Alcohol, smoking and drugs in pregnancy

Drinking alcohol, smoking or taking drugs during pregnancy or while breastfeeding can affect your child's health. Women who are pregnant, trying to conceive or breastfeeding should avoid smoking, drinking alcohol or taking illegal drugs. Always speak with your doctor or midwife before taking any medication.

Alcohol guidelines

The current medical guidelines are that:

  • if you are pregnant or planning a pregnancy, the safest approach is not to drink alcohol at all to keep risks to your baby to a minimum
  • drinking in pregnancy can lead to long-term harm to the baby, and the more you drink the greater the risk

If you are trying to get pregnant, you need to be aware that drinking alcohol can reduce your fertility and ability to conceive. Drinking too much, especially getting drunk, can lead to a miscarriage in the early stages of pregnancy.

To keep the risks to an absolute minimum, the safest approach is not to drink at all.

When a pregnant woman drinks alcohol, the alcohol passes through the placenta and can affect the baby’s development. This happens throughout the pregnancy, not just in the first few weeks.

Drinking too much can lead to:

  • premature birth
  • low birth weight
  • impacting on the physical and mental development of the child, a condition known as Foetal Alcohol Syndrome (FAS)

Women are therefore strongly advised to not drink alcohol at all at any stage during pregnancy because there may be an increased risk of miscarriage. The current advice is to avoid alcohol completely.

Alcohol and breastfeeding

Alcohol passes to the baby in small amounts in breast milk. The milk will smell different to the baby and may affect their feeding, sleeping or digestion. The best advice is to avoid drinking shortly before a baby’s feed.

Whether you’re breastfeeding or not, the recommended benchmark is to consume no more than 14 units of alcohol per week, spread evenly over three days or more because if you have one or two heavy drinking sessions, you increase your health risks.

Foetal Alcohol Syndrome

Children born with FAS can have growth problems, facial defects and lifelong learning and behaviour problems.

Foetal Alcohol Spectrum Disorder (FASD) describes the range of less obvious effects that can be mild to severe and relate to one or more of the following symptoms of FASD;

  • low birth size
  • problems eating and sleeping
  • problems seeing and hearing
  • difficulty following directions and learning to do simple things
  • trouble paying attention and learning in school
  • trouble getting along with others and controlling their behaviour

Children with FASD may need medical care all their lives or may need special educational support.

FAS and FASD are completely preventable by not drinking alcohol during pregnancy.

Advice from your doctor

Your doctor can help you to get advice and a referral to services for help with an alcohol or drug addiction problem.


Smoking while pregnant not only damages your own health, but can also harm your baby.

It has been linked to a variety of health problems, including:

Every year, more than 17,000 children under the age of five are admitted to hospital because of the effects of secondhand smoke. If you stop smoking, you will reduce the risk of harm to yourself and your baby.

If you are struggling to quit smoking, having a cigarette after feeding, rather than before, will help reduce your baby’s exposure to nicotine. Only giving up cigarettes altogether, however, will completely protect them.

Giving up smoking

If you’re trying to give up smoking, also encourage those around you to do the same. Second hand smoke contains tar and toxic chemicals that are harmful to you and your baby’s health.

Only you can decide to quit, but you can get help and support to stay a non-smoker.

Illegal drugs

Illegal drugs like cannabis, ecstasy, cocaine and heroin can harm your baby. If you use any of these drugs, it is important to talk to your doctor or midwife so they can provide you with advice and support to help you stop.

They can also refer you for additional support. Some dependent drug users will need treatment to stabilise or come off drugs to keep the baby safe.

Pills, medicines and other drugs

As well as illegal drugs, some medicines, including some common painkillers, can harm your baby’s health. This can include medication to treat long-term conditions such as asthma, thyroid disease, diabetes and epilepsy.

To be safe, you should:

  • keep taking your medication until you check with your doctor
  • always check with your doctor, midwife or pharmacist before taking any new medication
  • make sure your doctor, dentist or other health professional know you are pregnant before they prescribe you any medication or give any treatment
  • talk to your doctor if you take regular medication, ideally before trying for a baby or as soon as you know you are pregnant
  • use as few over the counter medicines as possible

Medicines and treatments that are usually safe include paracetamol, most antibiotics, dental treatments (including local anaesthetics) some immunisations (including tetanus and flu) and nicotine replacement therapy.

You should still check with your GP, pharmacist or midwife, however, if you are using any of these.

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