This article is devoted to the controversial subject of alcohol and women, especially as it relates to pregnancy, breast-feeding and breast cancer.
If women stick to the recommendations for safe drinking levels, limiting themselves to a maximum of two standard drinks per day then there are no problems. But if women abuse alcohol, that is a different matter. Moderation is still a vital issue.

Pregnancy

In the United States of America, wine bottles have to have an official Government Health Warning label attached to them which states, among other things, that women should not consume alcohol while they are pregnant. This warning has been taken to its extreme, in litigation-conscious America. Pregnant women with an obviously enlarged abdomen are usually not served alcoholic drinks in restaurants etc., for the fear of being sued if the baby is born defective.

This increased apprehension is due to Foetal Alcohol Syndrome (FAS), where babies born to mothers who abused alcohol during their pregnancy are born with certain facial malformations and mental defects. This will not occur if the mother limits herself to the safe drinking limits.

It always amuses me to think of waiters refusing to serve alcohol to the obviously pregnant women but would just as happily serve alcohol to other women, (even if they were pregnant), as long as they have a flat tummy.

In fact, most defects actually occur in the first semester of a pregnancy, when the woman doesn’t ‘show’. This is when the baby has formed everything in the first 13 weeks. So if any damage is done, it is when the woman actually does not ‘show’. The second 13 weeks is for the growth and development of the already formed baby and the last 13 weeks is for maturation and “fatting up” of the baby prior to birth. That is why neonatologists (doctors of new born babies) can now keep babies alive who are only 26 weeks in gestation, as they are fully developed, missing out only on the last part where they get ready for their birth.

Many studies have shown that there are no occurrences of FAS in moderate drinking pregnant women. Studies show that FAS occurs only after five or six standard drinks are consumed per day, regularly. In my experience, I have encountered patients who may not have been aware that they were pregnant, consumed more than the safe limit of alcohol, and later spent the rest of their pregnancy worrying about the possible occurrence of Foetal Alcohol Syndrome. Interestingly, a study by Dr. Walpole in Western Australia, found that most harm, in fact, occurred as a result of pregnant women worrying about Foetal Alcohol Syndrome, than from moderate drinking during the pregnancy.

The Royal College of Obstetricians and Gynecologists in Britain has a policy statement saying that consuming alcohol in moderation during pregnancy is safe. The American Health warning about pregnancy and drinking is a political statement to appease the anti-alcohol lobby. It is not a medical statement based on medical fact, otherwise, it would just say “Don’t abuse alcohol while you are pregnant.” The Foetal Alcohol Syndrome may eventually turn out to have a multi-factorial cause or pathogenesis because most women who have babies with Foetal Alcohol Syndrome come from lower economic groups in large cities. So, there may be other poor nutritional and pollution factors involved that we don’t know about yet and not just alcohol abuse which may be just one factor.

Breast Feeding

The next logical thing after wine and pregnancy is wine and breast- feeding. Alcohol is secreted in breast milk. If the lactating mother sticks to moderation, the amount of alcohol in her milk would be minimal and at worst, would make the baby a little drowsy, hence allowing the baby to sleep better. It is a different story if the lactating mother abuses alcohol. Here the anti-coagulant effect of the alcohol can cause excessive bleeding in the baby.

Breast Cancer

Breast cancer is naturally an emotive issue with women. Some studies have shown a slightly increased risk of developing breast cancer in drinkers whilst other studies have shown no increase or an actual reduction in the rate. The jury is still out on this one. If there is an increase, it is minimal and must be put into proper perspective by balancing against the known vascular and other benefits from consuming wine in moderation. Women are much more likely to die from an increase in vascular disease as an abstainer, for example, than they are from breast cancer if they drink alcohol. Everything has to be weighed up accordingly.
In Australia, for example, approximately 2,600 women die each year from breast cancer but greater than ten times that number die from vascular disease (mainly heart attacks and strokes).

Dr Phillip Norrie is a physician in Sydney Australia and a wine and medical historian.
He owns Pendarves Estates Winery in the Hunter Valley..

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