Conception to Age 2: The First 1001 Days
Bill Presented — Marriage Registration Bill – in the House of Commons at 3:16 pm on 17th December 2015.
Excerpts related to foetal alcohol:
Fiona BruceChair, International Development Sub-Committee on the Work of the Independent Commission for Aid Impact 3:43 pm, 17th December 2015
Something that we ought to be much clearer about in this country, but that we sadly are not, is the effect of alcohol consumed by the mother during those first precious days of a child’s life in the womb. The National Society for the Prevention of Cruelty to Children estimates that about 7,000 babies born in the UK each year suffer the effects of alcohol drunk during pregnancy.
I pay tribute to Bill Esterson, who is chair of the all-party parliamentary group for foetal alcohol spectrum disorder, of which I am the vice-chair. This week, we published a report on the picture of FASD in the UK today, following an inquiry that ran throughout the autumn. We held a number of hearings with families and young people who have been affected by FASD, as well as with members of the medical professions and other interested organisations. The report is so substantial and so deeply concerning that, although you have been good enough to call me before the chair of the all-party group, Madam Deputy Speaker, it might have been more appropriate if we had been called the other way around. None the less, the report has such a lot of substance that I hope what I say will complement, rather than duplicate, what he will say.
The evidence that we gathered was severely alarming in respect of both the far wider impact of FASD compared with what is understood in this country and the lack of clinical and other support available to families who are affected. We learned that a mother need not consume large amounts of alcohol during her pregnancy to be affected, because individual women’s constitutions respond differently to alcohol consumption.
The impact on the unborn child, which can last for the rest of their life, can be profound. FASD causes organic brain damage in an unborn child. We were told that it causes heart defects, dental issues, eyesight problems, bladder difficulties, walking difficulties, cognitive challenges and memory and behavioural difficulties. Often it means that babies are premature. We heard about the emotional impact on those affected by FASD as they develop into young people and move into adulthood: they can withdraw from society, become unpredictable and even become suicidal. That places great stress on parents and carers, many of whom experience periods of isolation and ill health. The inquiry heard that it is likely that a much higher proportion of children are born with FASD than is currently recognised. Those children will have a variety of difficulties in childhood and in later life.
The tragedy is that, theoretically, FASD is 100% preventable if all pregnant women are given clear advice on the risks of alcohol intake to their unborn child. We were told that the best advice for young women is not to drink if they are considering becoming pregnant, since there are effects even at the earliest stage.
Equally tragic is the fact that in the UK, there have been decades of mixed messages regarding the right level of alcohol intake during pregnancy. I remember that from when I had my children, which is well over 20 years ago. The all-party group was advised that a clear message should be given by Government Departments that, just as smoking during pregnancy affected the unborn child and should be avoided, so too did alcohol and it too should be avoided.
For the UK not to be sending that message is not only tragic for the families concerned; it goes against international best practice, which is to advocate that alcohol be avoided if a woman is pregnant, thinks she might be pregnant or is trying to conceive. In Canada, children as young as primary school age are taught that. Pregnant women in Denmark, France, Israel, Norway, Mexico, Australia, Ireland, New Zealand, Spain and the Netherlands are advised to abstain completely from alcohol. Since 1981, the USA has advocated that
“no alcohol is safest for baby and you.”
Without such a clear message, pregnant women in the UK are left confused and uncertain. I know from my work as the chair of the all-party group on alcoholharm that few people can accurately measure one unit of alcohol. If a message is sent out that one or two units a week is okay, it is probably easy to think, “Well, why not three or even four or more?”
One of the reasons that women are confused stems from the unclear guidelines provided by UK professional and governmental bodies. Although NICE and the Department of Health warn of the potential for alcohol to harm an unborn child, incredibly they do not go on to stipulate that women should abstain from drinking during pregnancy. The Government are currently carrying out an alcohol review, and I hope they will seriously consider that issue. By contrast, the British Medical Association advocates that no alcohol should be drunk during pregnancy. As a result of those mixed messages, not only are women confused but many midwives are uncomfortable about giving advice on alcohol. A study that questioned 200 midwives found that only 60% asked women about their drinking habits, 30% advised against binge-drinking, and only 10% were aware of FASD. As our report says:
“this is astonishing and deeply worrying, and something which must be rectified as a matter of urgency.”
More encouragingly, 93% of midwives said that they would be comfortable advising that no alcohol should be drunk during pregnancy if that was the consistent message from the Government. In the absence of such clarity, however, they are afraid to offer such advice.
