“Everything in moderation.”

Except alcohol during pregnancy.

That’s the word from the American Academy of Pediatrics (AAP) last month from a new report of Fetal Alcohol Spectrum Disorders. Recognizing that, “prenatal exposure to alcohol can damage the developing fetus and is the leading preventable cause of birth defects and intellectual and neurodevelopment disabilities,” the authors of the report conclude that any consumption of alcohol during pregnancy is ill-advised:

  • Alcohol-related birth defects and developmental disabilities are completely preventable when pregnant women abstain from alcohol use.
  • Neurocognitive and behavioral problems resulting from prenatal alcohol exposure are lifelong.


The AAP wants us all to know that during pregnancy:

◦ no amount of alcohol intake should be considered safe;

◦ there is no safe trimester to drink alcohol;

◦ all forms of alcohol, such as beer, wine, and liquor, pose similar risk;

◦ binge drinking poses dose-related risk to the developing fetus.


The typical facial features seen in fetal alcohol syndrome (FAS) can be subtle and lie across a spectrum of signs and symptoms, as do other effects of alcohol on the fetus:

Prenatal alcohol exposure is a frequent cause of structural or functional effects on the brain, heart, bones and spine, kidneys, vision and hearing. It’s associated with a higher incidence of attention-deficit/hyperactivity disorder and specific learning disabilities such as difficulties with mathematics and language, visual-spatial functioning, impaired impulse control, information processing, memory skills, problem solving, abstract reasoning and auditory comprehension.


Recent surveys have shown that approximately half of women of childbearing age report “past month alcohol consumption.” Of those, 15% report binge drinking (defined for women as “drinking four or more drinks per occasion.”) But even lesser amounts — as little as one drink per day — has been shown to have effects on the fetus, including growth retardation. Mothers who drink in the first trimester have a 12-fold increased risk of having an infant born with fetal alcohol syndrome; first and second trimester drinking increases the FAS risk 61 times; and drinking during all three trimesters increases the odds of FAS by 65.

Here’s the big problem the AAP’s report highlights: By the time a woman finds out she’s pregnant, many weeks have passed since conception. The best advice would be that any woman of childbearing age should not drink any alcohol if pregnancy is even a remote possibility. But how realistic is that?