By Dr Carolyn Blackburn, Senior Fellow in Early Childhood and Inclusion, Birmingham City University.

Christmas is a time for celebration with friends and family but it is also a period where increased alcohol consumption poses a risk for children and families. December is the month when the highest number of babies are conceived and the month in which the highest amount of alcohol is consumed. (Office of National Statistics, 2015).  It is crucial therefore that families are aware of guidelines about the effects of prenatal exposure to alcohol and developmental risk for children so that they can enjoy the festive period more easily.

Last year the Telegraph reported on a study from the Office for National Statistics of the most popular birth month in England and Wales. The study found that more babies are conceived at Christmas than at any other time of the year. Following an analysis of 20 years of birth records the study undertaken by ONS showed a dramatic spike in the number of children born in late September, nine months after Christmas. In addition the NHS guidance on ‘Keeping Safe at Christmas’ reports that Britons consume 41% more alcohol in December than at any other time of year  leading to increased risk of injury and death from accidents and health related mortality (NHS, 2012).

This is a cause for concern for children and families as individual risk from prenatal exposure to alcohol cannot be determined. Variables such as maternal and fetal genetics, timing and dosage of alcohol and other family characteristics need to be taken into account. This means that any amount of alcohol consumed during pregnancy is best avoided where possible. High amounts of maternal alcohol consumption and in particular binge drinking are known to cause serious problems for fetal development not to mention maternal health and mental health (Williams and Smith, 2015).

The range of effects arising from prenatal exposure to alcohol are known as Fetal Alcohol Spectrum Disorders.  Alcohol is a teratogen which crosses the placenta and causes damage to the central nervous system (Institute of Medicine, 1995). The effects include facial anomalies, developmental delays and disabilities, physical disabilities, sensory impairments, speech, language and communication problems. If not identified and supported in early childhood, secondary complications arise which include school exclusion, isolation, mental health problems, contact with the criminal justice system and suicide.

The current prevalence of Fetal Alcohol Spectrum disorders is thought to be 2-5% of the school population (May et. al 2009). FASDs are considered a “hidden disability” because most individuals affected by prenatal exposure to alcohol are not identified until adolescence or adulthood, if at all (NOFAS.ORG). Support groups in the UK such as NOFAS UK, and the FASD Network and the European Birth Mothers Network  work hard to raise awareness about concern for children and families and to support parents.  In addition the specialist FASD Clinic assesses and treats children and adults with FASD.  However, the paucity of knowledge about FASD and prenatal risk from alcohol consumption amongst health, education and social care professionals means that the message about healthy pregnancies the need to avoid alcohol is not always clear.

Current guidance from the British Medical Association is clear:

It is crucial that women who are pregnant or considering a pregnancy are provided with clear, reliable guidance on alcohol consumption that minimises the risk of harm. We believe that the safest approach is for women who are pregnant, or who are considering a pregnancy, should be advised not to consume any alcohol. This is in line with proposed guidance from the UK chief medical officers published in January 2016, recommending that the safest approach is not to drink alcohol at all during pregnancy. 

It is important that women and the partners and family that support them are informed about this simple message so that they can celebrate Christmas without concern over when and how much they can drink if they are planning a family or already pregnant.

Professionals must maintain a non-judgemental approach to supporting pregnant women who may not have planned their pregnancy or realised that they were pregnant in the early stages.  Many children with FASDs are fostered or adopted and this needs to be taken into account.

It is also important for women to remember that their well-being is of paramount importance during pregnancy.  As many pregnancies are unplanned and many women do not realise they are pregnant in the early stages of pregnancy, the key message here is that you can still plan for the remainder of your pregnancy and consult your GP or Midwife for help and support and at any point. The FASD support groups will support women and their partners with advice information.

More information can be obtained from the BMA or any of the FASD support groups.

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