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Alcohol in pregnancy

Advice from the NHS Choices website 

It’s still unclear exactly how much, if any, alcohol is completely safe for you to have while you’re pregnant, so the safest approach is not to drink at all while you’re expecting.


Is it safe to drink alcohol when pregnant?

The Chief Medical Officers for the UK recommend that if you’re pregnant, or planning to become pregnant, the safest approach is not to drink alcohol at all, to keep risks to your baby to a minimum. Drinking during a pregnancy can lead to long-term harm to the baby; with the more you drink the greater the risk.


How does alcohol affect my unborn baby?

 When you drink, alcohol passes from your blood through the placenta and to your baby. A baby’s liver is one of the last organs to develop and doesn’t mature until the latter stages of pregnancy. Your baby cannot process alcohol as well as you can, and too much exposure to alcohol can seriously affect their development.

In addition to the risk of miscarriage, more recent research found that drinking, particularly in the first three months of pregnancy, also increases the risk of premature birth and low birth weight.

Should you choose to drink after the first three months of your pregnancy, consuming alcohol carries risks of affecting your baby after they’re born. The risks are greater the more you drink. The effects include learning difficulties and behavioural problems.

Drinking heavily throughout pregnancy can cause your baby to develop a serious condition called foetal alcohol syndrome (FAS).

Children with FASD have:

  • Poor growth
  • Facial abnormalities
  • Learning and behavioural problems

Drinking less heavily, and even drinking heavily on single occasions, may be associated with lesser forms of FAS. The risk is likely to be greater the more you drink.


How to avoid alcohol in pregnancy

It may not be as difficult as you think to avoid alcohol completely for nine months, as many women go off the taste of alcohol early in pregnancy. Most women do give up alcohol once they know they are pregnant or when planning to become pregnant.

Women who find out they are pregnant after already having drunk during early pregnancy should avoid further drinking. However, they should not worry unnecessarily, as the risks of their baby being affected are likely to be low. If they are concerned, they should consult their doctor or midwife.


Binge drinking in pregnancy

Binge drinking, where you have more than five units of alcohol in one session, may make you less aware of your baby’s needs. If you do binge drink, it’s essential your baby is cared for by a sober adult.

Never share a bed or sofa with your baby if you have drunk any alcohol. Doing this has a strong association with sudden infant death syndrome (SIDS).

 

For more information check out NHS Start 4 Life, RCOG & Drinkaware*.


Approaching someone who is drinking while pregnant

As drinking alcohol can be dangerous for the baby’s health, it is important to keep drinking to a minimum or better yet, not drink at all. It might be difficult to confront someone who is drinking while pregnant and we have gathered a few tips on how to do this:

  • Stay respectful and calm.
  • Support and listen to the person.
  • Tell her statistics and facts about FASD and how it can be very harmful for the child. Try to stay logical.
  • Approach her again when she’s sober while still offering support. She might be more open to listening to you when there’s no alcohol involved.
  • Help her find support groups and people to talk to about the situation.

 


Breastfeeding

Is it safe to drink alcohol while breastfeeding?

Anything you eat or drink while you’re breastfeeding can find its way into your breast milk, and that includes alcohol.

There’s some evidence that regularly drinking more than two units of alcohol a day while breastfeeding may affect your baby’s development. But an occasional drink is unlikely to harm your breastfed baby.

One unit of alcohol is approximately a single (25ml) measure of spirits, half a pint of beer, or 125ml (small) glass of wine, although this depends on the strength of the drink.

To check units in other drinks, see Alcohol Concern’s alcohol unit calculator.


Managing social occasions 

If you do intend to have a social drink, you could try avoiding breastfeeding for two to three hours per unit after drinking. This allows time for the alcohol to leave your breast milk. You will need to make sure breastfeeding is established before you try this.

You may want to plan ahead by expressing some milk before a social function. Then you can skip the first breastfeed after the function and feed your baby with your expressed milk instead.  Bear in mind your breasts may become uncomfortably full if you leave long gaps between feeds.


Alcohol and your breast milk supply

There’s no evidence that alcohol, including stout, helps you produce more milk.

Rest, being well in yourself, and letting your baby breastfeed whenever they want will all help increase your milk supply.

 

For more information check out the Drinkaware* & the NHS website.

*DRiNKLiNK has no affiliation with Drinkaware


Related links:

FASD: The Facts

The Dangers and Risks of Drinking

Pregnancy and alcohol

FASD Network UK

NOFAS UK

Living with FASD – Strategies for Parents

Drinkaware: Alcohol and pregnancy

Sudden Infant Death Syndrome

Support groups

Alcohol misuse has an impact on more than just the person drinking. Those with regular contact are likely to be negatively effected by the person’s condition.