Our inquiry also revealed a similar lack of in-depth knowledge about FASD across the medical profession. There is only one specialist FASD clinic in the UK, and it is wholly overstretched. That lack of in-depth knowledge means that children with FASD are often given multiple inaccurate diagnoses, such as ADHD, autism or an attachment disorder. Appropriate support mechanisms are rarely put in place, and families are left frustrated and confused. It is critical that FASD is given a higher priority within the NHS for research, diagnostic, and support services.
The hon. Lady is making a fascinating contribution. Given that the Minister is in his place, is this a good moment for her to comment on the failure to fund research into the prevalence of foetal alcohol syndrome? I am sure she is coming to that, but given that the Minister is paying great attention, perhaps this is a good moment to get that message sprayed on to the Department’s eyeballs.
Fiona Bruce Chair, International Development Sub-Committee on the Work of the Independent Commission for Aid Impact
I thank the hon. Gentleman for that intervention. Our report states that because of inadequate research in this country, there is insufficient information to encourage those involved—including, we believe, Government representatives—to take action.
Several of our witnesses testified that there must be more appropriate training on FASD among the medical profession, and national standards must be adhered to. For example, we heard how diagnosis could take place as early as for a one-month-old child, or as late as at 10 years, or not at all. It appears to rely on which professional a child sees. Time and again we heard from families, including parents, grandparents, adoptive parents and foster carers, that they had to explain to medical staff the diagnostic nuances of FASD.
As I have said, the extent of this condition has been under-recognised by successive Governments. Research now indicates that 30% to 50% of children in foster care could be affected by FASD, and a study mentioned in our report from an audit in Peterborough, published in October 2015, showed that 75% of children referred for adoption had a history of pre-natal alcohol exposure. If those figures are extrapolated across the UK, that should have major implications for Government policy on fostering and adoption. Sadly, there are also impacts on the criminal justice system, and our inquiry heard of vulnerable young people with FASD who move into adulthood where they cannot meet societal expectations and behavioural norms. Those people are being exploited by criminal gangs and sexual predators, which is a result—certainly in part—of a lack of concern, understanding and support for them and their condition.
In conclusion, the seriousness of the problem cannot be overstated. Our report makes a number of recommendations that the hon. Member for Sefton Centralmay well go into in more detail. The impact on the early stages of a child’s life cannot be overstated. Even the alcohol industry has taken considerable steps to send warnings not to drink during pregnancy. Ninety-one per cent. of alcoholic drinks in bottles and cans now carry a warning.
That is not enough, however. A study by Drinkaware revealed that more than half of pregnant women in the UK receive no advice at all about drinking while pregnant. The original clinical diagnosis of FASD was made in 1973. Our inquiry showed that
“in the four decades since then, the UK as a whole has still barely acknowledged its existence.”
That must change, and the Government must take a lead.
I am grateful to Fiona Bruce, who has been an excellent vice-chair of the all-party group on foetal alcohol spectrum disorder. I congratulate hon. Members on bringing the debate to the House because it gives us a timely opportunity to talk about the initial findings of our inquiry, of which Tim Loughton was another valued member.
I want to repeat as forcefully as I can the point that the hon. Lady made about the need for a prevalence study. I have asked the Minister about it previously in questions, and I put it to him that such a study is essential. The evidence we took in our inquiry is backed up by evidence that has come from around the world over many years—the hon. Lady identified a number of those countries. The time has long since passed for us getting that evidence base in this country so that we can understand as well as possible exactly how great a problem it is and what solutions are needed. The Minister can intervene now, but perhaps he will address that point later.
The hon. Member for East Worthing and Shoreham and my hon. Friend Mr Allen mentioned brain development and the damage done by alcohol during pregnancy when a mother and baby are susceptible to that damage. They are frightening results….
I am glad the hon. Lady managed to get that point on the record. That is an incredibly important part of the picture of the damage done to brain development. I want to concentrate my remarks on the damage from alcoholand the inquiry report that the all-party group has just published, but I am grateful to her. Her point is very complementary to my remarks.
