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Women, Pregnancy, Breastfeeding, Children and Alcohol

Women and Alcohol

Women, more likely than men, drink to relive anxiety or depression [1].

Women may have about 30% higher blood alcohol concentration (BAC) after drinking the same amount of alcohol than men of the same body weight [2]. Menstrual cycle does not significantly affect the absorption or elimination of alcohol [3]. Women eliminate alcohol at about the same rate as men of the same body weight [3].

Moderate Drinking

Moderate drinking in women is defined as 1 drink per day, which is one 12 oz can of beer (4% abv), one 5 oz glass of wine (12% abv) or one 1.5 oz jigger of spirit (40% abv or 80 proof).

Moderate drinking is associated with reduced risk of osteoporosis in women after menopause [4].

According to several observational studies, even moderate drinking may increase the risk of breast cancer in women [7].

Effects of Heavy Drinking

Heavy drinking may increase blood estrogen levels, which may result in irregular menstruation or infertility [5].

Acute alcohol intoxication increases the blood levels of the hormone testosterone in women [6].

Alcohol and Pregnancy

Pregnant women and women who may get pregnant soon should not drink any alcohol (including “nonalcoholic” beer) in order to prevent its harmful effects on the unborn babies.

Does alcohol affect the pregnancy test?

No, alcohol and illegal drugs do not affect pregnancy tests [22].

Fetal Alcohol Syndrome (FAS)

Heavy drinking during pregnancy may cause damage to a developing fetus known as fetal alcoholic syndrome (FAS). Alcohol passes the placenta and may damage the internal organs of the unborn baby, especially the brain and heart. Symptoms and signs of FAS may include [7,8,9]:

  • Facial abnormalities: small head, short-width eyelids, low nasal bridge, short nose, thin upper lip, no groove between the mouth and nose. NOTE: Resembling facial features may be seen in some healthy children or in certain genetic disorders.
  • Poor growth, low birth weight, deformities of joints, limbs and fingers, low muscle tone, impaired coordination
  • Vision and hearing problems
  • Seizures
  • Mental retardation, difficulty learning
  • Affected children tend to be hyperactive, anxious, with poor judgement and short attention span.

There is no safe level of drinking during pregnancy that would prevent FAS [35]. Even drinking less than 1 standard drink per week during pregnancy may result in behavioral abnormalities in children [16]. The risk of FAS increases with the amount of alcohol drunk and frequency of binge drinking [35]. The risk of facial and other physical abnormalities is greatest when a woman drinks in early pregnancy (the first trimester) [10].

Diagnosis of FAS

FAS can not be diagnosed during pregnancy [10]. There is no specific test for FAS, but a pediatrician should be able to establish a diagnosis from the mother’s drinking history and physical examination of a child. Investigations may reveal small brain size, cleft palate, heart defects or other abnormalities.

Treatment of FAS

There is no cure or specific treatment for FAS [11]. Physical abnormalities may require surgery. An early diagnosis may help to improve the prognosis and an experienced counselor may help with behavioral and learning problems. The mother of a child with FAS may need treatment of alcoholism.

Other possible complications caused by alcohol drinking during pregnancy include spontaneous abortion, placental abruption, preterm delivery, stillbirth and sudden infant death syndrome (SIDS).

Breastfeeding, Alcohol and Infants

Doctors usually do not prohibit moderate drinking (up to 1 drink per day) during the breastfeeding period [12]. A mother who had 1 alcoholic drink should not breastfeed a baby for 2 to 3 hours afterwards, because this is the time in which the alcohol from 1 drink is eliminated from the breast milk [13,14]. Pumping and dumping does not speed up alcohol elimination from the breast milk [12]. The concentration of alcohol in breast milk is about the same as in the blood [15-p.387]. In one study, the average concentration of alcohol in the breast milk after drinking about 1.5 drink was 0.03 g/100 mL of milk [17].

In 2 studies in which mothers drank 1 drink (beer or ethanol added to orange juice) before breastfeeding, their babies drank about 20% less milk in average [17,18]. According to another 2 studies showed that when mothers drank alcohol before breastfeeding, infants fell asleep sooner, but slept for shorter periods of time and more often during the day than when mothers did not drink [17,19].

Excessive drinking during breastfeeding may be harmful or even life dangerous for the infant!

  • A 5-week-old infant who was breastfed by a heavy drinking mother had been sleepless and had developed seizures; 3 days after stopping breastfeeding, the infant started to sleep calmly [36].
  • The infant of the mother who has drunk 750 mL of port wine over the 24 hours was unable to arouse and to suck the milk, was sweating excessively and has weak pulse [36].
  • One Russian mother drank 1 liter of port wine during breastfeeding her 14-day-old son. The infant died thereafter; his blood alcohol concentration was 0.04 g/100 mL [20].
  • Another Russian mother drank 50 g of wine and 1.5 liters of beer while breastfeeding her newborn son. The infant died; his blood alcohol concentration was 0.04 g/100 mL [21].

Children, Teenagers and Alcohol

Small children may get intoxicated by drinking alcoholic beverages, alcohol-containing medicinal syrups, mouthwash, perfumes or after-shave lotions.

