FASD: It’s time to Stop the Debate.

A video clip came up on my Twitter feed this morning about results of a study Bristol University conducted looking at 70 years of studies to find evidence of outcomes for “light drinking” during pregnancy.

While they agree on the evidence about the risks of heavy alcohol consumption during pregnancy, their objective was to “determine the effects of low-to-moderate levels of maternal alcohol consumption in pregnancy on pregnancy and longer-term offspring outcomes.”

They argue that their study revealed insufficient evidence on health outcomes other than that delivery of a “small baby” so conclude the message to not drink alcohol was based on a “better safe than sorry” principle and “guidance could advise abstention as a precautionary principle but should explain the paucity of evidence.” Which I think means, they agree the message should be no alcohol, but a footnote should be made that evidence of light drinking causing harm is so small or insufficient studies exist to make the claim light drinking causes harm.

It is the latter part of their message most media picked up on.

Here is the conclusion from the Study:

In conclusion, we found limited evidence for a causal role of light drinking in pregnancy, compared with abstaining, on most of the outcomes examined. Despite the distinction between light drinking and abstinence being the point of most tension and confusion for health professionals and pregnant women and contributing to inconsistent guidance and advice now and in the past, our extensive review shows that this specific question is not being researched thoroughly enough, if at all. In addition, there has been no evidence regarding possible benefits of light alcohol consumption versus absence. Further studies, including those using designs that improve causal inference, are required to provide further evidence and a better estimation of the likely effects. Formulating guidance on the basis of the current evidence is challenging. However, describing the paucity of current research and explaining that ‘absence of evidence is not evidence of absence’, appears warranted

I can see why the media picked up the limited evidence message. It’s the first thing noted in the conclusion. My question to the University: why did you have to do a study about studies? More importantly if you feel more studies need to be done, then why didn’t you complete those studies first instead of releasing information about lack of studies which continues to perpetuate the confusion you note in your conclusion?

As a caregiver to someone with FASD I live every day with the effects. My daughter lives everyday with the effects. She hasn’t (nor her birth mother that I know of) been included in any studies, but I can list all the challenges she faces everyday because her mother did consume alcohol. I don’t care if it was a little or a lot. It was enough. And that is NOT to put blame on birth mother – it’s because 70 years on we are still having these arguments that confuse the public and babies are being born with FASD.

It’s time to stop the debate: What does it matter if it’s light drinking, moderate or heavy. It has an effect. There are millions of people worldwide living the effects. Did the birth mom of every one of the people with FASD alive today drink copious amounts of alcohol? I doubt it. To the naysayers: Do you believe alcohol causes any harm to any person in any way?

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If alcohol causes these effects on a developed human would they not have a detrimental effect on a developing human even in small amounts?

  1. But to those who say if it’s only been proven for heavy drinking – I say why take the risk? Tell the millions around the world with FASD there was no effect.
  2. To those who say the evidence doesn’t support light drinking, do you question why there is not a plethora of studies? How would we get this information.
  3. If a woman did use alcohol, is she going to remember the exact days and amounts so that could be recorded for study.
  4. And if she did remember or record that, do countries have a database that doctors can enter this information in so it can be tracked over time to satisfy your questions as to the validity that light to moderate drinking causes harm?
  5. If we don’t have that database, then should we recruit women (and men) for a study and have them drink various amounts of alcohol at varying times before and during pregnancy then follow the child for next 20 years to see if and what effects of light to moderate drinking are? Should we put babies at risk?
  6. If we don’t think this is a good idea (having men and women drink alcohol and produce a child so we can study light to moderate effects) then how do you propose we find a way to look at light to moderate drinking. If heavy drinking causes harm, why would light to moderate not cause harm?
  7. Instead of debating light to moderate versus heavy, clouding the matter and causing even more confusion about alcohol, let’s admit maybe we will never know how much and when alcohol would be safe (if ever) and agree that it just isn’t safe to consume alcohol while pregnant based on the research that has already been done.
  8. And if that doesn’t work, the people who think drinking any alcohol throughout pregnancy is okay should talk to people with FASD and see the challenges and difficulties first hand these individuals live with because there was alcohol consumption.
  9. And if you don’t think it is alcohol that causes these disabilities, then maybe tell us what you think are the cause.

So instead of continuing debate on if and how much is safe these naysayers and sensationalists should focus on posing the question: How can we help the people with FASD now? The ones living with the effects.

Instead of asking for more proof, ask the people recovering from addiction if it affected their lives.

For years we denied the harmful effects of smoking. We know different now. We know alcohol does harm. Why should it make a difference if it’s one drink or a hundred.

Except for those with an addiction, what is the issue with giving up alcohol for nine months to ensure your baby is healthy? No one is telling you to stop drinking for the rest of your life. You can choose to drink or not drink. All we are asking, based on what evidence is out there, and based on the people living with FASD, is to not drink any alcohol before conception and during pregnancy to give your baby the best chance at a healthy start to life. Is that too much to ask?

It’s time to adopt the no amount is safe at any time. Support healthy pregnancies. Help people with addiction. And support the people already with FASD. We don’t need another study on consuming alcohol during pregnancy. We’ve been there, done that. It’s time to move on.

Here is a response from NOFAS-UK which makes valid points:

 

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In addition to the above news release, Sandra Butcher, the Executive Director of NOFAS-UK published an article to help counteract some of the negative press response. It’s well worth the read. There Is No Proven Safe Amount Of Alcohol In Pregnancy. No Alcohol, No Risk. In the article, she states:

There is nothing new here. But watch the headlines roar once again. The British pub culture runs deep. Nothing wrong, some will claim, with a little tipple to relax you and your bump…

Except that is not what this research says.

The fact remains there is no PROOF that it is SAFE to drink low levels of alcohol while pregnant.

The ‘new’ research simply says there’s not enough research. Charities are once again claiming therefore that the guidance against drinking alcohol in pregnancy is too rigid. They will cynically confuse the message yet again.

Earlier this week people in more than 60 countries marked the international FASD Awareness Day on 9/9. Yet here in the UK we are still ignoring common sense.

Stay safe. Be healthy. And ask your politicians to fund more research and provide support for those with FASD and for pregnant women. These should be messages on which we all can agree today and every day.

I think it is safe to say it isn’t only in the UK where some people still ignore common sense! While I have seen a few posts reconfirming the no alcohol, since this post, the fact that organizations have to counter the headline grabbing sensationalism that creates confusion (in my opinion) takes away from important tasks of supporting women to have healthy pregnancies, prevention efforts and supporting people with FASD. On the flip side, it’s an important conversation and this Study has offered an excellent opportunity for the experts to weigh in and reiterate the no alcohol message.

Here is the Study: Low alcohol consumption and pregnancy and childhood outcomes: time to change guidelines indicating apparently ‘safe’ levels of alcohol during pregnancy? A systematic review and meta-analyses

 

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And even though the above graphic has nothing to do with the Study, it came across my feed today as another example of our love affair with alcohol. I’m not even going to comment. I suggest you read the article Mixing Booze and Babies, the author makes a great argument against this event.

We have come along way in almost 70 years, but not far enough.

 

 

 


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