wine, or a single measure of a spirit. You can use the DrinkAware calculator to double-check the exact units, as they depend on the ABV of the beverage.

How much you can drink will also depend on how well you metabolise alcohol. However, regardless of your tolerance, remember that even the smallest amount of alcohol will be passed to your baby. Since the liver is one of the last organs to develop, just a sip will affect them much more dramatically than it will you.

What Are the Risks of Drinking Alcohol During Pregnancy?

Alcohol consumption carries many risks, whether you’re pregnant or not, but it affects pregnant women even more, and not just because there are two people involved. However, because of the lack of thorough studies and mixed information, it is also possible that other factors, such as diet, stress, or living environment, can play a role.

The most common consequence of drinking while pregnant are low birthweight and premature birth (8%), but other risks for the baby include:

  • Miscarriage

  • Stillbirth

  • Respiratory problems

  • Acute myeloid leukaemia
  • Cognitive impairment

  • Poor organ development

  • Foetal alcohol syndrome (FAS)

  • Other foetal alcohol spectrum disorders (FASD)

Foetal alcohol syndrome is the most severe consequence on the spectrum, and it can range in severity as well. It is essentially the abnormal development of the baby due to alcohol poisoning. This can mean:

  • Behavioural problems

  • Poor coordination

  • Cognitive impairment and learning disabilities

  • Hearing and vision problems

  • Brain and organ damage

  • Cleft palate

Children with FAS are also more likely to engage in alcohol or drug use, or other risky behaviours. They are also more likely to have trouble with socialising and authority.

All of the above-mentioned risks may not be evident at first. A baby may be born appearing to be healthy. However, problems, especially cognitive-related ones, may arise as the child ages.

Risks for the Mother

Pregnancy can be hard for many women, with issues like morning sickness and anaemia, among many others. Drinking alcohol increases the risks of many such complications, including high blood pressure and gestational diabetes.

You may also elevate your level of depression, stress and anxiety if you drink. Alcohol is known to increase all of these conditions over time. Alcohol can also have a negative effect after birth, especially if the mother is suffering from postnatal depression.

The baby’s well-being aside, miscarriage and stillbirth can also be devastating for the mother to experience. Effects can be both psychological and physical. In addition, raising a child with a disability can be challenging for many.

Risks of Alcohol Before Pregnancy

Alcohol can also have affects on pregnancy and/or the baby if consumed before conception or after birth. For example, alcohol lessens fertility for both men and women. Development-related risks also still exist, though are minor.

Risks When Breastfeeding

After the baby is born, many mothers ask if they can drink while they breastfeed. As with drinking while pregnant, the answer is not fully clear and is ultimately up to the mother. However, it is considered harmful to the baby and at Smarmore Castle we advise any mother to abstain completely from alcohol while breastfeeding. 

Alcohol passes through breast milk and can affect the baby. It may even contribute to alcoholic behaviour in the child at a later date. It can also affect how much milk the mother produces.

Also, the baby may be put-off by the alcohol and end up eating less. This doesn’t necessarily mean malnourishment, but it does mean the baby will need to be fed more often. The alcohol can also disrupt the baby’s sleep, which is likely to be irregular to begin with.

If you do choose to drink while breastfeeding, keep in mind that it takes two hours for one unit of alcohol to be processed by your body. As long as you breastfeed once you’ve metabolised the alcohol, there shouldn’t be complications for your child.

I Didn’t Know I Was Pregnant and Had Alcohol, Now What?

It is unlikely you have caused any damage, even if you had one too many, but it is possible. After all, many women continue to drink alcohol normally until they are aware that they are pregnant.

If you’re concerned, stop immediately and do not drink anymore. Only your doctor can truly assess your and your baby’s health so it is best to speak to a medical professional.

What if I Am Concerned About My Drinking?

You shouldn’t be afraid to speak to your GP or midwife if you have any concerns about whether or not or how much you can drink. You can also find more information and links to appropriate services at

Many women find it harder to quit drinking alcohol when pregnant than they thought. It isn’t always easy for anyone. However, it can be done. It is helpful to have support from your partner, friends, and family. If you don’t want to miss out, you can switch to mocktails or other non-alcoholic beverages when you’re in company. Alternatively, try to engage in activities that do not involve alcohol at all.

If you have no intention of drinking, you should make it clear in the beginning and do not hesitate to repeat yourself. Social pressure is one of the main reasons why women choose to continue drinking. You can also ask those around you to avoid drinking around you.

However, if you cannot stop or limit your drinking, it is best to consult your doctor or local alcohol service. There is no shame in doing so. You can also find an Alcoholics Anonymous meeting near you to start. Failing to quit despite multiple attempts may be a sign of addiction.

How Is Alcoholism During Pregnancy Treated?

Alcoholism during pregnancy is rare, as most women do not exceed the low-limit guidelines, however it can happen. If so, it is treated the same way as alcoholism is most people. This means a period of detoxification, therapy and aftercare.

Inpatient treatment for alcohol addiction is highly recommended in long-term or heavy users, due to the risk of dangerous withdrawal symptoms. And it is also advised for all pregnant women, as there could be complications involved.

It is very important to treat alcoholism in pregnant women properly. If a mother is alcohol dependent, it is possible for the baby to experience withdrawal symptoms after birth, so there needs to be swift medical intervention.

Smarmore Castle offers help for all people with alcohol and drug dependencies, as well as other addictions. You and your baby can be sure to be taken care of as we have fully trained medical staff on site 24/7. If you are considering rehab for your alcohol use, you can call us at +353 41 214 5111 for a consultation.

Remember, pregnant or not, no amount of alcohol is healthy. Many mothers choose to take the cautionary route and avoid alcohol during pregnancy, but it is your right to decide what is best for you and your future child. So if you have doubts, it is best to stop drinking for a while. 

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