'No alcohol in pregnancy' advised

[daredelvis]

Link?

Don't have a link, it was from an old fashion graduate course many years ago. I am sure the information is out there if you want to search for it. To sum it up, it turns out that the levels of mercury that are toxic to developing humans are MUCH lower then the levels that are toxic to adults. At one time that was a very controversial position. There is plenty of data supporting that on the Google. Check out the Minamata Bay disaster, I recall that is where much of the information about human development and mercury levels was first clearly observed.

There also seems to be a lot of anecdotal evidence that drinking during pregnancy is no big deal. All that shows it that the drinking done during that particular pregnancy by that particular person at those particular times was no big deal. People are different. Sensitivities are different. Ask the woman that was on folic acid supplements during the course of her pregnancy who still gave birth to a child with spinal bifida. Some women need more folic acid then others.

Again, when you are talking about development it makes sense to err on the side of caution. "Evidence" is very hard to collect about factors that influence human development. What is true for rats, cats, and dogs is not always true for humans. I see no harm in recommending that pregnant women stay off the booze. 9 months vs. a human lifetime. Not worth the risk.

Daredelvis

 

[Jaggy Bunnet]

Again, when you are talking about development it makes sense to err on the side of caution. "Evidence" is very hard to collect about factors that influence human development. What is true for rats, cats, and dogs is not always true for humans. I see no harm in recommending that pregnant women stay off the booze. 9 months vs. a human lifetime. Not worth the risk.

Daredelvis

What substances, other than alcohol, are you willing to apply the same logic to?

 

[brodski]

The lie is that there is a need to change the current advice when there is absolutely zero evidence that the new advice is any safer than the existing advice.

Given that the amendment to the advice will only affect those who currently follow the advice but will be evil bad parents under the new advice, who do you think it is aimed at?

The new advice is aimed at those that currently exceed the current 1-2 units a week advice, trough ignorance of how to measure alcoholic units, or who think that they can go just a bit over and still be safe. It is expected that have some women will still drink a little, but probably less than they would drunk otherwise.
Its the same reason that the adverts you get from DFT say "don't drink and drive" and not "don't drink enough to put your blood alcohol limit over 80 milligrammes of alcohol in 100 millilitres of blood."

Is this also the nanny state demonising drinkers, or is it effective use of marketing?

 

[Beth]

Again, when you are talking about development it makes sense to err on the side of caution. "Evidence" is very hard to collect about factors that influence human development. What is true for rats, cats, and dogs is not always true for humans. I see no harm in recommending that pregnant women stay off the booze. 9 months vs. a human lifetime. Not worth the risk.

My first pregnancy, I agreed with that idea and avoided not just alcohol, but aspirin and all other over the counter medications, so I can certainly understand that point of view and agree with it from an individual perspective. My last pregancy, I was drinking before I knew I was pregnant (long story there about why I didn't know) and I had the occasional glass of wine afterwards, but it was less than one glass of wine a month so it was well within the 'moderate use' range. Basically, at that point I had read the research and knew it wouldn't be harmful to my developing child at that stage of his development.

The biggest risk for FAS is drinking heavily during the first couple of months when many women, (including me with my last pregnancy), don't realize they are pregnant. Personally, I think it would make more sense to recommend abstaining from the point you start planning to get pregnant through the first trimester, but since many pregancies are unplanned, that often isn't a realistic option.

The harm comes from a governmental agency making policy that isn't based on evidence, but a subjective assessment that it's more important to promote the idea that drinking alcohol is bad than it is to maintain the integrity of their decision-making process.

This approach, which can be summed up as "just don't - it's always bad", is typical of most recreational drug use policies. Personally, I think it is a mistake because once people discover that the policy isn't based on a realistic risk assement, it undermines the credibility of any and all policy recommendations the agency makes.

 

[Jaggy Bunnet]

The new advice is aimed at those that currently exceed the current 1-2 units a week advice, trough ignorance of how to measure alcoholic units,

Evidence? Surely aiming at those people would involve educating them on how to measure units (which in most cases means read the number on the bottle that the drink came in so lets not pretend it is some complex art form)?

or who think that they can go just a bit over and still be safe. It is expected that have some women will still drink a little, but probably less than they would drunk otherwise.

So instead of giving real advice, the government should guestimate how far over the official guidelines people will assume is still safe and then reduce the guideline accordingly? Does that really strike you as a sensible idea?

If so, then what guideline should the government set when the only safe level is zero? A negative amount? It can't be zero as the expectation is that if they set the level at zero people will assume a little is safe.

Why is giving people inaccurate advice seen as a good thing?

