Doctors aghast as Brits OK booze for expectant moms

First, overweight moms-to-be were told, stop eating for two. Now, there's a move in Britain -- though not in Canada -- to advise pregnant women it's safe to drink a little bit of alcohol daily during pregnancy.

The influential National Institute for Health and Clinical Excellence in London says its experts have concluded "no consistent evidence" exists that low-to-moderate alcohol during pregnancy (less than one drink per day) is harmful to the fetus after the first three months of pregnancy, though they can't rule out zero risk.

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 alcohol, whether it's 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. It's not known when the new guidelines will be published. The Ottawa-based group currently recommends women be encouraged to avoid 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 pure alcohol) per 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 on standard drink as a 330 mL bottle of beer or a 125 mL glass 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 Toronto's Hospital for Sick Children, called the British move "scary."

"It's 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 on light drinking during pregnancy by Canada's public health agency says one study that tracked 580 children and their mothers found detectable "deficits" in height, weight and head circumference at exposure levels of below one drink per 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 per week.

"Alcohol is not good for the (developing) brain. So why suggest to women they can drink. What's 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."

Heavy drinking during pregnancy is known to increase the risk of fetal alcohol syndrome. According to Health Canada, it's 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.

Koren worries that women who hear it may be OK to drink a little bit of wine won't know how much is a little. Problem drinkers especially have a hard time with limitations and boundaries.

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