Here are some ways that people can be impacted:

Financial Problems

Families and others that rely on a sufferer of alcoholism are likely to experience problems related to financial troubles caused by drinking habits.

The costs of alcohol increase as the alcoholic person builds tolerance to the drug in his or her system. This requires the person to take in ever-greater amounts of alcohol in order to feel the same effects.

The psychological effects of this alcohol tolerance and dependency may cause the sufferer to become withdrawn and less supportive of colleagues, friends and family members.

Sufferers may no longer attend social functions that do not allow drinking and may not be fully aware of their behaviour if attending functions where their drug of choice is allowed.

A lack of networking and communication with peers may cause further financial problems if the sufferer loses promotion opportunities.

Greater drains on income and lessened opportunities may cause undue troubles for others financially dependent on the sufferer, requiring a spouse or roommate to pick up extra hours or a second job to keep bills at a manageable level.


Relationship Problems

The constant agitation, drowsiness and confusion experienced by those suffering the effects of alcoholism are likely to cause problems for anyone in a relationship with the sufferer.

People who find themselves in a romantic relationship with an alcoholic may end up making excuses for their lack of attendance or improper conduct at social functions.

They may find their options for other social interaction limited, and this may further be compounded by financial troubles or other problems related to the incidence of alcoholism.

Alcoholics may have trouble relating to teetotallers or those who do not share their propensity for drinking to excess, and they may attempt to convince friends or loved ones to join them in drinking. This can lead to additional problems as others experience the challenges faced by having a sufferer in their personal relationships.

In a recent study, Living with and alcoholic partner, The researchers looked specifically at the problems faced and coping strategies used by wives of alcoholic clients. This is not isolated to gender, however gives you an indication of some of the challenges that spouses can face.


Family Problems

Families rely heavily on one another for support. This includes both financial and emotional support, which alcoholism can erode over time.

Children are likely to experience a number of problems related to the conduct or financial situation of their parents when alcoholism is involved. Children may experience neglect or physical and mental abuse as a parent loses awareness of their actions due to the effects of alcohol.

Children may also find problems with their own social development appearing due to an alcoholic parent becoming unwilling or unable to support the child’s endeavours. This can range from missed events, such as football games or birthday parties, to outright neglect.

You can find out more about life with an alcoholic here.

 


 

Related links:

Life with an alcoholic

Effects of drinking

Mental health

Treatment centers

Support groups

Financial aid

Alcohol-related bereavement can cause you to experience a whole range of emotions. For some people, you may have had a bit of warning, however for others, death may be a sudden realisation to deal with.


The Five Stages of Grief

Denial: Denial helps us to pace our feelings of grief. Numbs us is you will. As you accept reality and start to ask questions, you are starting the healing process.

Anger: The more you feel anger, although it may feel endless, the more you heal. This is not limited to friends and family. This can go way beyond.

Bargaining: Even after death we will bargain for this persons life and play over the event. We want to go back in time to take action and stop the death from happening.

Depression: Empty feelings start to present themselves and we can become depressed.

Acceptance: This is purely accepting the reality that a loved one is gone and that this is a permanent reality.


What makes bereavement through drugs and alcohol different?

Every bereavement can be difficult and painful. But when someone we care for dies as a result of drug or alcohol use there are some common factors that can make it even harder.

Shame and stigma: Those of us who have lost a loved one to drugs or alcohol often feel that society is judging us, leading to a sense of shame and disgrace. People may assume that an addict had a choice, or that their addiction and death were their own fault. Many people will be understanding, but not knowing who is thinking like this can lead to us avoiding others and feeling isolated.

Traumatic circumstances: When someone dies through drugs or alcohol it can be in traumatic circumstances. The police and other officials are often involved. There may be an inquest and a post-mortem which are stressful and delay funerals and memorials. We may have questions about how and why a loved one died which are never fully answered. Sometimes there is media interest which can be distressing and intrusive.

Experiences before the death: Many people bereaved through alcohol or drugs have been living with an addiction in the family, sometimes for many years. When someone close is experiencing addiction it can make life very difficult: emotionally, practically and financially. Issues you faced beforehand can often carry over into bereavement.

Suddenness and shock: Whether or not the death was expected or feared it can still feel like a devastating shock when it happens. Some people do not know beforehand that their loved one was using drugs or drinking too much and some loved ones may have only recently begun experimenting.

