Coffee, wine and sushi! New pregnancy book says OK (AP interview of Emily Oster)

[alp227]

Gee whiz, a Jenny McCarthy wannabe?

Emily Oster isn't a baby doctor. She's an economist and a mom who wanted to know more about all those rules handed down to women after the pregnancy stick goes pink.

Only two cups of coffee a day! No alcohol. Beware deli meats.

Being pregnant, she said, felt a lot like being a child, so she decided to take a deep dive into research covering everything from wine and weight gain to prenatal testing and epidurals. What she found was some of the mainstays of pregnancy advice are based on inconclusive or downright faulty science.

To this data-cruncher, an associate professor in the University of Chicago's business school, those magical nine months became a question of correlation and causation.

Some of her conclusions? Weight gain during pregnancy is less important than a woman's starting weight and not gaining enough may be more harmful. Light drinking is fine (up to two glasses of wine a week in the first trimester and up to a glass a day in the second and third trimesters). And much of the evidence supports having three to four cups of coffee daily, which made Oster very, very happy.

An interview with the author follows this excerpt.

[TwilightGardener]

1. What's "childlike" about not putting potentially harmful substances

(alcohol, in particular) into your and your baby's body during pregnancy? That's actually called "being an adult", to me.

[CTyankee]

2. If often wonder what French and Italian women do about wine intake during pregnancy.

Wine is so central to eating in those countries and women there usually have wine with their evening meal, altho you don't see much if any public drunkenness, except from American tourists who find out the wine is cheaper than Coca cola and then go ape drinking. It's embarrassing.

[msanthrope]

4. They drink a glass or two. It's no big deal there. When I was pregnant

my doctor said sushi was okay in moderation (be careful of mercury!) but to avoid lunch meats and hotdogs because of the listeria threat.

[CTyankee]

13. They had this author on Morning Joe today with Dr. Nancy Schneiderman. Dr. Nancy

pointed out that wine should be consumed with a meal and considered part of a food group. Exactly what European women do, altho she didn't point that out but probably should have.

[GeorgeGist]

3. University of Chicago. Business School. Nonsense.

[CTyankee]

19. Well, she actually looked at the research and crunched numbers. Even Dr. Snyderman today

congratulated her on her data research!

[unblock]

5. the "no alcohol" advice is based not only on the harmful effects of too much alcohol, but also

based on the fact that some people find it difficult if not impossible to stop at one drink.

for many, *no* alcohol is a whole lot easier to stick to than two a week in the first trimester and one a day thereafter. so even if she's correct on the medical effects of the higher limits she mentions (i'm not agreeing that point, i just don't know) that doesn't make it good advice.


the same goes for the limits on many over-the-counter medications. many people can go over the printed limits on occasion, or even for a long time, without problems. but that doesn't mean that printing higher limits on the label is a good idea. the higher the printed limit, the more people bad outcomes.

[CTyankee]

14. That's the U.S. Not Europe where people have a saner idea about drinking.

In this country, it seems people go to extremes. Either getting snockered or out and out teetotaling. Moderation doesn't seem to be the American thing...

[LisaLynne]

17. I think it's because we're weird about alcohol in America.

Weird in a prohibitive sense, like from all the Puritans and Prohibition and stuff. It's sort of the same thing as with sex. We're all obsessed with it because it's still so oddly seen as "wrong" by so many. It seeps into our psyches and you know how tempting anything "forbidden" is.

[CTyankee]

18. Actually, we were once a nation of drunks. I took a course in grad school about U.S. history in the

50 years after the creation of our Constitution. We were big ale and hard cider drinkers, owing largely to the upheaval of the Industrial Revolution and westward expansion. Then we stopped! It was due to a massive temperance movement, sponsored heavily by the industries that would benefit from having more sober employees in the factories, but then backed by religious groups. There were big tent meetings where people would get all whipped up with stories about the destruction of families, deaths caused by workers falling drunk into machinery, and wife and child abuse. So we had no real grounding in what it meant to drink moderately.

[LisaLynne]

20. Right, that's exactly what my point was.

We are all or nothing and have never been able to develop sort of a relaxed, no big deal sort of attitude towards alcohol.

[CTyankee]

21. Yeah, it was interesting to learn about the roots of this attitude. I had no idea that early

industrialists were behind the early temperance movement (before the religious nuts go hold of it). But it makes sense. When we were a nation of family farms, people would get drunk and sleep it off and no big deal. But when they started to work in factories and started falling into large machines, it was obviously a problem for factory owners' bottom line and needing to hire sober workers. Profit first!

[LisaLynne]

22. Yeah, that is REALLY interesting.

Hmm, corporations enlisting the help of religion in their own self-interests ... Good thing that doesn't happen today!

[Sheldon Cooper]

23. There's nothing insane about avoiding alcohol during pregnancy.

While many are pooh-poohing the various restrictions on pregnant women, the FACTS are: 1) alcohol is the only known preventable cause of mental retardation (now called intellectual and developmental disability, or IDD), and 2) there is no known 'safe' limit of alcohol that can be consumed during pregnancy and still protect the fetus.

So, the best possible advice for pregnant women is to avoid alcohol for the nine-month period of pregnancy. Of course in the olden days many pregnant women drank, some drank a lot, and never gave birth to disabled kids. But really, do you want to be the one to risk it, and end up with a child with Fetal Alcohol Syndrome?

