People need and expect clear advice

Women who are pregnant or trying to conceive need and expect clear advice on substances that can harm their pregnancy and developing baby – like alcohol.     

One in seven women drink alcohol after becoming aware of their pregnancy1 and one in four who are pregnant or would consider having a baby soon, are unaware that drinking alcohol during pregnancy can cause Fetal Alcohol Spectrum Disorder (FASD)2

Health professionals play an important role in providing clear and accurate information and advice about how to have a healthy pregnancy. 

A healthcare worker with tablet talking to pregnant woman indoors at home.


Looking for training?

Update your knowledge and skills with our eLearning course, Supporting alcohol-free pregnancy and safe breastfeeding. It’s free and accredited by the Royal Australian College of General Practitioners (RACGP), the Australian College of Midwives (ACM), the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and the Australian College of Rural and Remote Medicine (ACRRM).  

This short online course provides information about how to:

  • explain the latest evidence about the risks of alcohol consumption during pregnancy, when trying to conceive and when breastfeeding
  • describe the impact of alcohol at all phases of pregnancy, including the early weeks
  • use the validated AUDIT-C tool for assessing alcohol consumption during pregnancy.
  • provide positive reinforcement, strengths-based brief intervention, or referral, according to the assessed level of risk.
  • confidently provide advice that is consistent with the National Health and Medical Research Council’s (NHMRC) Alcohol Guidelines to reduce health risks from drinking alcohol.

The Foundation for Alcohol Research and Education (FARE) partnered with Medcast and consulted a range of health professionals to produce this evidence-based eLearning course. 

The course contains five modules and three case studies. It is accredited and covers the risks of consuming alcohol during pregnancy, how to talk about drinking alcohol during pregnancy sensitively and effectively, and how to assess this using a prescribed assessment model.

Other activities include:  

  • A summary of evidence on pregnancy and alcohol  
  • Fetal Alcohol Spectrum Disorder  
  • Brief intervention and motivational interviewing  
  • Breastfeeding and alcohol.  

The course takes approximately  60 to 90 minutes to complete.

Healthcare professional touching pregnant woman's abdomen
Pregnant woman at doctor’s office

The moments you spend with her matter

This includes making it routine practice to ask about alcohol, assessing use with a validated tool, and providing advice and support based on the level of risk.    

As one of the most trusted sources of information on pregnancy, health professionals are vital in communicating the updated National Health and Medical Research Council’s (NHMRC) Australian guidelines to reduce health risks from drinking alcohol, which advise:  

  • women who are pregnant or planning a pregnancy should not drink alcohol.  
  • for women who are breastfeeding, not drinking alcohol is safest for their baby. 

Looking for
more information?

Browse resources for health professionals, including topic guides and evidence briefs.

Find specialist AOD services for people who are pregnant.

Pregnant Woman Meeting With Nurse In Clinic

Facts at a glance

No established safe level of alcohol consumption during pregnancy and when trying to conceive has been found3. This was the conclusion of a review of evidence during the preparation of the National Health and Medical Research Council’s Australian Guidelines to reduce health risks from drinking alcohol.

Drinking alcohol during pregnancy increases the risk of miscarriage, stillbirth, and babies being born prematurely, small for gestational age, or with low birth weight4,5,6.

A developing baby’s blood alcohol level will increase as the mother’s blood alcohol level increases.

Prenatal alcohol exposure at any stage of pregnancy can disrupt fetal development and can damage developing organs including the brain7,8. The dose and timing of exposure impacts the organs and systems affected and the extent to which they are affected9.

Fetal Alcohol Spectrum Disorder (FASD), a consequence of prenatal alcohol exposure, is the leading cause of preventable non-genetic developmental disability in Australia.

The Australian Guide to the Diagnosis of FASD was produced in 2016 to assist in the diagnosis and management of FASD. Diagnosis is dependent on impairment in at least 3 of 10 specified domains of central nervous system structure or function, and the status of pre-natal alcohol exposure is confirmed or unknown10.

Women are likely to accept advice that they should not drink alcohol during pregnancy if this is discussed routinely in an open, factual, culturally safe, and supportive manner.

Some women may find it difficult to stop drinking and will need further support. If they are drinking at high levels, they should not stop without medical supervision.

Common questions

A review of evidence associated with the 2020 revision of the National Health and Medical Research Council’s Australian Guidelines to reduce health risks from drinking alcohol found no established safe level of alcohol consumption during pregnancy and when trying to conceive.

A variety of maternal and fetal factors influence the risks from drinking alcohol when pregnant, making it impossible to predict the level of risk in individuals.

Alcohol consumption at any stage of pregnancy can result in adverse pregnancy outcomes, including miscarriage, stillbirth, and babies being born prematurely, small for gestational age, or with low birth weight.

Prenatal alcohol exposure can also cause Fetal Alcohol Spectrum Disorder (FASD), a lifelong neurodevelopmental condition that impacts the brain and body. Different organs and systems of the baby’s body may be impacted, leading to structural or functional anomalies.