My hon. Friend the Member for Nottingham North made a powerful point on the potential of early intervention—he said it could be the biggest deficit reduction scheme of all and mentioned the figure of £17 billion. That is an important point when it comes to foetal alcohol spectrum disorders. In Canada and the US, they use the term “million dollar baby”. It refers to the lifetime costs of the damage done by alcohol during pregnancy. The hon. Member for Congleton and others have mentioned many of those costs, whether it is the inability to engage socially or hold down a job. Many end up in the criminal justice system and many of us care for children and young adults who were damaged by alcohol during pregnancy. All of these things have huge economic and social costs. It is incredibly important that we take those points on board, whether on alcohol harm or other forms of damage and deprivation caused during pregnancy and in the early years.
The all-party group took evidence from a great many experts: Martin Clarke of the Adolescent and Children’s Trust; the consultant psychiatrist and nationally renowned expert on FASD, Dr Raja Mukherjee; Sir Al Ainsley Green, now President of the British Medical Association; SABMiller from the drinks industry; the British Pregnancy Advisory Service; Public Health Research; a midwife; and parents and carers, as well as young adults living with foetal alcohol spectrum disorders. We heard heartrending examples of damage done, difficulties faced and the life-limiting effects of alcohol during pregnancy.
I want to pay tribute to and thank the Foetal Alcohol Spectrum Disorder Trust for the secretariat support, and other organisations such as the National Organisation for Foetal Alcohol Syndrome, which has for many years attempted to improve the education of professionals in health, education and other sectors on what is needed to prevent the disorder and to support people who care for children and young adults; and Mencap, which advises GPs.
There have been some puzzling changes over the past 20 or 30 years, something the hon. Lady touched on. In the 1970s, alcohol consumption in the UK was one of the lowest in the western world. From that low base, however, there has been a steady increase. There is a remarkably strong correlation between the increase in alcohol consumption and the increase in the incidence of mental health problems, attention deficit hyperactivity disorder, autism, Asperger’s, and many different kinds of learning and physical disabilities. The remarkably close correlation suggests causality. Brain damage is not reversible and is clearly significant. As the hon. Lady said, the World Health Organisationestimates that 1% of people born today are affected by FASD. Even at 1%, that is 7,000 children born every year. That is 7,000 too many.
For anyone new to this subject, there is a widely shared video of the effect of a small drop of alcohol on an embryo, which is compared with an embryo that does not experience the ingestion of a small drop of alcohol. The difference is stark. For two hours, the embryo stops moving altogether. We can only wonder at the damage done at that very early stage of pregnancy. International evidence suggests that the damage is done in the early days and weeks in particular.
As the hon. Lady said, the advice is far from clear. On the one hand, people are told not to drink. That seems clear. From the evidence heard by the all-party group, that is the right advice. However, the advice also says that if a woman chooses to drink, she should drink only one or two units. The advice appears inconsistent and contradictory. We took evidence from health professionals, the vast majority of whom do not appear to be aware of the real level of risk and danger. They do not appear to be passing on advice to women planning to conceive or who are pregnant. That is why our inquiry recommended it be made clear that the best thing for mother and baby is for the mother not to drink at all.
I hope that the Minister—I am sure he will—and all who are interested will read the report and carefully consider its recommendations. It is only an initial report—we plan to continue our work—and I hope that he or one of his colleagues will come to one of our meetings to discuss this matter in greater detail. As my hon. Friend the Member for Nottingham North said, early intervention gives us a fantastic opportunity not only to improve the life chances of many people but to save a lot of money. When it comes to the damage done by alcohol during pregnancy, the 7,000 figure, which, from the evidence we received, might well be on the low side, suggests that there is a huge opportunity. I hope that, as a result of the work we have done and the fine work of those Members responsible for today’s report, progress can be made and that the Minister will agree to commission the prevalence study, so that we can start to reduce the number of children damaged every year in this country.
Hansard source (Citation: HC Deb, 17 December 2015, c1795)
It is a pleasure to follow the hon. Members for Congleton (Fiona Bruce) and for Sefton Central (Bill Esterson), and I completely endorse their points about foetal alcohol syndrome. It feels like we have not caught up with the evidence, and we need to do so urgently, given the awful carnage being done to babies by this dreadful condition, so I congratulate the all-party group on foetal alcoholspectrum disorder on its work.
My party will work collaboratively across this House to ensure that in Scotland and across the UK children have the very best start, which they deserve. I am impressed and pleased that we have guidelines from the all-party group on foetal alcohol spectrum disorder and I am happy to share those with the Scottish Government and to look at key recommendations.