Its the same reason that the adverts you get from DFT say "don't drink and drive" and not "don't drink enough to put your blood alcohol limit over 80 milligrammes of alcohol in 100 millilitres of blood."

Is this also the nanny state demonising drinkers, or is it effective use of marketing?

The limit here is a legal fiction. Nobody pretends it actually discriminates between those safe to drive and those unsafe, but it does form a nice clear objective standard as is required in a criminal case. It is therefore completely irrelevant to the current discussion unless you are suggesting that mothers who drink should be prosecuted for doing so.

 

[Jaggy Bunnet]

My first pregnancy, I agreed with that idea and avoided not just alcohol, but aspirin and all other over the counter medications, so I can certainly understand that point of view and agree with it from an individual perspective. My last pregancy, I was drinking before I knew I was pregnant (long story there about why I didn't know) and I had the occasional glass of wine afterwards, but it was less than one glass of wine a month so it was well within the 'moderate use' range. Basically, at that point I had read the research and knew it wouldn't be harmful to my developing child at that stage of his development.

The biggest risk for FAS is drinking heavily during the first couple of months when many women, (including me with my last pregnancy), don't realize they are pregnant. Personally, I think it would make more sense to recommend abstaining from the point you start planning to get pregnant through the first trimester, but since many pregancies are unplanned, that often isn't a realistic option.

The harm comes from a governmental agency making policy that isn't based on evidence, but a subjective assessment that it's more important to promote the idea that drinking alcohol is bad than it is to maintain the integrity of their decision-making process.

This approach, which can be summed up as "just don't - it's always bad", is typical of most recreational drug use policies. Personally, I think it is a mistake because once people discover that the policy isn't based on a realistic risk assement, it undermines the credibility of any and all policy recommendations the agency makes.

Anecdotal I know but there was a woman on Radio 5 this morning talking about how she was asked by a diner at a nearby table (I think, it might have been the waiter - I wasn't paying lose attention) whether she knew that the sauce on the dessert she ordered had alcohol in it. Completely in line with the new zero tolerance guidelines, completely divorced from the reality of whether it endangered her child.

 

[Rolfe]

Its the same reason that the adverts you get from DFT say "don't drink and drive" and not "don't drink enough to put your blood alcohol limit over 80 milligrammes of alcohol in 100 millilitres of blood."

That seems to me to be an excellent analogy.

Rolfe.

 

[daredelvis]

Personally I would prefer that health advice is based on science, but if you want to join the homeopaths and base medical advice on feelgood factors then that is your choice.

This advice is not devoid of science. Alcohol does have an effect on development, the only question is how much, and when.

Daredelvis

 

[Darat]

...snip...

Personally I would prefer that health advice is based on science, but if you want to join the homeopaths and base medical advice on feelgood factors then that is your choice.



...snip...

So you didn't agree with the old advice either?

 

[Darat]

Anecdotal I know but there was a woman on Radio 5 this morning talking about how she was asked by a diner at a nearby table (I think, it might have been the waiter - I wasn't paying lose attention) whether she knew that the sauce on the dessert she ordered had alcohol in it. Completely in line with the new zero tolerance guidelines, completely divorced from the reality of whether it endangered her child.

How do you know it was totally divorced from reality? Did the woman know how many units of alcohol was in her dessert? How would your educational idea approach how to measure the alcohol units in a dessert?

Indeed I'd say this is a good example of why the new guidelines are better then the older (but still not scientifically accurate) advice.

 

[Beth]

How do you know it was totally divorced from reality? Did the woman know how many units of alcohol was in her dessert? How would your educational idea approach how to measure the alcohol units in a dessert?

Because even if it was 100% alcohol, it's unlikely that the sauce on a dessert would have sufficient alcohol to be of danger to a women who is obviously pregnant - i.e. more than 2 months along. And if the sauce has been cooked, the most of all of the alcohol will have evaporated out it.

 

[sophia8]

There also seems to be a lot of anecdotal evidence that drinking during pregnancy is no big deal. All that shows it that the drinking done during that particular pregnancy by that particular person at those particular times was no big deal. People are different. Sensitivities are different. Ask the woman that was on folic acid supplements during the course of her pregnancy who still gave birth to a child with spinal bifida. Some women need more folic acid then others.

Neural tube defects (spina bifida, anencephaly etc) develop within the first 6 weeks of pregnancy. So taking folic acid after that time is useless. Ideally, folic acid supplementation needs to be started before conception.

