Since alcohol affects every fetus differently, new research suggests that pregnant women should avoid drinking at all costs.

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We've all seen the Surgeon General's warning: Pregnant women should not drink. But many moms-to-be (about 1 in 10) still do – whether it's having an occasional celebratory glass of wine, a regular nightcap, or a more serious struggle with alcohol addiction. And despite what you might have heard, new research suggests that all of these scenarios can harm your baby.

If you've had a drink or two since learning you were pregnant, don't panic, but you might want to think twice before you have another. A January 2019 study from the University of Washington examined 84 sets of twins and siblings whose mothers drank alcohol during pregnancy. They concluded that genetics – as well as the timing and amount of alcohol exposure – determined the severity of neurological damage caused by fetal alcohol spectrum disorders (FSDF). Since there’s no way to determine how an individual fetus will react to alcohol exposure in utero, the study concluded “the only safe amount to drink is none at all.”

As many as 1.1 to 5 percent of American children, many of whom seem happy and healthy, could have one of the fetal alcohol spectrum disorders, according to a February 2018 study published in the journal JAMA. This is above the old estimate of 1 percent of the U.S. population.

FASD is a term that describes a number of health and behavioral problems, including fetal alcohol syndrome (FAS), partial fetal alcohol syndrome (PFAS) and Alcohol Related Neurodevelopmental Disorder (ARND). These conditions frequently cause recognizable symptoms like abnormal facial features (a smooth ridge between the nose and upper lip), lower-than-average height and/or weight, small eye openings, and smaller than average heads.

But not all affected children have the hallmark features, which is why previous studies may have underestimated the prevalence. "Many of the features do not look extremely abnormal, and the behaviors and cognitive abilities can also blend into the normal range," says Dr. Philip May, a professor of public health at the University of North Carolina at Chapel Hill and lead researcher in a 2014 study involving FASD published in Pediatrics. What's more, evidence suggests that behavioral conditions, like attention deficit hyperactivity disorder (ADHD), in otherwise "normal" children could be linked to a pregnant woman's drinking, too.

The Problem with Drinking While Pregnant

There's no safe amount or type of alcohol when you're pregnant, according to the American College of Obstetricians and Gynecologists (ACOG). Research from the National Institutes of Health shows that binge drinking (four or more drinks on one occasion) puts the fetus at the most risk, but even lesser amounts of alcohol can have a detrimental effect. That's because during pregnancy alcohol passes through your baby's bloodstream in the same concentrations that it passes through yours – and can interfere with the development of organs, including the brain. Even low levels of alcohol can play a role in miscarriage, premature birth, stillbirth, and sudden infant death syndrome, according to the American Academy of Pediatrics.

And every pregnancy is different. Even if you had a healthy baby after drinking while pregnant before, the baby you're carrying now could still be harmed, ACOG says. The risk of harming your baby from drinking alcohol also increases as you get older.

But despite a strong stance against drinking while pregnant from the government and organizations like the March of Dimes, many women are still doing it. Experts blame partners who drink and social pressures. "Knowing that one should not drink during pregnancy and practicing that are often two different things," Dr May said. "There are social pressures to drink on certain occasions when you're pregnant. There are times when women say, as soon as I know I have a verified pregnancy, then I'll quit drinking. That may be too late."

Adding to the problem is conflicting advice. A 2010 study from Britain found that women who had two to six drinks per week early in the pregnancy tended to have children with more positive behavior than women who didn't drink at all. Meanwhile, another British study said light drinking during pregnancy is not linked to adverse behavioral or cognitive outcomes in children.

Dr. Eugene Hoyme, MD, professor of pediatrics and medical genetics at the University of South Dakota, believes these studies are misleading and belie the serious risks of drinking while pregnant. "There have been few things in prenatal medicine that have been researched as extensively as the effect of alcohol. The great preponderance of evidence in humans and in animals shows that alcohol is by far and away the most dangerous external agent women can expose themselves to in pregnancy."

Bottom line is, women who are pregnant, considering pregnancy, or who may become pregnant should not drink. "No safe amount, no safe time, and no safe type of alcohol exists during pregnancy," said Dr Leigh Tenkku Lepper, PhD, director of research at the University of Missouri's School of Social Work, who has been given funding by the Centers for Disease Control and Prevention to prevent FASD. "If moms-to-be know the dangers, why would they take the risk?"

7 Ways to Stop Drinking

Tempted by that beer with friends or champagne at a wedding? These tips from ACOG can help:

  1. If you're ordering at the bar, opt for a club soda with a lime. No one will be the wiser. Or try a mocktail.

  2. Stick around people who help you not drink (including those who would be happy to not drink around you if they know you'd be tempted)

  3. Avoid risky places and situations like bars and clubs if they make you want to drink. At parties, stay away from the drinks table and closer to the snacks.

  4. If you smoke, quit. Apart from the obvious risk to your baby, cigs increase your cravings to drink.

  5. Drink lots of water. It keeps you less thirsty for the hard stuff.

  6. Exercise – those endorphins help you knock back your cravings

  7. Keep stress at bay: take a bath, meditate or take some deep breaths when you're feeling a craving