Intensity of emotion: It can be very difficult to make sense of a death when it feels like it happened at the wrong time, and in the wrong way. Because of this, and the other factors which make bereavement through drugs and alcohol so difficult, we know it can be very, very painful. It can take a long time to work through and process this pain.

 

You can find out more about bereavement through drugs and alcohol here

 


 

Related links:

The BEAD Project

ADA – Families and Friends Support Group

Understanding your grief

Living through grief

Managing your grief

Alcohol abuse and dependence can often arise from the use of alcohol as a coping mechanism.

Scottish culture celebrates alcohol as a way to unwind after a hard day at work, drown sorrow in hard times, and as a social lubricant in all sorts of situations. However, using alcohol as a catch-all way to balance out emotional experience or become less present has some real consequences.


What is a Coping Mechanism?

A coping mechanism is something that helps a person deal with something that is difficult for them. While all coping mechanisms provide the person using them with a real or perceived benefit, some coping mechanisms have more negative consequences associated with them.

Unfortunately, alcohol is a coping mechanism the temporary benefits of which are often outweighed by the long-term negative effects on health and relationships, poor decision-making under the influence, as well as increased dependency.


People may use alcohol to cope with:


Does Alcohol Function as a Coping Mechanism?

Alcohol functions to slow down the central nervous system, creating feelings of relaxation. It also reduces inhibition, judgement, and memory. All of these qualities are reasons that some people use alcohol to try to cope.


Who Uses Alcohol as a Coping Mechanism?

People from all walks of life use alcohol as a coping mechanism, from business people stressed by a heavy workload to college students overwhelmed by social anxiety, to veterans suffering from PTSD.


Dangers of Alcohol Use as a Coping Mechanism

Addiction: Whether or not substance abuse and/or addiction run in your family, all people experience increased tolerance for alcohol the more and longer that they drink. More alcohol is required to achieve the same effect. In extreme cases of physical dependence on alcohol, a person can become so addicted that they experience withdrawal symptoms without the substance, such as tremors, sweating, insomnia, headaches and more. Alcohol withdrawal can be fatal in severe cases.

Damage to Relationships: Using alcohol as a coping mechanism tends to have consequences in relationships. At best, it tends to create distance between loved ones. At worst, it can contribute to anger, fighting, and irresponsible behaviour in relationships.

Failure to develop alternate coping skills: If a person is constantly using alcohol to, for example, avoid feelings of sadness and loneliness, they may fail to develop other ways of managing this distress, such as developing close relationships, practicing mindfulness, or seeking help from a mental health professional. Alcohol becomes a crutch and a barrier to developing more adaptive or effective coping strategies.


Developing Alternate Coping Skills

One of the most effective ways of addressing alcohol dependence and abuse that arises from using alcohol as a coping mechanism is to develop other effective coping mechanisms. Rather than simply resolving to “stop drinking,” which removes one coping skill without replacing it with another, it is important to have other skills in place. After all, you were drinking for a reason, so it’s important to address that reason and find other ways to meet the need it filled.

Some examples of alternate coping skills include:

  • Reaching out to others for comfort and support
  • Physical activity like walking, swimming, sports
  • Mindfulness practices like meditation or yoga
  • Breathing techniques
  • Distraction, like watching TV or listening to music
  • Learning and practicing social skills to address social anxiety
  • Talking to a therapist
  • Making art
  • And many more

Looking for the Root of the Problem

Finding a sustainable solution to alcohol abuse and addiction requires a good understanding of what drives the problem and what exactly you are using it to “cope” with. This often requires doing some introspective work and addressing topics that may be vulnerable, like past trauma, a high-stress lifestyle, or feelings of low self-worth. Some of the ways that people may explore and address what is driving their use of alcohol as a coping mechanism include:

  • Group therapy
  • Individual counselling
  • Family therapy
  • Trauma therapy (EMDR, etc.)
  • Intensive Outpatient Programs for Alcohol
  • Day Treatment Programs for Alcohol
  • Residential Treatment Programs for Alcohol

 


 

Related links:

Mental health

Coping with stigma

Support groups

Managing expectations around alcohol recovery

Letter

 

Alcoholism is destructive to those closest to the alcoholic, and it affects families in several different ways. Many times, rehabilitating an alcoholic is only one part of the process of healing a home. Family members may also need support and counseling.

Alcoholic families suffer from a range of problems. Spouses can live in constant conflict. Children may develop low self-esteem, loneliness and fear of abandonment. Infants may even be born with lifelong birth defects. When support is not sought out, the results can be severe.

