Here's a message that bears repeating:

Alcohol and pregnancy don't mix.

Whenever you take a drink, your baby does, too. That's because alcohol easily crosses your placenta and enters your baby's system. And because a developing body can't process alcohol as quickly as an adult, an unborn baby can end up with a higher level of blood alcohol than its mother.

It's well known that drinking heavy quantities of alcoholic beverages is risky during pregnancy. Every year, thousands of babies are born with Fetal Alcohol Syndrome (FAS) as a result of alcohol exposure. The condition is characterized by cognitive and behavioral impairments, growth deficiencies and specific changes in facial features. Fetal Alcohol Syndrome is also the most common cause of preventable mental retardation. In addition to severe learning difficulties, affected children have poor coordination, poor social skills, impulsivity and a shortened attention span. Abstaining from alcohol during pregnancy completely prevents this condition.

While it is clear that frequent drinking, defined as more than seven drinks a week, or binge drinking, consuming more than five drinks at a time, increases the risk of FAS, no level of drinking has been determined to be safe during pregnancy. Many children have lifelong cognitive and behavioral problems stemming from prenatal exposure, and some studies have shown problems resulting from as little as one drink per week. Furthermore, animal studies reveal that as little as one exposure to alcohol can interfere with nerve cell development.

More than 40,000 children a year are born with some degree of alcohol-related impairment. While most may not show the physical features of Fetal Alcohol Syndrome, they do have learning difficulties and behavioral problems including hyperactivity, impulsivity and poor communication skills.

Heavy alcohol use has other consequences as well. Pregnant women are at risk for vitamin and mineral deficiencies, liver damage, depression and certain kinds of cancer. Other effects of alcohol include increased rates of infertility, miscarriage and low birth- weight infants.

These facts prompted the U.S. Surgeon General to release an advisory, in February of 2005, on alcohol use in pregnancy. The new recommendation advises all pregnant women as well as those trying to conceive to completely abstain from alcohol to prevent all alcohol-related birth defects. This replaces previous federal advisories that recommended limiting alcohol intake during pregnancy.

But what about the occasional glass of wine—is this a problem? It's likely that drinking a small amount every now and then won't cause significant harm, especially after the 1st trimester. However, while I tend to offer reassurance to patients who have indulged in an occasional drink, no one has ever studied whether there is a safe level of alcohol consumption during pregnancy. So it's prudent to avoid further alcohol exposure for the remainder of pregnancy

. To summarize:

• No level of alcohol is known to be safe during pregnancy.
• Avoid alcohol if you are trying to conceive.
• The risk and severity of fetal alcohol disorders increase as the amount of alcohol consumed increases.
• Alcohol may pose a risk at any stage of pregnancy. Earlier exposure may be linked to Fetal Alcohol Syndrome. Later exposure may affect growth and behavior.
• The cognitive and behavioral impairments resulting from prenatal alcohol exposure are irreversible and lifelong.
• Alcohol related birth defects are entirely preventable.

Further information on alcohol effects and ways to stop drinking can be obtained through the following organizations:

Alcoholics Anonymous (AA)
http://www.alcoholics-anonymous.org

National Council on Alcoholism and Drug Dependence
http://www.ncadd.org

National Institute on Alcohol Abuse and Alcoholism http://www.niaaa.nih.gov

National Organization on Fetal Alcohol Syndrome
http://www.nofas.org