Fiona Bruce rightly highlighted the staggering and shocking statistics about alcohol intake during and indeed before pregnancy, and rightly said that a clear message needs to be sent out about the risks. She rightly paid tribute to the work of my hon. Friend Bill Esterson with his all-party group on foetal alcoholspectrum disorder. The group took a great deal of evidence in preparation for its report, which has been released today. It is unambiguous in its recommendations about the need for clear and consistent advice to be given on the dangers of alcohol during pregnancy and the need to improve training and education across the board. He has laid down a clear challenge for the Minister in this area and I look forward to hearing what his response will be.
My hon. Friend Fiona Bruce and Bill Esterson raised foetal alcohol issues. I commend them for the report that has, I think, come out today, following the inquiry by the all-party group on foetal alcohol spectrum disorder.
Thank you very much.
It is too early to respond to the report, but I can say that it is really important. It is not like a Select Committee report, in that the Government do not have a duty to respond to it, but I would be extremely surprised if colleagues did not want to do so in due course, because it is so important. The official advice given is this:
“Our advice remains that women who are trying to conceive or are pregnant should avoid alcohol…If women choose to drink, to minimise the risk to the baby, they should not drink more than one to two units of alcohol once or twice a week and should not get drunk.”
We will shortly publish a consultation on the UK chief medical officer’s alcoholguidelines review. This will offer an opportunity to work with clinicians and other professionals to ensure that they are fully informed about the content of the guidelines and able to explain them to the women they care for and help them make informed choices on alcohol consumption. I would imagine that the substance of the inquiry ought to form part of that consultation and discussion. I think that the most important part of the advice is:
“Our advice remains that women who are trying to conceive or are pregnant should avoid alcohol”.
I am grateful to the Minister for those comments. The international examples given by his colleague Fiona Bruce are very clear. The advice is not in two parts; it is a simple, single piece of advice: the best advice for mum and baby is to not drink at all. That is what happens around the world. The Minister has mentioned Dame Sally Davies. I hope she will agree with that and that that is what we will end up with, because it would make a massive difference
If the Minister is moving on from foetal alcohol syndrome, it is important to put it on the record again that, as of a couple of weeks ago, the attempt to have a prevalent study on foetal alcohol syndrome has not found funding. It is really important that we try to understand the issue in depth and get some evidence on how widespread it is. Will the Minister please consider looking at the matter in the light of the report he will receive today?
I take the hon. Gentleman’s point and I will raise it with the appropriate Minister.
At times the debate risked being hijacked by the report of the all-party group on foetal alcohol spectrum disorder, of which I am a member. I am delighted that we had an opportunity to give the group a voice, because it is a very important subject.
Health: Liver Disease — Question
– in the House of Lords at 3:14 pm on 9th December 2015.
As we enter the festive binge drinking season, do the Government recognise that 28% of deaths in 16 to 24 year-old males are alcohol-related and that 85% to 90% of the cost of in-patient liver disease is due to alcohol? By raising the floor cost of alcohol by 10%, we may be able to reproduce the Canadian evidence of a 30% fall in deaths attributable to alcohol. Do the Government also recognise that we have a responsibility to the next generation because in pregnant women hepatitis, obesity and alcohol are each risk factors, each compounding the other? If we implement a six-in-one vaccine programme for hepatitis B in neonates, we may prevent the next generation suffering from hepatitis B as well as decrease the incidence of foetal alcohol syndrome by tackling alcohol abuse in pregnancy.
My Lords, there was quite a lot in that question. Some 6,000 babies suffer from foetal alcohol syndrome and it is a shocking and appalling by-product of alcohol. Canada has increased the floor price of alcohol and I understand it has seen some reduction in alcohol-driven disease as a result of that. We are watching what happens in Canada carefully. Of course, Scotland is considering a similar move although it is awaiting the outcome of a court case in the European Union. I gather that Wales will possibly follow suit if that court case goes accordingly. We will watch what happens in those other countries, study it and then make up our minds accordingly.
Children of Alcoholics
– in Westminster Hall at 10:58 am on 24th November 2015.
Bill Esterson (Sefton Central) (Lab): I commend my right hon. Friend for the bravery he has shown this morning in his moving description of his own experiences and what happened to his dad. He is asking the Minister a list of things. As he mentioned, I chair the all-party group on foetal alcohol spectrum disorders. Will he include in his list of asks the children of alcoholic mothers who drink during pregnancy? We need the awareness and support that he has been talking about to be applied to that group as well.