Adolescents seem to be less sensitive to depressant and other unpleasant effects of alcohol, including hangover and withdrawal symptoms [23,25]; however, they, in average, experience more blackouts after heavy drinking than adults [26].

Adolescents who drink are more likely to have problems in school, engage in a risky sexual behavior, be involved in fights, traffic accidents or be victims of robbery or rape [27].

Teenagers who start to drink at early age or have a habit of binge drinking are at increased risk to become alcohol dependent later in life [23,27]. Teenagers who start to drink before age of 15 are at several times increased risk to develop alcohol dependence later in life than those who start to drink after age 21 [29].

Preschool children may eliminate alcohol at the rate up to 0.030 g/100 mL/hour, probably due to greater liver/body weight ratio [15-p.386; 28,30]; the elimination rate in young adolescents and non-alcoholic adults is about 0.015 g/100 mL hour [30,31]. Infants eliminate alcohol at half the rate of adults [14].

In small children who have not eaten for few hours, even small amounts of alcohol may cause hypoglycemia [28].

Typical symptoms of alcohol poisoning in children are coma, hypoglycemia, hypothermia and seizures, which may occur when blood alcohol concentration exceeds 0.05-0.1 g/100 mL [28,32].

Heavy alcohol drinking during adolescence may cause a brain damage that can result in lower attention span in males and impaired visuo-spatial cognition (drawing, puzzles) in females [33].

Signs of excessive drinking in teenagers

  • Staying out late, alcohol in the breath
  • Joining to a new groups of friends
  • Poor performance in school, lost interest for hobbies
  • Frequent mood changes
  • Defensive behavior
  • Reference: [24,34]

  1. Busko M, 2008, Alcohol Craving in Women, Not Men, More Likely to Be Linked to Depression  Medscape
  2. 2003, Alcohol Problems in Intimate Relationships: Identification and Intervention  National Institute on Alcohol Abuse and Alcoholism
  3. Mumenthaler MS et al, 1999, Gender Differences in Moderate Drinking Effects  National Institute on Alcohol Abuse and Alcoholism
  4. Sampson HW et al, 1998, Alcohol’s Harmful Effects on Bone  National Institute on Alcohol Abuse and Alcoholism
  5. 2004, ALCOHOL—AN IMPORTANT WOMEN’S HEALTH ISSUE  National Institute on Alcohol Abuse and Alcoholism
  6. Sarkola T et al, 2000, Acute effect of alcohol on androgens in premenopausal women  PubMed
  7. Alcoholic Beverages  Linus Pauling Institute
  8. Vaux KK, Fetal Alcohol Syndrome Clinical Presentation  Emedicine
  10. Fetal alcohol syndrome, symptoms  Mayo Clinic
  11. Fetal alcohol syndrome, treatment  Mayo Clinic
  12. LaFleur E, I’m breast-feeding. Is it OK to drink alcohol?  Mayo Clinic
  13. What about drinking alcohol and breastfeeding?  La Leche League International
  14. Koren G, 2002, Drinking alcohol while breastfeeding – Will it harm my baby?  PubMed Central
  15. Barceloux DG, 2012, Medical Toxicology of Drug Abuse: Synthesized Chemicals and Psychoactive Plants
  16. Alcohol during pregnancy  March of dimes
  17. Mennella JA et al, 1991, The Transfer of Alcohol to Human Milk — Effects on Flavor and the Infant’s Behavior  The New England Journal of Medicine
  18. Mennella JA et al, 1993, Beer, Breast Feeding, and Folklore  PubMed Central
  19. Mennella JA et al, 1998, Effects of Exposure to Alcohol in Mother’s Milk on Infant Sleep  Pediatrics
  20. 2011, Mother kills son after breastfeeding him drunk  PerthNow
  21. 2012, Mother kills baby with alcohol in her own breast milk  Pravda.ru
  22. Pregnancy tests  Womenshealt.gov
  23. Underage drinking  National Institute on Alcohol Abuse and Alcoholism
  24. Ten Alcohol Rehab  Newport Academy
  25. White AM et al, 2005, Age-related effects of alcohol on memory and memory-related brain function in adolescents and adults  PubMed
  26. 2004, Parenting influences on adolescent alcohol use  Australian Institute of Family Studies
  27. Talk to your child about alcohol  National Institute on Alcohol Abuse and Alcoholism
  28. Fernandez E, Ethanol toxicity  Emedicine
  29. Ricci D, 2011, Alcohol Consumption by Teens Often Leads to Early Onset of Addiction  New York State Office of Alcoholism and Substance Abuse Services
  30. Lamminpåå A, 1995, ALCOHOL INTOXICATION IN CHILDHOOD AND ADOLESCENCE  Alcohol and Alcoholism
  31. Jones AW, 2010, Evidence-based survey of the elimination rates of ethanol from blood with applications in forensic casework  PubMed
  32. 2013, Alcohol intoxication in children  DJMet.med
  33. Tapert SF et al, Alcohol and the Adolescent Brain—Human Studies National Institute on Alcohol Abuse and Alcoholism
  34. Alcohol use disorder prevention  Mayo Clinic
  35. Fetal alcohol syndrome  MedlinePlus
  36. Alcohol use while breastfeeding  Drugs.com

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