 

[Darat]

Because even if it was 100% alcohol, it's unlikely that the sauce on a dessert would have sufficient alcohol to be of danger to a women who is obviously pregnant - i.e. more than 2 months along. And if the sauce has been cooked, the most of all of the alcohol will have evaporated out it.

So as I said the woman couldn't know if the dessert was above or below the previous advice.

 

[Beth]

So as I said the woman couldn't know if the dessert was above or below the previous advice.

Huh? It was below. How could it be otherwise? Sauce on a dessert would be of insufficient volumn to be above the previously advised level. The only confusion is with the new advice. It's above the zero limit, but it wouldn't be detrimental to her developing child.

 

[Darat]

Huh? It was below. How could it be otherwise? Sauce on a dessert would be of insufficient volumn to be above the previously advised level.

So you asserted previously - I'm still waiting for the evidence of how you could (from the information provided) know that.

The only confusion is with the new advice. It's above the zero limit, but it wouldn't be detrimental to her developing child.

Again an assertion - how do you know the woman hadn't already had a unit of alcohol or already had her one unit (or perhaps two who knew from the old advice?) twice (or perhaps just once who knew from the old advice? ) that week so any alcohol would put her over the old advice limits?

 

[Darat]

As an example by the way - I traditionally make a sherry trifle at Christmas, that contains a good 2 or more glasses of sherry so probably about 8 units in total - but I couldn't accurately tell you. Therefore a quarter serving would potential be the maximum or more (since the old advice was vague over what the maximum may be for a specific woman).

So if I was serving that the new advice would mean a woman could just say "oh a sherry trifle looks lovely but no thanks I'm pregnant".

 

[Darat]

I've just been looking at what the old advice used to be - it was crap!

http://www.patient.co.uk/showdoc/23069189/

...snip...

Pregnant women. If you have one or two drinks of alcohol (one or two units), once or twice a week, it is unlikely to harm your unborn baby. However, the exact amount that is safe is not known. So, many women have little or no alcohol when they are pregnant.​

...snip..

So the old advice was:

1) We don't know what level is safe.
2) We think (but we don't know) that one or two units once or twice a week will be OK

The new advice is:

1) We don't know what level is safe.
2) Therefore don't drink.

To me the new advice is actually much more "scientifically" valid than the previous advice. (ETA: If it is true we don't know what levels are safe but we do know alcohol can cause problems.)

 

[strathmeyer]

What substances, other than alcohol, are you willing to apply the same logic to?

Cocaine, gamma-hydroxybutyrate, glue, ether, nitrous oxide, psilocybin and psilocin, lysergic acid diethylamide, methamphetamine, MDMA, ephedrine, opiates, ketamine, phencyclidine, diphenhydramine hydrochloride, nutmeg, barbituates, and nicotine.

But I'm no doctor so what do I know? Perhaps psilocybin and psilocin are ok.

 

[Beth]

So you asserted previously - I'm still waiting for the evidence of how you could (from the information provided) know that.

Because we were discussing the amount of alcohol in a sauce on a dessert. Based on my experience, I can make a reasonable guess as to what amount of sauce would be served with a dessert. Do you really want to make the argument that a sauce on a single serving of a dessert would contain more than the maximum amount of alcohol it would be safe for a noticably pregnant woman to consume? You gave the example of a sherry trifle you make, but that's a dessert itself, not a sauce added to the dessert. I'll certainly concede that there are desserts made with alcohol that might surpass that limit, but I think it very unlikely that a sauce served with the dessert would surpass that limit.

Again an assertion - how do you know the woman hadn't already had a unit of alcohol or already had her one unit (or perhaps two who knew from the old advice?) twice (or perhaps just once who knew from the old advice? ) that week so any alcohol would put her over the old advice limits?

I don't know what she might have had previously, but we weren't discussing her total alcohol consumption, but the amount alcohol that might be in the dessert sauce.

 

[Darat]

Because we were discussing the amount of alcohol in a sauce on a dessert. Based on my experience, I can make a reasonable guess as to what amount of sauce would be served with a dessert.

So a guess. In my opinion I would have to say guessing seems a rather poor way to make such a decision.

I don't know what she might have had previously, but we weren't discussing her total alcohol consumption, but the alcohol in the dessert sauce.

No the discussion was about which were better the previous or new guidelines. As I've demonstrated the new ones are better in at least two ways . One they use our current knowledge and don't go beyond that (i.e don't guess what may or may not be OK for most women) and secondly it means a woman doesn't need to guess (as you did) as to the amount of alcohol in any given dessert/food/drink - they now know that they should avoid it if it has alcohol in it.

To paraphrase Brodski the new message is "Don't gestate and drink" - nice and simple.