Here's some info on that particular condition:

http://en.wikipedia.org/wiki/Fetal_alcohol_syndrome


Alcohol crosses the placental barrier and can stunt fetal growth or weight, create distinctive facial stigmata, damage neurons and brain structures, which can result in psychological or behavioral problems, and cause other physical damage.[1][2][3] [4]

The main effect of FAS is permanent central nervous system damage, especially to the brain. Developing brain cells and structures can be malformed or have development interrupted by prenatal alcohol exposure; this can create an array of primary cognitive and functional disabilities (including poor memory, attention deficits, impulsive behavior, and poor cause-effect reasoning) as well as secondary disabilities (for example, predispositions to mental health problems and drug addiction).[3][5]

Alcohol exposure presents a risk of fetal brain damage at any point during a pregnancy, since brain development is ongoing throughout pregnancy.[6]

I was pregnant twice, and even smoked during my first pregnancy, so I am not one to point fingers at anyone. Frankly, I think the increasing amount of restrictions are becoming a bit ridiculous, but having made a career of working with people with IDD, I can wholeheartedly support the restriction on alcohol. It seems such a small price to pay in the big scheme of things.

[CTyankee]

25. I'm aware of the risks. My point was that European doctors know those risks as well

and I was speculating on whether they prescribe total abstinence throughout pregnancy for their patients.

[Sheldon Cooper]

26. Well, even if the European doctors don't prescribe total abstinence,

it doesn't diminish the wisdom of abstaining. I think worrying about coffee and hot dogs and sushi is overkill, frankly, but avoiding alcohol just isn't in that league.

[CTyankee]

27. To be on the safest possible side, yes, abstaining is preferable.

But I don't think European doctors "don't know any better." The World Health Organization has cited France with the best health care system in the world, on a number of benchmarks universally recognized as valid. But I really don't know. I do know that wine is part of the culture of several western european countries and they have lower alcoholism rates than we do in the U.S.

I also had 3 pregnancies, but since I didn't drink at all during them, I wouldn't be able to judge. I did smoke and I am horrified that I did so, but we didn't know any better at that time. So doctors in this country were wrong on that...

[LisaLynne]

16. Yeah, but couldn't they have actually phrased it that way?

A glass or two is fine, but if you think you won't be able to stop there, you're better off abstaining all together? To me, it just smacks of treating women as idiot children who need to be protected from themselves. That attitude is always there, but it gets so much worse when it's a pregnant woman because then it can be seen as only trying to protect the baby.

[virgogal]

6. My generation smoked,could drink,and consumed coffee. I don't know any

kids that were harmed by it,and we all had large families.

All these "kids" are now in their forties and fifties.

[alp227]

10. Really? that is the stuff of right wing viral emails.

DU debunks "kids who survived the 40s to 70s" meme.

See also the comments section at this right wing dad blog entry.

[HappyMe]

11. It has nothing to do with 'right wing'.

It is a fact that back in the day, some women smoked and probably had a couple of drinks while pregnant.

[alp227]

12. But then birth defects happen. n/t

[virgogal]

28. Huh? Right wing E-mails? What on earth does politics

have to do with my statement of fact?

That's the way it was and the "kids" are all okay.

[alp227]

31. Says which medical journal? Anecdotes ain't proof enough. nt

[CTyankee]

15. back in the 60s when I had my kids docs didn't tell women to stop smoking. I smoked thru my

3 pregnancies, I am ashamed to say. I didn't drink alcohol but I did consume coffee (but not a lot). Docs in those days wanted pregnant women not to gain more than 20 lbs. I remember crying from the hunger pangs in my first pregnancy, making my dr. checkups (where they weighed you and if you went over a certain number of pounds in your given trimester you were given a stern lecture by the doctor!) before I ate lunch, even limiting my food the day before in the vain hope that I would weigh a little less the next day. Compared to today, my babies were probably smallish at birth: 8.2, 7.12, 6.12.

The reason my doc gave me for gaining no more than 20 lbs? I would have trouble taking it off and regaining my figure after giving birth! He seemed to be more concerned about my remaining good looking (for my husband, of course) after...THAT made a feminist out of me a few years later!

[virgogal]

29. I forgot about the weight gain limitation. My doctor

allowed 16 lbs. Eight for me and eight for the baby.God,it was awful.

Like you mine were smaller that they are today (ranged between 7.0 and 8.4) but they all were,and are just fine.

[CTyankee]

30. I imagine that my smoking helped in the effort to keep a low weight gain. That, and

I was in my early 20s and had no weight issues at all. And I did breastfeed so that took weight off pretty fast after giving birth.

I'm lucky, too, that my kids are doing fine.

[RebelOne]

7. When I was pregnant many, many years ago,

I used to smoke and drink pots of coffee every day. When I was about 2 months pregnant, suddenly cigarettes and coffee made me sick. I couldn't not stand to even look at a cigarette or a cup of coffee. If I could just trick my body into thinking it was pregnant now, I could maybe stop smoking.

[KittyWampus]

8. Let's call it "Extreme Pregnancies"! Maybe even a reality tv show. Bungie chord jumping episode #1.

You're disqualified if you have a miscarriage.

[HappyMe]

9. I think I probably had

about 3 glasses of wine (with dinner) total through the entire pregnancy. I had a small cup of coffee every day too. My sons are fine.

[NightWatcher]

24. My wife had sushi, craved the stuff... Now our daughter

craves sushi and can almost work chopsticks, and she's two.

The trick about sushi is to eat it where you know it's safe and won't upset your stomach. We have a local fav that we've eaten at regularly for 4+ years. I would not recommend eating sushi from Walmart or a gas station.