International Guidelines on Drinking during Pregnancy

 

Country	Standard Drink	Guidance
Australia	10g	Australian Alcohol Guidelines [1] from the National Health and Medical Research Council (NHMRC, 2001), state:   "If you are pregnant, or are planning to become pregnant:   §         you should consider not drinking at all; §         most importantly, you should never become intoxicated; §         if you choose to drink, you should have less than 7 standard drinks over a week, AND no more than 2 standard drinks (spread over at least two hours) on any one day*; and §         you should note that the risk is highest in the earlier stages of pregnancy, including the time from conception to the first missed period.”   * Note: The 2001 guidelines are currently under review by the NHMRC in collaboration with the Australian Government Department of Health and Ageing. The revised draft, Australian Alcohol Guidelines for Low-risk Drinking, is now available for public consultation (the draft advises that both men and women limit their alcohol consumption to 2 standard drinks or less in any one day and states that “not drinking is the safest option” for youths aged under 15 years and women who are pregnant, are planning to become pregnant, or are breastfeeding). Progress on the revised guidelines (not yet officially adopted) can be traced at: http://www.nhmrc.gov.au/consult/index.htm.
Canada	13.6g	Nutrition for a Healthy Pregnancy – National Guidelines for the Childbearing Years [2] from Health Canada (1999) state, “Although the prudent choice for women who are or may become pregnant is to abstain from alcohol, health practitioners can reassure women who have consumed small amounts of alcohol occasionally during pregnancy, that the risk to the fetus in most situations is likely minimal. They should also explain that the risk is relative to the amount of alcohol consumed, body type, nutritional health and other lifestyle characteristics specific to the pregnant woman.”   Low-risk Drinking Guidelines: Maximize Life, Minimize Risk [3], issued by the Centre for Addiction and Mental Health (CAMH), recommend: “Don't drink if you are pregnant or planning to become pregnant.”   The Sensible Guide to a Healthy Pregnancy [4] by the Public Health Agency of Canada (2007) warns, “There is no safe amount or safe time to drink alcohol during pregnancy.”
France	12g/beer 8g/wine	French Ministry of Health, Youth & Sports recommends that pregnant women avoid drinking alcohol (National Program for Health and Nutrition / Programme National Nutrition Santé, PNNS). [5]
Ireland	10g	Little Book of Women and Alcohol [6], published by Ireland’s Health Promotion Unit in 2003, states: “Stopping drinking during pregnancy is the safest advice. Baby’s vital organs, e.g., heart, brain, and skeleton are formed between 10–50 days after conception. Often, this is before you know you are pregnant. Cutting down or stopping alcohol while trying to become pregnant protects your baby…. There is no known safe level of alcohol use in pregnancy, and stopping completely is advised.”   Health Promotion Unit’s Health Files [7] advise that “those who are pregnant or trying for a baby should: drink as little as possible, or avoid alcohol altogether; never drink to excess.”
Netherlands	9.9g	Netherlands Institute for Health Promotion and Disease Prevention (NIGZ) advises [8]:   “Are you pregnant, breastfeeding, or trying to become pregnant? The most safe choice for you and your baby is not to drink alcohol. This is why:   • Drinking alcohol may reduce fertility (including among men) and raise the chance of a miscarriage; • Even an occasional glass of alcohol during pregnancy may be detrimental, since alcohol is a toxic substance and even in small quantities can cause damage to the developing brain; • Alcohol consumption by the mother may damage the child’s development during stages of pregnancy…”
New Zealand	10g	Food and Nutrition Guidelines for Healthy Pregnant and Breastfeeding Women: A Background Paper [9], issued by the New Zealand Ministry of Health in 2006 recommends that:   • “Women who are pregnant or planning to become pregnant should avoid drinking alcohol. (The message from health practitioners to abstain from alcohol during the entire pregnancy is unequivocal and should be promoted by all health practitioners.)   • Continue avoiding alcohol when breastfeeding, especially during first month (if it is not possible for the woman to abstain from alcohol, they should be advised to limit themselves to 1 to 2 standard drinks occasionally… Mothers who do choose to drink moderately… during breastfeeding, but with to avoid exposing the baby to alcohol [should] wait until maternal blood alcohol level drops, allowing two to three hours to pass after drinking alcohol.)”
Spain	10g	Spanish Ministry of Health (Ministerio de Sanidad y Consumo) advises that pregnant women abstain from alcohol. [10]
Switzerland	10g–12g	Swiss Institute for the Prevention of Alcohol and Drug Addiction (ISPA) [11]:   “The principal recommendations of the ISPA to the pregnant women are as follows:   • Do not drink alcohol. • If you do decide to drink, do not drink more than 1 glass per day, and do not drink every day. • Avoid excessive consumption at all costs (even occasionally).”
United Kingdom	8g	The U.K. Department of Health (2007) advises that “pregnant women or women trying to conceive should avoid drinking alcohol. If they do choose to drink, to minimise the risk to the baby, they should not drink more than 1 to 2 units of alcohol once or twice a week and should not get drunk.” [12]   Royal College of Obstetricians and Gynaecologists in its 2006 guide, Alcohol and Pregnancy: Information for You [13], states, “The safest approach in pregnancy is to choose not to drink at all. Small amounts of alcohol during pregnancy (not more than 1 to 2 units, not more than once or twice a week) have not been shown to be harmful.”   The National Institute for Health and Clinical Excellence (NICE) in its clinical guideline Antenatal Care (2003)** for England and Wales concludes, “Excess alcohol has an adverse effect on the fetus. Therefore, it is suggested that women limit alcohol consumption to no more than 1 standard unit per day.”   ** Note: The 2003 NICE guideline is being partially revised, to be published in March 2008. The preliminary guideline, now out for consultation, advises, “Pregnant women should limit their alcohol intake to less than 1 standard drink (1.5 U.K. units or 12g of alcohol) per day and if possible avoid alcohol in the first 3 months of pregnancy. Women should be informed that binge drinking may be particularly harmful during pregnancy.” See: http://guidance.nice.org.uk/page.aspx?o=451448.
USA	14g	Dietary Guidelines for Americans 2005 [15], published by the U.S. Department of Health and Human Services (HHS) and Department of Agriculture (USDA), states: “Alcoholic beverages should not be consumed by some individuals, including those who cannot restrict their alcohol intake, women of childbearing age who may become pregnant, pregnant and lactating women, children and adolescents, individuals taking medications that can interact with alcohol, and those with specific medical conditions.”