Alcohol abuse can lead to many family problems. These are a few of the most prominent:

Visit Adfam’s website here to find out how to get help for a family member using drugs or alcohol

 

 

There are many different kinds of abuse, but those most commonly associated with domestic relationships are:

 

Physical Abuse/Domestic Violence

This is the easiest type of abuse to recognise as it often involves visible injuries such as cuts and bruises. This deliberate form of harm includes aggressive injuries such as hitting, slapping, punching, choking, pushing and deliberate wounding, but it can also include less obvious things like inappropriate restraint, improper use of medication and withholding food and drink. Some abusers choose to inflict injuries that cannot be seen by others, and it is important to remember that a bruised arm or leg is just as unacceptable as a black eye.


Sexual Abuse

Any sexual act that has not been consented to is classed as sexual abuse. This includes rape, sexual harassment, forcing someone to perform a sex act and filming sex acts or body parts without permission. It is important to remember your right to say “no”, and any refusal to respect this can be seen as sexual abuse.


Emotional Abuse/Coercive Control

This is regarded by many experts as the most psychologically damaging kind of abuse as it is harder to recognise, so victims often stay longer than they would if they were being physically attacked. This kind of abuse is used to control and humiliate, and can include deprivation of basic emotional needs, isolating the victim from friends and family, verbal insults, abandonment and intimidation. “Gaslighting” is a common form of emotional abuse which involves regularly lying about things that have happened and been said, leaving the victim questioning their own sanity.


Financial or Material Abuse

This kind of abuse is closely linked to coercive control and happens when the perpetrator limits the victim’s access to their own money or causes deliberate financial hardship. This can include fraud, theft and controlling bank accounts, pensions and housekeeping money.

 

There are many places to go for help if you suspect you are a victim or know someone who is a victim of domestic abuse. Click here for more information. 

 


 

Related links:

National Domestic Abuse Helpline

Support for domestic abuse victims

Domestic Abuse (Scotland) Act 2018

The Survivor’s Handbook

How to report domestic abuse

The safety risks

Living with an alcoholic is emotionally and physically exhausting, and you may often feel unsafe in your own home. There may be severe mood swings to deal with, which can often seem to come out of the blue, but even if your partner is not deliberately being aggressive towards you there are other dangers to you, your loved ones and your home. The safety risks can include:

  • Physical abuse (e.g. punching, hitting, choking, throwing things at you)
  • Fire hazards (falling asleep with a cigarette, leaving the chip pan on, barbecuing near a shed or tree)
  • Trips and falls (drunk people are unsteady on their feet and can knock things over or fall into you)
  • Danger to pets and children (again, this may not be deliberate but can be caused by stumbling while under the influence)
  • Broken glass (glasses and other sharp items can get broken, increasing the risk of accidents)
  • Emotional damage (living with an alcoholic long term presents a significant risk to your mental health, often leading to depression and anxiety)

You can check out the types of abuse here. 


Effects on friendships

When someone drinks too much, it doesn’t just affect them. Alcohol abuse has devastating effects on relationships of all kinds, and you may feel that your friendship is really being put under pressure. Let’s take a look at some of the most common effects that alcohol has on friendships. 

 

Aggression   

Alcohol and aggression have been linked for centuries, and it’s well known that people are more likely to become irritable and lose their temper after too much drink. If you find yourself in a situation where your friend is violent, aggressive or argumentative towards you, remember that you don’t have to accept this behaviour.  

Denial 

A common part of any addiction is denial. If you feel that your friend’s drinking is out of control yet they continue to accept that they have a problem, it can be extremely frustrating to deal with. 

Financial problems  

If your friend is drinking too much, you may find that they’re struggling with their finances too. This could impact on you by never being able to pay for things when you go out or regularly asking to borrow money. Although it’s important to be there for your friends in times of need, it’s not your responsibility to handle their finances or constantly bail them out. And if they’re asking for money to buy drinks, remember that giving in to this request isn’t helping, it’s enabling the alcohol problem to take over. 

Embarrassment  

Our friendship groups are reflections of ourselves, so if your friend is constantly getting drunk or causing trouble this can have a really negative impact on how people see you too. People who have alcoholic friends can often feel embarrassed by their behaviour, so if you’re regularly finding yourself having to apologise on someone else’s behalf it could mean they have a problem.  

