Drinking, Smoking, and Your Pregnancy

A glass of wine or a puff on a cigarette is a part of many women's social lives. But if you're pregnant, whatever you take into your body reaches your baby too. Smoking and drinking can hurt your baby, so it's important that you change your habits.

The best time, of course, is before you and your partner decide to start trying. A baby's brain and other organs start to develop before you even realize you're pregnant. But even if you're expecting, you can reduce the risk to your child if you kick these habits now.

Drinking for Two

When you lift your glass, make sure it's filled with grape juice, not wine. The reason? When you drink, alcohol passes through the placenta to your growing fetus. Because a developing baby's body breaks down alcohol much more slowly than an adult's, a fetus's blood alcohol level can rise much higher than its mother's and stay elevated longer. The damage can be long-lasting and severe, ranging from mental retardation to heart damage.

Unfortunately, according to the National Academy of Sciences, 20 percent of women who drink alcohol continue to do so during pregnancy. And about 1 in 29 women who know that they're pregnant report dangerous levels of drinking (defined by the Centers for Disease Control and Prevention as more than seven drinks in a week or five and above on one occasion).

Does a Sip or Two of Alcohol Count?

Resist the urge to take a small sip, even for a toast, because research has shown that occasional drinking may be harmful too. A recent study at Wayne State University, in Detroit, found that women who consumed as little as one drink a week during pregnancy were about three times as likely as non-drinkers to have a child diagnosed with behavioral problems such as aggression and difficulty paying attention. Preschoolers of women who drank moderately (one to three drinks a day) sometimes fare worse. In fact, a number of studies have found that these children have an increased risk of learning problems and decreased IQ in addition to significant behavioral problems later on.

The list of potential health and developmental problems doesn't end here; drinking heavily throughout pregnancy increases your risk of having a baby with fetal alcohol syndrome (FAS). FAS, which affects about 1 in 1,000 babies in this country, is one of the most common causes of mental retardation and central nervous system problems, abnormal facial features, and, often, heart defects. Even if they're not mentally retarded, these children may have problems with learning, memory, attention, speech, and hearing, as well as severe behavioral problems.

In addition, past studies have shown that women who consume three drinks per week in their first trimester are more than twice as likely as non-drinkers to have a miscarriage.

Will Caffeine Hurt a Pregnancy?

Wondering if coffee can be dangerous during pregnancy? The experts disagree. While some studies have linked heavy caffeine consumption during pregnancy with an increased risk of miscarriage, most have found little or no risk with moderate consumption (one or two cups a day).

Until we know more about how much caffeine is completely safe in pregnancy, the wisest choice is to try to cut it out of your diet or limit your intake to 300 milligrams a day, the amount in two 8-ounce cups of coffee. If you're a tea drinker, remember that some brewed teas may contain nearly as much caffeine as coffee, although amounts vary greatly. Keep in mind that other foods and beverages -- chocolate and colas, for example -- also contain caffeine, so read labels carefully.

How Smoking Can Affect Baby

You know that cigarettes aren't good for you, and they aren't good for your growing baby either. In fact, smoking nearly doubles your risk of having a low birth weight baby, whose odds of serious health problems and even death are greater. The good news: If you quit smoking by mid-pregnancy, you're no more likely to give birth to a low birth weight baby than a woman who never smoked. Even quitting late in pregnancy can increase your baby's birth weight. A new study at Case Western Reserve University, in Cleveland, found that women who quit by their 32nd week reduced their risk of having a low birth weight baby to levels similar to nonsmokers.

Smokers also face an increased risk of ectopic pregnancy (when the embryo implants outside the uterus, usually in a fallopian tube) and placental complications. Placenta previa, in which the placenta attaches too low in the uterus and covers part or all of the internal opening of the cervix, is at least twice as common in smokers as in nonsmokers. So is placental abruption, in which the placenta separates from the uterine wall before a woman's delivery. If you smoke, you are also more likely to have your water break before labor begins (called premature rupture of the membranes). When this situation occurs before 37 weeks of pregnancy, it often results in the birth of a premature baby.

Why Smoking Is Still Harmful After Birth

Babies of smokers may face even more problems after birth. A study at Brown University suggested that babies of mothers who smoke throughout pregnancy may experience withdrawal-like symptoms (such as being jittery, sad, or difficult to soothe) similar to those seen in babies of mothers who use drugs. Smoking may also increase a baby's risk of various birth defects, including cleft lip, cleft palate, and clubfoot. Even more frightening is research suggesting that babies whose mothers smoked during pregnancy are more likely to die of sudden infant death syndrome (SIDS).

It's also important to stay smoke-free after your baby is born. Babies who are exposed to smoke suffer from more respiratory illnesses, asthma, and ear infections than do other babies. In fact, infants whose mothers smoke are 38 percent more likely to be hospitalized for pneumonia during their first year of life than are babies of nonsmoking mothers.

How to Quit Smoking and Drinking During Pregnancy

Now that you know all the facts, it's time to call it quits. If you're having trouble abstaining from alcohol, you may have a drinking problem and need help. Call the National Council on Alcoholism and Drug Dependence (800-NCA-CALL), or check your local phone book for an Alcoholics Anonymous chapter in your area. These organizations can help you control your problem.

• Visit the National Council on Alcoholism and Drug Dependence
• Visit Alcoholics Anonymous

Smoking is also a tough habit to kick. If you have tried and failed, contact your doctor. She may recommend medication or techniques to help you quit or at least reduce your habit. You may also contact the American Cancer Society (800-ACS-2345) or the American Lung Association (800-586-4872) for further assistance.

• Visit the American Cancer Society
• Visit the American Lung Association

Richard H. Schwarz, an obstetrical consultant to the March of Dimes, is past president of the American College of Obstetricians and Gynecologists; Vice Chairman for Clinical Services, Department of Obstetrics and Gynecology, Maimonides Medical Center; and Emeritus Distinguished Service Professor of Obstetrics and Gynecology, SUNY Downstate Medical Center, both in Brooklyn, New York.

All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.