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Alcohol and Substance

Frequently Asked Questions

What is a teratogen?
A teratogen is an agent that causes physical or developmental abnormalities in the fetus. In order for a drug or chemical to be considered a teratogen there must be substantive evidence that taking the drug or being exposed to the chemical causes congenital abnormalities. What would Motherisk rate as a significant breakthrough in mother-child health care and research?

What would Motherisk rate as a significant breakthrough in mother-child health care and research?
Medical science has made significant progress in the prevention of neural tube defects, such as spina bifida and anencephaly. These conditions can be prevented if women take enough folic acid before and while they are pregnant. Folic acid is a vitamin found in foods like dark green vegetables, liver and lentils. Please see our recommendations about Taking Folic Acid Before You Get Pregnant. It is crucial that women of childbearing age get this message.

Must a woman avoid all medications while she is pregnant?
Although there is good reason for therapeutic caution during pregnancy, in some instances the benefit/risk ratio favours continuation of drug therapy. One of the best examples is the proper use of medication to treat seizure disorders.

How many women has Motherisk counselled?
Since its inception in 1985, the Motherisk team has counselled nearly a million women, their families and health professionals. Motherisk counsels approximately 200 callers each day. The telephone information service at Motherisk operates daily from 9:00 a.m. to 5:00 p.m. Each week 10 to 20 women are scheduled for the Motherisk clinic following exposure to known or suspected teratogens, new drugs with sparse information, chronic drug therapy or drugs of abuse.

Do drugs ingested by the mother reach her breast milk?
Quite often. But that doesn't mean they will affect the baby. Motherisk is currently working to understand what controls the amounts of drugs that find their way into breast milk. Most medications enter the breast milk to some degree. Researchers and clinicians who study the use of drugs during lactation will tell you that in most cases, the amount of medication that enters the breast milk will not be high enough to cause harm to the baby (less than 10% relative infant dose). In most cases, there is no need to interrupt breastfeeding. To know which specific drug is safe to use while breastfeeding, please talk to your doctor or call Motherisk.

What is the safest medication to take in pregnancy?
When it comes to medication use in pregnancy, we try to assess the safety based on animal and human studies, or on the pharmacologic and pharmacokinetic property of the drug. The safest medication should be the drug that will work best for you, has the least number of side effects, and has not been shown to cause harm to the fetus. The benefit of taking the medication should outweigh the potential risk. Always talk to your doctor before taking medications in pregnancy.

How much alcohol is safe to drink while pregnant?
Currently there is no research to indicate how much alcohol is safe. It is best not to drink any alcohol while pregnant. All alcoholic drinks are potentially harmful in pregnancy - a mixed drink, a wine cooler, a glass of wine or a bottle of beer - all contain alcohol.

When is it safe to drink alcohol while pregnant?
While most of the baby's organs develop during the first and second trimesters, brain development continues throughout pregnancy and even after birth. Exposure to alcohol at any time in the pregnancy can affect the baby's brain. Therefore, it is safest not to drink any alcohol throughout pregnancy. In fact, it is best to stop drinking before pregnancy.

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Motherisk is a proud affiliate of MotherToBaby, an information service of the non-profit Organization of Teratology Information Specialists (OTIS) across North America.

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The information on this website is not intended as a substitute for the advice and care of your doctor or other health-care provider. Always consult your doctor if you have any questions about exposures during pregnancy and before you take any medications.

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The Hospital for Sick Children (SickKids) is a health-care, teaching and research centre dedicated exclusively to children; affiliated with the University of Toronto. For general inquires please call: 416-813-1500.

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