Family issues  

Alcohol abuse causes huge amounts of trouble in family relationships, and you may feel obliged to get involved. If you are close with your alcoholic friend’s family they may ask you to stage an intervention. On the other hand, you may find yourself with no choice but to speak to their family and have an awkward conversation that they may not be ready to hear. 

Loss of friendship  

Often, the friends of people with serious alcohol problems find themselves with no choice but to end the friendship. This can be particularly difficult if you’ve been friends for a long time, and can lead to intense feelings of grief. If you can, try to talk to your friend and get them to accept support. In turn, you may also want to find someone who can support you, too. 

Peer pressure 

This is particularly problematic among younger people who find it difficult to say no to binge drinking. It’s important to remember that you have the right to say no and don’t have to go along with what your friend is doing, no matter how awkward the conversation may be.  

 

If you yourself have a problem with drinking, you may also find yourself having issues with how you socialise. If your friendships have always revolved around drinking it can be difficult about how to sustain them without it. The truth is, genuine friendships are based on respect, so if you tell your friends that you’re no longer drinking they should accept your choice and support you. 

 

If you’re worried about your friend’s drinking (or your own) contact us for confidential support and advice.  


Parental alcohol misuse

Parental substance misuse can have a negative impact on children at each stage of their development. We have given some examples below:

  • Physical and emotional abuse or neglect as a result of inadequate supervision, poor role models and inappropriate parenting
  • Behavioural, emotional or cognitive problems and relationship difficulties
  • Taking on the role of carer for parents and siblings
  • Preoccupation with, or blaming themselves for, their parents’ substance misuse
  • Infrequent attendance at school and poor educational attainment
  • Experiencing poverty and inadequate and unsafe accommodation
  • Exposure to toxic substances and criminal activities
  • Separation from parents due to intervention from children’s services, imprisonment or hospitalisation
  • Increased risk of developing drug or alcohol problems or offending behaviour themselves.

Living in a household where a parent or carer misuses substances doesn’t mean a child will experience abuse but it is a risk factor. An analysis of 175 serious case reviews from 2011-14 found that 47% of cases featured parental substance misuse.

Children most at risk of suffering significant harm live in families experiencing a number of different problems, such as substance misuse, domestic abuse, and parental mental health problems or learning difficulties.

The impact of substance misuse on parents and carers can lead to negative consequences for children.

You can find out more about this on the NSPCC website.

Assessing the risk:

When assessing the risks, practitioners should consider:

  • If the parent is willing to acknowledge their difficulties and seek help and support
  • The relationship between the parent and the child
  • What social support is available to the family, such as relatives or friends who can provide the children with care and stability, offer financial support and make sure the home is clean and safe
  • How excessive consumption of alcohol or drugs affects the parents. Some people lose consciousness whereas others may become aggressive. Effects may vary and depend on their current state of mind, personality, tolerance of the substance, dosage and means of administration
  • If the substance abuse is dependent, hazardous or recreational
  • How old the child is. Babies and young children are completely dependent on their carers for all their day-to-day needs whereas teenagers are more in need of guidance and support as they transition to adulthood
  • If the child has some autonomy, is attending school and able to ask for help
  • If there’s conflict or violence in the home or unsafe visitors
  • The parent’s and child’s general physical and mental health
  • if one parent is having difficulties or both parents
  • If daily routines are maintained
  • If the child has to take on a caring role for their parent and siblings
  • If harmful substances and equipment are stored safely and not accessible to children
  • If anything has changed recently. Substance dependency is a chronic, relapsing condition and a situation can change very rapidly.

If you are concerned about a child and the affect alcohol is having on their life, you can find out about your local GIRFEC service here.

Alternatively, contact the NSPCC.

Domestic abuse can be difficult to predict, and people can often become violent for what seems like very little reason. However, there are some common triggers of aggression, such as:

  • Drinking too much
  • Drug use
  • Financial hardship
  • Problems at work
  • Being challenged about drinking
  • Frustration
  • Being unable to access alcohol
  • Feeling “questioned”
  • Jealousy

If you are in a relationship with a drinker who becomes aggressive, it is important to understand that it’s not your fault. It can feel like you’re walking on eggshells and that the slightest thing can trigger an argument, but you are not responsible for your partner’s behaviour. If you feel unsafe, seek advice from an organisation such as Scottish Women’s Aid, Abused Men in Scotland or Scotland’s Domestic Abuse and Forced Marriage Helpline.

 


 

Related links:

Women’s Aid

Abused Men in Scotland

Scotland’s Domestic Abuse and Forced Marriage Helpline

Early indicators of abuse

How to Stay Safe At Home

Domestic Abuse Victim Support

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