24 Nov 2015 : Column 315WH
Liam Byrne: I congratulate my hon. Friend on the leadership that he has shown on that. Mothers who drink during pregnancy are absolutely included in the asks. I hope that the Government will accelerate the publication of advice for pregnant mums about what it is safe and not safe for expectant mothers to drink.
Learning Disabilities and Autism
Oral Answers to Questions — Health – in the House of Commons at 11:30 am on 17th November 2015.
Bill Esterson (Sefton Central) (Lab): The all-party group on foetal alcohol spectrum disorders took evidence last week about the link between alcohol consumed by mothers during pregnancy and the growing incidence of learning disability and autism. In Canada, this has been widely known for many years, and the Canadian Government at national and federal levels have invested heavily in raising awareness. When can we expect the same in this country?
Alistair Burt: The syndrome to which the hon. Gentleman rightly draws attention is well known here as well. I understand from the public health Minister, my hon. Friend the Member for Battersea (Jane Ellison), that a consultation in relation to this will be announced shortly, and of course there will be new guidelines in response. The all-party group is right to draw attention to this, and anything that can protect women during pregnancy and, of course, their children is of benefit to all.
Clause 13 — Local authority adoption functions: joint arrangements
Bills Presented — Armed Forces – in the House of Commons at 4:30 pm on 16th September 2015.
Bill Esterson: I am grateful to the Minister for giving way. One of the issues that I have raised is the evidence of the prevalence of foetal alcohol spectrum disorders and the very high numbers of looked-after children and adopted children who appear to have that condition. Will he ensure that awareness and support for those caring for those children is part of what he has been talking about?
Edward Timpson: An essential element of all of this work is that anyone who takes on a child who has had trauma in their early life understands what it is. I am talking about not just its presentation but its causes. As part of that, we need to look at foetal alcohol syndrome, and I commend the hon. Gentleman for the work that he and his new all-party group are doing to raise awareness of that issue. I am happy to engage with him on that matter as I indicated in Committee.
Health: Children and Young People — Question for Short Debate
– in the House of Lords at 6:35 pm on 7th July 2015.
I begin by reminding noble Lords that most factors that influence child and adolescent physical and mental health lie outside the health sector and that a preventive approach is essential to secure the best outcomes. Health outcomes, social achievement and resilience in adult life are largely set during the developmental period: in the first 18 years of life and particularly in the first 1,001 critical days from conception to age two. Even before conception, maternal behaviour can have long-term consequences for a child’s health and well-being. I am thinking here, for example, of foetal alcohol syndrome, which is the leading preventable cause of disability in children, and the need for women to be better informed and to discontinue drinking alcohol before conception. At the moment, government advice on the matter of alcohol in pregnancy is less than clear.
Clause 13 – Local authority adoption functions: joint arrangements
Education and Adoption Bill – in a Public Bill Committee on 2nd July 2015.
An area of concern that has recently come to my attention is the damage done by alcohol consumed by mothers during pregnancy. The damage caused to babies by foetal alcohol spectrum disorders can continue for their whole lives, as the brain damage is irreversible. In this country, we are only recently coming to realise how much of a problem foetal alcohol spectrum disorders are. One estimate is that 7,000 children are damaged each year in that way, but the true figure may be much higher. The all-party group on foetal alcohol spectrum disorders was formed just two days ago—I happen to be its chairman. [Hon. Members: “Hear, hear.”] Thank you. I urge all Members to follow our work in raising awareness and attempting to improve support. A high proportion of the children who are damaged by alcohol during pregnancy end up in the care system, and a significant number end up being adopted. The members and supporters of the Foetal Alcohol Spectrum Disorder Trust and other groups that are supporting the APPG are often people who have adopted children who have been damaged by alcohol during pregnancy.
There is a need for better identification—that is certainly true in the context of adoption—and for much greater support. The evidence I have seen shows that behavioural problems among children who end up in care or being adopted, with which we are all familiar, are far worse among children who have foetal alcohol spectrum disorders. I want to draw the Minister’s attention to that serious problem. The problem is not growing, but awareness of it is, so perhaps he will refer to it in his response.
I also agree that supporting adopted children through their education, into employment, in their mental health and in the original matching decisions is vital. I commend the hon. Member for Sefton Central on the formation of his new all-party parliamentary group on foetal alcohol syndrome because that remains a feature of the lives of far too many children and it needs to be tackled. I welcome his interest and look forward to hearing of the work of his group in due course.
