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U.K. doctors rethink ban on alcohol in pregnancy
An influential British medical association has concluded there is no consistent evidence that moderate drinking during pregnancy is harmful to the fetus after the first trimester.
However, the National Institute for Health and Clinical Excellence in London cautioned that it couldnt rule out risk altogether.
The draft recommendation caught Canadian doctors and officials by surprise. The Public Health Agency of Canada says there is no known time during pregnancy when it is safe to drink beer, wine, cocktails, coolers, hard liquor or even hard ciders.
Their position is clear: Pregnant? No booze.
The Society of Obstetricians and Gynaecologists of Canada said Thursday it is working on updated recommendations on the topic. Its not known when the new guidelines will be published. The group currently recommends avoiding alcohol and unnecessary drugs during pregnancy.
The British group, which provides national public health guidance, is proposing moms-to-be limit their alcohol intake to less than one standard drink (or 12 grams of alcohol) a day and if possible avoid alcohol in the first three months of pregnancy.
Women should be informed that binge drinking (defined as more than five standard drinks on a single occasion) may be particularly harmful during pregnancy, according to the draft recommendation. The U.K. measures a standard drink as a 330 mL bottle of beer or a 125 mLglass of wine.
Spokesperson Alice Law says experts crafting the new guideline have carried out a systematic review of all the evidence available on the risks of drinking alcohol in pregnancy.
They concluded that there is no consistent evidence of adverse effects from low-to-moderate alcohol during pregnancy (less than one drink per day), but the evidence is probably not strong enough to rule out any risk, according to a statement Law e-mailed.
Experts are still being consulted and the final recommendation is due out in March.
Dr. Gideon Koren, founder and director of the Motherisk program at Torontos Hospital for Sick Children, called the British move scary.
Its quite shocking for us to see it. It neglects, or just ignores, a huge body of evidence that does show mild drinking does cause issues.
An as yet unpublished review by Canadas public health agency of light drinking during pregnancy says one study that tracked 580 children and their mothers found detectable deficits in height, weight and head circumference at exposure levels of less than one drink a day. At 10, 14 and 16 years of age, the exposed kids also showed problems with intellectual ability and learning difficulties. Another study found six- and seven-year-olds exposed to alcohol in the womb were 3.2 times more likely to have behaviour and aggression problems compared to non-exposed children. The effects were seen at as low as one drink a week.
Alcohol is not good for the (developing) brain. So why suggest to women they can drink? Whats the advantage of it? says Koren, professor of pediatrics, pharmacology, pharmacy and medical genetics at the University of Toronto.
There is no way in Canada any responsible body will tell (pregnant) women they can drink.
But he worries some people may automatically accept the British advice as if it were homegrown. Canadians share the same language and much culture with Britain, and dont think of the British medical establishment as being all that foreign.
Heavy drinking during pregnancy is known to increase the risk of fetal alcohol syndrome. According to Health Canada, its estimated that at least one child is born with fetal alcohol syndrome each day in Canada, with the lifetime costs of caring for such children estimated at $1.4 million.
Fetal alcohol syndrome causes lifelong learning, memory and attention problems. Babies are born with damaged brains, impaired growth, small heads, flat mid-faces, thin upper lips and other distinct facial features. It has been called the leading preventable cause of birth defects.
Koren worries that women who hear it may be OK to drink a little bit of wine wont know how much is a little. Problem drinkers in particular have a hard time with limitations and boundaries.
About three-quarters of the Canadian female population between the ages of 18 to 44 drink alcohol, and about half of pregnancies are unplanned.
It doesnt mean we should scare women who happened to have had a drink before they knew they were pregnant, Koren says. But here is a national body telling women you can go and drink. In my mind theres no research to prove its safe.
According to an Environics survey for Health Canada in July 2002, 98 per cent of women surveyed know that alcohol use during pregnancy is harmful, but almost half 48 per cent believe that small amounts can usually be considered safe.
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