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Monday, January 7, 2008

Alcohol and Babies don't mix... (ahem, Britney)

So officially, the American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists (ACOG) both do not have a "safe" amount of alcohol to imbibe during pregnancy or breastfeeding. As you can imagine, it can be a slippery slope and it can depend on what developmental stage the baby is in. Fetal alcohol syndrome is the most common preventable cause of mental retardation in the US. That is the party line (to prevent us docs from getting sued).

I don't know what it is about pregnancy when all the things on the forbidden list of no-no's makes you crave a peach margarita like a socialite craves attention. Or like a hooker craves, oh never mind... Personally, I probably had the equivalent of 2-3 small glasses of red wine spread out over the 9.5 months of my pregnancy. So that works out to about 0.043 oz/day (yes, I am a big nerd and I actually calculated it). Which is about a baby sized dropper of wine a day. Granted, that logic doesn't work very well, but it makes me feel better, so shut it, okay?

I have heard old school OBs/nurse-midwives actually recommend an occasional small glass of wine towards the end of pregnancy as a tocolytic (an agent that can relax the uterus to ease the intensity of Braxton-Hicks contractions). I would err on the side of caution with alcohol during PG and abstain. Do as I say, not as I do. I don't want to be the reason that your kid didn't get into Harvard. State school is good enough for us.

After pregnancy, I will admit that my husband and I shared a small bottle of real champagne in the hospital room about 6 hours after the baby was born. My lactation consultant friend told me that in the Middle Ages, midwives gave new mothers beer to help with the breastfeeding. My suspicion was that a little beer helped chill out the mothers during the stressful process of learning to breastfeed. I didn't even have time to think of drinking in the first few months, though. According to La Leche League, it is probably safe to BF in pregnancy. Here is the article. Some common sense advice for drinking while lactating (but please read the article):

-ALWAYS drink in moderation
-wait until you baby goes to sleep for the night before having or drink
-don't breastfeed if you are feeling the effects of the alcohol
-pump and dump if it makes you feel better
-don't co-sleep while intoxicated (seems like that would be obvious, but you'd be surprised)
-if you are not sure, give your baby some expressed breast milk or a bottle of formula.

Now for real fun, drop the kid at the sitter's or Grandma's and drunk dial someone you love. Ahhh, memories....(just kidding)


Beth Sprague said...

Thanks for addressing this; it's ovbiously a popular question form other comments, and I'd wondered it myself! I plan to enjoy a 1/2 glass of red wine in months 8 and 9, but hey, state school is good enough for us too (we can't afford Harvard!!) wink wink...

Michelle said...

As a former fetal alcohol syndrome prevention researcher, here's my bit. There are a number of medical journal articles out there that actually review the recommendations by obgyns regarding their take on alcohol use during pregnancy. One Swedish study actually found that when doctors said to women "you can have a drink every once in a while during pregnancy" women took that to mean anywhere from once during pregnancy to 6 drinks a week! I feel that if it's the most preventable thing, why not abstain...there are so many other factors we absolutely cannot control during the baby's development in utero and that is one thing we can. Of course the neonatologist that worked on my study admitted to a few drinks during all her pregnancies so there ya go.

When I asked my friend, the La Leche League leader, what her feeling was on drinking while breastfeeding, she said a drink or two won't hurt anything. Granted, doctors used to actually tell women to have a drink as it aided in milk let down. Of course we know this is not true...more often it just made the women relax and when you are relaxed it's easier to let down.

Anonymous said...

Thanks for addressing this Tobi. I've wondered why there is such conflicting information and wonder if some of it isn't societal / cultural norm or perspective. After all, from what I understand, pregnant women in other parts of the world do drink occassionally while pregnant without horrific consequences to themselves or their babies. And I mean like one drink every two weeks, not 6 drinks per week.

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