Business of the House
– in the House of Commons at 10:34 am on 11th June 2015.
Foetal alcohol spectrum disorder affects at least 7,000 children born every year in this country. A new all-party group on foetal alcohol spectrum disorder will hold its inaugural meeting on 30 June, and I encourage Members to attend. The chief medical officer is carrying out a review of the advice given to pregnant women on how much alcohol, if any, can be taken during pregnancy. Has the Leader of the House had any indication from colleagues in the Department of Health on when a statement will be made to the House on the chief medical officer’s updated advice?
I congratulate the hon. Gentleman on the work he is doing. That is one of those issues that divide no one in this House politically. We all have an opportunity to be champions for those affected by some of the most dreadful diseases and health problems in our society. My right hon. and hon. Friends in the Department of Health will have noted what he said, but I will ensure that his concerns are passed on to them and that they get back to him and indicate when a statement will be made.
First Aid Techniques: National Curriculum — [Sir David Amess intheChair]
– in Westminster Hall at 2:30 pm on 10th March 2015.
I am not arguing against the inclusion of CPR in a school’s teaching curriculum; I am arguing about whether teaching these things should be statutory. There is more than one way to achieve an objective.
Also, if we look at the list of issues that people argue should be included for consideration in the national curriculum, we see that many of them would save a significant number of lives each year: relationships; drugs and alcohol; emotional and mental health, and well-being; emergency life support skills; homelessness; forced marriage; violence; transgender issues; tobacco; animal welfare; bullying; gambling; gender equality; cancer; symptoms of brain tumours in young people; fire and road safety; body image; the UN declaration on the rights of the child; environment; the dangers of carbon monoxide; cooking; media literacy; knife crime; parenting; chess; and foetal alcoholspectrum disorder.
Those are all specific cases where Governments, including the previous Government, have been lobbied over the years for things to be included in the national curriculum. It would be easy for any Minister—Conservative, Labour or Liberal Democrat—to say yes to those issues, only to find that there was little time in the national curriculum for the core academic subjects that we want children to learn. However, that does not mean that we do not think those other things should be taught in schools.
– in the Scottish Parliament on 26th February 2015.
Presiding Officer, you asked us to confine ourselves to four minutes, so I will conclude by saying that substance misuse—involving both alcohol and drugs—is a big problem and I look forward to hearing from the minister, fairly soon, what progress has been made on foetal alcohol syndrome, which is another contributory factor in poor attachment.
– in the Scottish Parliament on 20th January 2015.
I recall that when I was the convener of the Health and Sport Committee, Harry Burns, the then chief medical officer for Scotland, told us that inequality begins in the womb. The mother might have a poor diet and she might be a smoker, an alcoholic or an addict. Tragically, babies have been born with foetal alcohol syndrome and withdrawal symptoms. I remember a long campaign that Duncan McNeil was involved in on the drug dependency of families and the need to tackle that because of the impact that it had on the children. Regrettably, achieving societal change through politics is sometimes like turning round the proverbial oil tanker.
Alcohol Labelling (Pregnancy)
– in the House of Commons at 2:43 pm on 7th January 2015.
I beg to move,
That leave be given to bring in a Bill to require establishment of a statutory scheme providing for clear and consistent labelling of alcoholic beverages as they relate to foetal health and safety and that of pregnant women;
and for connected purposes.
Seven thousand children a year are born in the UK damaged by alcohol. That is one in every 100 births. Mild brain damage can be caused to children by even small amounts of alcohol at the wrong time during pregnancy, especially in the early stages when an embryo does not have the protection of a bloodstream. Much scientific evidence suggests that there is no safe limit when it comes to drinking in pregnancy, but sadly, not everyone is aware of the dangers. The chief medical officer says:
“Women who are pregnant or trying to conceive should avoid alcoholaltogether. However, if they do choose to drink, to minimise the risk to the baby, we recommend they should not drink more than one or two units once or twice a week and should not get drunk.”
She goes on to say:
“There is uncertainty about how much alcohol is safe to drink in pregnancy”.
The CMO also says that if a low level is consumed, there is no evidence of harm to an unborn baby. However, this view is not universally shared.
