At Christmas, parents spend much time focusing on their children and wider families and often do not have time to think about their own health and well-being let alone the impact of their health related behaviour on their children.
The recent report on the Public Health Burden of Alcohol (2016) notes that parental alcohol consumption and attitudes about consumption can have a negative impact on children, young people and the family. This impact can range from instilling unhealthy social norms and attitudes around drinking through to child maltreatment. The report estimates that in England, almost 94,000 babies under one year old live with a parent who is a hazardous or harmful drinker. In 2010, more than 100 children, including children as young as five, contacted ChildLine every week, with concerns about their parents drinking or drug use.
Although, 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 a study from the Office for National Statistics of the most popular birth month in England and Wales was reported in the Telegraph. The study concluded 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).
Parents need to know about the significance of this 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).
Alcohol is a teratogen, which means that it can affect foetal development. Teratogens can cause birth defects or complications during pregnancy. Foetal alcohol spectrum disorder (FASD) is an umbrella term for a group of conditions that can occur in a person whose mother consumed alcohol during pregnancy. Problems may include facial anomolies, short height, low body weight, small head size, poor co-ordination, low IQ, behaviour problems and problems with hearing or seeing. The most easily recognisable diagnosis on the spectrum is known as foetal alcohol syndrome (FAS).
In England in 2014/15, there were over 6,700 hospital admissions for spontaneous abortion and low birth weight, accounting for less than 1% of all alcohol-related hospital admissions. Alcohol consumption during pregnancy is associated with the baby being born prematurely or underweight which poses further developmental risk. 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 (http://www.nofas-uk.org/), and the FASD Network (http://www.fasdnetwork.org/ ) and the European Birth Mothers Network (http://www.eurobmsn.org/) work hard to raise awareness about concern for children and families and to support parents. In addition the specialist FASD Clinic (http://www.fasdclinic.com/) 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 (BMA, 2016).
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.
By Dr Carolyn Blackburn, Senior Fellow in Early Childhood and Inclusion, Birmingham City University.