The question of whether pregnant women should abstain totally from alcohol continued to divide experts today.
Dr Mary Mather, a retired paediatrician, and Dr Kate Wiles of Guys and St Thomas NHS Trust, UK, say "inconsistent advice" is made by national organisations.
The authors say the Department of Health recommends pregnant women avoid alcohol but then gives an apparently "safe" level of no more four units a week. The National Institute for Health and Care Excellence advises to avoid alcohol in the first trimester, and the Royal College of Obstetricians and Gynaecologists says small amounts of alcohol have not been shown to be harmful.
Writing in The BMJ today (7 October) they state: "We should move to a clear recommendation to abstain" because "current guidance flies in the face of evidence and international consensus".
Pregnant women in the US, Canada, Denmark, France, Norway, Israel, Mexico, Australia, Ireland, New Zealand, Spain, the Netherlands, and Scotland are all advised to abstain from alcohol, they report.
But, writing in the same journal, Dr Patrick O’Brien of University College London Hospitals, UK, says: "Common arguments put forward in support of abstention are that the conflicting advice is confusing for women."
But, he states: "Women are intelligent and autonomous. It is not beyond our wit to explain the current evidence, including its limitations, to the wider population, particularly in the era of ubiquitous social media and internet access.
"We have produced a raft of conflicting guidance for women on this subject. This is our failing, not theirs. We need to resolve these inconsistencies then present the evidence in a clear and unambiguous way.
"We all deal with uncertainty in our lives on a daily basis; pregnant women are no less capable of doing so," he concludes.
Mather, M., Wiles, K. and O’Brien, P. Head to Head: Should women abstain from alcohol throughout pregnancy? BMJ 7 October 2015 doi: 10.1136/bmj.h5232 [abstract]
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