The National Organisation for Foetal Alcohol Syndrome UK tells us that there is no way to know for sure what impact drinking alcohol might have on an unborn baby. The same point is made by the British Pregnancy Advisory Service. According to NOFAS, a similar amount of alcohol might affect one baby but not another. We know that heavy drinking and binge drinking during pregnancy increase the risk of foetal alcohol syndrome, which is characterised by physical deformities, but there is a lack of consensus on the effects of smaller amounts of alcohol during pregnancy, as is shown by the apparent contradiction between that advice and the advice given by the chief medical officer.
The effects on a child can range from reduced intellectual ability and attention deficit disorder to heart problems and premature death. Many children experience serious behavioural and social difficulties that last a lifetime. In fact, what most of us take for granted is a lifelong struggle for them, and the damage that has been caused cannot be reversed. Not everyone whose mother drinks during pregnancy suffers damage that affects his or her life chances, and this is certainly not an attack on women, but the damage that is done by alcohol to too many children shows the need for action, and it shows that too many of us do not understand the potential risks of drinking alcohol at any point during pregnancy.
In 2007, Lord Mitchell introduced a private Member’s Bill which led to a voluntary system of labelling in the UK, but not all alcohol containers feature a warning, and there is also the vital question of how effective the labels are. The label that is used is only a few millimetres high, and is supposed to show a picture of a pregnant woman taking a drink with a line crossed through the picture to suggest that the woman should not be drinking
alcohol. However, many people do not notice the symbol or realise what it is. The fact is that the labels in this country are inadequate, as well as not being universal. However, labels on containers are not the only way in which awareness needs to be increased. In Canada, four to 11-year-olds learn about the dangers of drinking alcohol during pregnancy, which ensures that awareness is ingrained in the minds of the new generation. Posters about foetal alcohol syndrome are displayed in railway stations, airports, surgeries and shops.
I am pleased to see that the Under-Secretary of State for Health, Jane Ellison, is present. During my Westminster Hall debate on 14 October, she referred to the review by the chief medical officer. That review appears to be taking a very long time to complete. I hope that the chief medical officer will listen to the British Society of Gastroenterology, which wants to see a decent-sized warning message in writing rather than just a symbol on labels.
The president-elect of the British Medical Association, Sir Al Aynsley Green, told me that he thought there should be a much fuller debate about the risks to children from drinking alcohol during pregnancy. He suggested that the Government should examine the evidence from Canada, where education and awareness of the risks are combined with support for children, families and professionals who are dealing with the effects of foetal alcohol spectrum disorders. In the United States and in Canada, labels on all containers of alcohol include the message “Women should not drink alcohol while pregnant or trying to conceive”. In the United Kingdom, symbols are more common than warning messages, and when a written warning is used, it is so small that, like the symbols, it is hard to read. However, improving labelling is only part of the answer. We also need to help the children who are damaged, and those who are trying to support them or live with them.
My Bill is about making sure that all the facts are available, and about avoiding confusing or conflicting advice, whether it comes from the Government or from other sources. The existing labels are inadequate, which is why I am calling for a mandatory system of labelling that is clear, cannot be easily missed, and gives the best advice. That advice must be for women not to drink at all while they are pregnant or trying to conceive. Such a system of labelling should be designed to reduce the number of children who are damaged at great cost to themselves and to society.
I invite those who say that my Bill will make no difference to meet some of the children who have been damaged because their mothers did not know of the dangers and continued to drink. I invite them to talk to carers, to teachers and to NHS staff who are trying to help the children who are struggling to deal with a world in which their brains do not function properly as a result of damage caused during pregnancy. I invite them to say what they would do to reduce the number of children who are damaged during pregnancy as a result of the drinking of alcohol. If improving labelling is not part of the answer, then what is?
To the drinks industry I say, “Consider the content of the labels now, look at what happens in Canada and the United States, and make the necessary changes without legislation.” Some children will continue to be born suffering permanent damage from the effects of alcohol consumed by their mothers during pregnancy, but evidence shows what is needed if we are to reduce the number of children who suffer in this way. So to the Government I say, “Update the guidance, and support my Bill.”
Question put and agreed to.
That Bill Esterson, Rosie Cooper, Tracey Crouch, Nia Griffith, Julie Hilling, Kelvin Hopkins, Barbara Keeley, Tim Loughton, Lisa Nandy, Jim Shannon, Sir Andrew Stunell and Dr Sarah Wollaston present the Bill.
Bill Esterson accordingly presented the Bill.
Bill read the First time; to be read a Second time on Friday 6 March and to be printed (Bill 147).