Alcohol is deeply ingrained in our culture. Some Australians drink more during the festive season - Christmas Day, the Boxing Day Test, New Year's Eve celebrations. Everywhere you look, you see advertising and promotion of alcohol. Cheap, accessible, and almost inescapable.
COVID-19 has made 2021 difficult for many of us, and alcohol retail sales have soared. So have drinking rates among some parents - parents dealing with health and financial threats, lockdown, the stress of home schooling, and working from home.
The uncertainty of Omicron means this year the added pressure may lead to some people using alcohol to cope. But for women who are pregnant or trying for a baby, avoiding alcohol is crucial to prevent harm to their health and the health of their developing baby. Partners can help by taking a drinking pause, too.
The national alcohol guidelines, updated in 2020, recommend that "women who are pregnant or planning a pregnancy should not drink alcohol". The health advice is clear, but we need a community effort to deliver the message.
More than half of Australians drink during pregnancy, many unaware that there is no recognised "safe" level of prenatal alcohol exposure, as alcohol can cause damage to the developing baby and lead to Fetal Alcohol Spectrum Disorder (FASD).
That is why one key recommendation from the Senate inquiry into FASD, released earlier this year, was that Australia needed a national awareness campaign - its first such campaign - about the risks of alcohol use during pregnancy.
The campaign began this month, with the important message that "every moment matters" in your pregnancy.
"The moment you start trying, is the moment to stop drinking."
What is FASD and how is it diagnosed?
FASD may occur in children exposed to alcohol during pregnancy, but it is preventable. The Australian guide to the diagnosis of FASD, published in 2016, allows for a consistent approach to diagnosis, which includes three key elements:
- Confirmed exposure to alcohol in utero;
- Severe neurodevelopmental problems across at least three areas of function (this might include motor skills, cognition including IQ, language, or attention);
- Abnormal facial features and birth defects (including heart, kidney or lung). Hearing and vision loss may also result from alcohol exposure in during the first trimester.
Alcohol-induced brain injury and resulting brain dysfunction in FASD causes a range of learning, developmental and behavioural issues which can derail children at home and at school. Many children live in foster placements, some come in contact with child protection or the justice system, and most need lifelong support.
How has FASD impacted Australia?
We've come a long way in Australia. Before 2000, there were fewer than 10 publications on alcohol and pregnancy or FASD. Since then, through our systematic, national collaborative approach to research, we have made great advances in knowledge.
With government support, we now have a national FASD diagnosis guide, the FASD Hub website, the FASD Registry, and diagnostic clinics throughout Australia.
In the past five years, paediatricians have reported to the Australian FASD Registry that they've diagnosed more than 600 new cases of FASD - with enormous social, health, and economic impacts.
What needs to happen now?
We must address knowledge gaps about the risks of alcohol use in pregnancy.
Women tell us they want to know what is safest for them and their developing baby, and want clear advice.
Christmas is about family, love and community, an opportunity to reconnect and make up for time lost to lockdown. Let's create an environment that encourages women trying for or having a baby to feel supported to go alcohol-free, guided by sound health advice. Let's prevent FASD.
- Professor Elizabeth Elliott is a distinguished professor in Paediatrics and Child Health at the University of Sydney.