Although alcohol exposure can impact the developing baby at any stage of pregnancy, there are critical periods that are extra sensitive. This includes very early in pregnancy (3-8 weeks post-conception), when the embryo undergoes rapid cell division and differentiation to provide the foundations of the body systems.

If you think a person might have FASD, you should encourage and arrange for them to undergo a diagnostic assessment.

FASD is assessed and diagnosed using criteria based on prenatal alcohol exposure, impairment in neurodevelopmental domains, and the presence of sentinel facial features.

The Australian guide to the assessment and diagnosis of FASD  provides detailed information on clinical assessment, diagnosis, and management of FASD.

People with FASD can experience challenges in daily activities throughout their lives, and need support from family and loved ones, health professionals, and other support services.

FASD is recognised by the National Disability Insurance Scheme.

Health professionals are a key, trusted source of information about alcohol, pregnancy, and breastfeeding. Australian research has found that people who are pregnant, planning a pregnancy or breastfeeding want health professionals to ask them about their alcohol use, and want clear and accurate information about the risks.

It’s important not to assume that a person knows not to drink alcohol during pregnancy, or that they aren’t drinking. There are many factors that can influence whether someone consumes alcohol during pregnancy.

For example, they may have been drinking before they knew they were pregnant, or they may have been getting mixed messages about alcohol and pregnancy from family, friends, or other health professionals.

It is crucial to avoid judgment, stigma or shame when asking about alcohol use.

Use a validated tool such as AUDIT-C to assess their alcohol use and provide advice according to the assessed level of risk, including giving positive feedback to remain alcohol-free for those who are already avoiding alcohol. 

You should ask what their alcohol use was before the pregnancy was confirmed as well as after finding out, as this may vary.

For people who are breastfeeding, not drinking alcohol is safest for their baby.

Alcohol passes into breast milk. Breast milk has the same alcohol concentration as the blood of the person breastfeeding within 30-60 minutes of them consuming alcohol. It is only alcohol-free when the person’s blood alcohol level returns to zero. It can take up to two hours for blood alcohol levels to return to zero after one standard drink.

Even a small amount of alcohol while breastfeeding can lead to reduced breast milk production and consumption and disruptions to the baby’s sleep. Exposure to alcohol through breastmilk has also been linked to deficits in psychomotor development and cognitive ability in early childhood.

This is a common scenario. It is important to provide reassurance that being alcohol-free from the earliest opportunity in pregnancy is best for the pregnancy and developing baby. You can advise that the risk of harm to the baby is likely to be low following a one-off drinking episode, or if only small amounts of alcohol had been consumed before knowledge of the pregnancy. Provide positive reinforcement to remain alcohol-free during the pregnancy, and to return for support if she finds it hard to stop drinking.

Perspectives from health professionals

Professor Steve Robson
Obstetrician, Gynaecologist and AMA President

Dr Sarah Bombell
GP Obstetrician and Lactation Consultant


  1. Australian Institute of Health and Welfare. 2020. National Drug Strategy Household survey 2019.
  2. Kantar Public. 2021. Alcohol and pregnancy. Research conducted by Kantar Public on behalf of the Foundation for Alcohol Research and Education.
  3. National Health and Medical Research Council. 2020. Australian Guidelines to Reduce Health Risks from Drinking Alcohol. Commonwealth of Australia. Canberra.
  4. Bailey, B.A. & Sokol, R.J. 2011. Prenatal alcohol exposure and miscarriage, stillbirth, preterm delivery and sudden infant death syndrome. Alcohol Research & Health. 34(1) 86-91
  5. Patra, J., Bakker, R., Irving, H. et al. 2011. Dose-response relationship between alcohol consumption before and during pregnancy and the risks of low birthweight, preterm birth and small for gestational age. A systematic review and meta-analyses. BJOG. 188. 1411-21
  6. Aliya, M.H., Wilson, R.E., Zoorob R. et al. 2008. Alcohol consumption during pregnancy and the risk of early stillbirth among singletons. Alcohol. 42(5) 369-374.
  7. Caputo, C., Wood, E. & Jabbour, L. 2016. Impact of fetal alcohol exposure on body systems: A systematic review. Birth defects research part C. Embryo Today 108(2) 174-80
  8. Mattson, S.N., Bernes, G.A. & Doyle, L.R. 2019. Fetal alcohol spectrum disorders: A review of the neurobehavioural deficits associated with prenatal alcohol exposure. Alcohol Clin Exp Res. 43(6) 1046-1062
  9. O’Leary, C.M., Bower, C., Zubrick S.R. et al 2010. A new method of prenatal alcohol classification accounting for dose, pattern and timing of exposure. Journal of Epidemiology & Community Health. 64:956-962
  10. Bower, C. and Elliott, E.J. 2016. On behalf of the Steering Group. Report to the Australian Government Department of Health: Australian Guide to the diagnosis of Fetal Alcohol Spectrum Disorder (FASD).