Alcohol, smoking and caffeine in pregnancy

If you drank alcohol or smoked before you knew you were pregnant, tell your care team. They can help you plan what to do now. CDC advises stopping alcohol during pregnancy and getting help if that’s hard. Stopping smoking can help even late in pregnancy.

Alcohol: no known safe amount or timing

CDC says no amount of alcohol is known to be safe during pregnancy, and there’s no safe time to drink. Wine, beer and spirits can all cause harm. Alcohol can affect how the baby develops. It’s also linked with miscarriage, premature birth and stillbirth, among other harms.

NHS advice is to avoid alcohol if you’re pregnant or planning a pregnancy. If you’ve already had some, the amount or timing alone can’t tell you what has happened in your pregnancy. CDC explains that not every baby is affected, but there’s no way to know which babies will be.

Ask for help if avoiding alcohol is hard. In the UK, your GP or an alcohol support service can help you make a plan. Elsewhere, your doctor or a local treatment service can help. Tell them you’re pregnant, and explain what you drink and what happens when you try to cut down.

If cutting down brings on symptoms such as shaking, sweating, feeling sick or anxiety, get medical help before you try to stop suddenly. Alcohol withdrawal can be dangerous. Ask your care team for a plan with support.

Smoking: support is part of the plan

Cigarette smoke cuts the oxygen supply to the baby. Stopping smoking lowers risks including stillbirth, early birth and low birth weight. The NHS says the earlier you stop the better, but stopping even in the last weeks of pregnancy can still help. If you’ve tried before and found it hard, you can ask for help again.

Other people’s smoke matters too. Smoke from someone you live with can affect you and the baby, before and after birth. If it helps, include your home and the people around you when you talk about quitting. You can ask for a smoke-free space now.

In the UK, a midwife, pharmacist or GP can put you in touch with a stop-smoking adviser. NHS guidance allows nicotine replacement therapy (such as patches or gum) during pregnancy if it helps someone stop smoking and they can’t stop without it. Talk to a professional before choosing a product.

Vaping: the regional messages differ

The NHS says that if an e-cigarette helps someone stop smoking, it’s much safer than carrying on smoking. This compares vaping with smoking cigarettes. The NHS also accepts there are gaps in what we know about e-cigarettes. Talk to a stop-smoking adviser about what you use now, rather than seeing this comparison as a reason to start vaping.

CDC says e-cigarettes and other products with nicotine are not safe in pregnancy, and that nicotine can harm the baby’s developing brain and lungs. It advises people who can’t stop smoking to talk to their healthcare provider about treatment. UK and US wording differs, so ask your local care team for a plan to quit.

Caffeine: count more than coffee

The NHS advises no more than 200mg of caffeine a day. ACOG describes a moderate amount as less than 200 milligrams a day. The UK limit and the US description are close, but worded differently. Neither is a recommendation to have caffeine.

Caffeine is also in tea, cola, energy drinks, chocolate and some supplements or tablets. Think about your whole day when you check how much you have. The NHS notes that filter coffee and coffee-shop drinks can contain more caffeine than instant coffee. So counting cups alone may not give you the full picture.

Where to get help

If stopping tobacco or alcohol feels hard, book a chat with your midwife, GP or stop-smoking adviser in the UK, or your doctor or midwife elsewhere. You can simply say, “I want help with this.” Your care team can help you work out a plan to quit.

Contact your GP or alcohol treatment service today if cutting down on alcohol causes withdrawal symptoms. Call 999 now in the UK, 911 in the US, or your local emergency number for severe withdrawal symptoms such as confusion, seeing or hearing things that aren’t there, or a seizure after stopping drinking.