Women shouldn't drink when they're pregnant — absolutely no alcohol at all, according to the American Academy of Pediatrics. But it's been getting a lot of pushback about that edict.
After we reported on it last week, the comment stream exploded with hundreds of people arguing over whether moderate drinking in pregnancy is safe.
First, TwentyTwo Over Seven wrote:
Every time that I see anything on this topic it tends to conflate "drinking" (which is binary, you either had any amount of alcohol or you didn't) with something most people would consider moderate to heavy drinking (several drinks a week or at a time). I've also seen repeated studies (mostly out of Europe) that have shown zero effects for those who had 1-2 drinks (or less) a week.
KHolmes countered with:
What you are missing is the nature of alcohol, its toxicity to human cells, and the fragile and rapidly growing brain of the fetus. Nearly anything can be justified by those who wish to justify, but ANY alcohol gets to the brain of the fetus. Articles written with vague assumptions by those wishing to sell magazines, and who know how to write a "feel good" article, do not constitute research.
Inherit the Window added:
Pregnancy is stressful and difficult. Your whole life is changing and it's about to change even more dramatically. Whatever harm may be vaguely associated with one or two small glasses of wine per week, that you consume over the course of several hours (the strategy I've most often seen with light drinking during pregnancy), that harm has to be weighed against the psychological benefits of said consumption.
We probably all know someone who had a few glasses of wine while pregnant and the baby turned out just fine. Up to 10 percent of women say they drank alcohol at some point in pregnancy, according to the Centers for Disease Control and Prevention. And we're not seeing big problems in 8 to 10 percent of children.
That seems to be fueling the sense that the doctors are being too doctrinaire here.
But Janet Williams, a professor of pediatrics at the University of Texas Health Science Center in San Antonio and lead author of the report, says it's really impossible to say what level of drinking is safe. "Not finding something is not necessarily the same as being safe. It could be that our tests are not sensitive enough to detect it."
When fetal alcohol syndrome was first identified in the 1970s, the focus was on serious birth defects and developmental disabilities caused by excessive drinking. But now scientists say they've identified many more subtle effects, including learning disabilities and problems with vision and hearing, that are associated with alcohol exposure in the womb.
How much alcohol? We don't know. We also don't know who's most at risk. Susceptibility varies among people, and there's no way to predict if you, or your baby, are among the vulnerable.
That's why Janet Williams says she has no problem being an absolutist on this one. "The choice is really between your desire to have a desirable effect from alcohol versus the risk of lifetime harm to the baby. That's the choice."
STEVE INSKEEP, HOST:
Now we have the latest advice for women who are pregnant. The advice is. don't drink. Now, this is not a question of whether you drink a lot. People have known for decades that's a bad idea. They've known about fetal alcohol syndrome. The real question is whether a pregnant woman can drink a little. To that question, the American Academy of Pediatrics says no, absolutely not, no alcohol at all. This zero-tolerance policy is getting a surprising amount of pushback. Here's NPR's Nancy Shute.
NANCY SHUTE, BYLINE: I thought we all agreed that women shouldn't drink while pregnant. Boy, was I wrong. When we posted a story about the pediatricians' report on NPR's Shots blog, the comments exploded. There were hundreds of people arguing over whether moderate drinking in pregnancy is safe. One person wrote...
UNIDENTIFIED WOMAN: (Reading) I've seen repeated studies that have shown zero effects for those who had one to two drinks or less a week.
SHUTE: And then there's this.
UNIDENTIFIED WOMAN: (Reading) It makes you feel good and relaxed. Feeling good is good for you and your baby.
SHUTE: Now, 8 to 10 percent of women say they drank alcohol at some point in pregnancy. And we're not seeing big problems in 8 to 10 percent of children. So why zero? To find out, I called Janet Williams, the lead author of the report.
JANET WILLIAMS: Not finding something is not necessarily the same as it being safe. It could be that our tests are not sensitive enough to detect it.
SHUTE: That's not the case with severe birth defects linked to fetal alcohol syndrome.
WILLIAMS: At high levels of alcohol exposure, it's definitive. There's no question that this is a toxin. And it's considered the leading preventable cause of birth defects and neurodevelopmental disabilities.
SHUTE: But scientists also know that drinking in pregnancy is related to more subtle problems, like learning disabilities. And we don't know how much alcohol causes that or who's most at risk.
WILLIAMS: Some people - we can't predict who - are more sensitive to alcohol effects, whether you're pregnant or not.
SHUTE: Which may mean some babies do face more risk.
WILLIAMS: To say something is safe is a whole leap in faith.
SHUTE: Some of our commenters say doctors are being way too hard on women. But Janet Williams says if you're pregnant, it's just not worth it.
WILLIAMS: The choice is really between your desire to have a desirable effect from alcohol versus the risk of lifetime harm to the baby. That's the choice.
SHUTE: So maybe indulge in a massage or a bowl of ice cream instead. Nancy Shute, NPR News. Transcript provided by NPR, Copyright NPR.