• Women, children, and drinking: The double standard

    The Centers for Disease Control has a new public health campaign with the message that sexually active women who are not using birth control should stop drinking. The goal is to prevent Fetal Alcohol Spectrum Disorder. I agree with Aaron that the CDC is pursuing an important goal, but their messaging has many problems. What puzzles me most is that the message is only for women, because children can be harmed in many ways by their father’s drinking.

    There is good evidence a father’s exposure to alcohol before conception can harm children. In a 2015 review, Fingeresh and his colleagues report that

    In humans, several groups have now shown that children of fathers with AUD [Alcohol Use Disorder] have higher risk for psychosocial abnormalities, including increased risk for psychiatric disorders…, decreased performance on measures of intelligence…, personality changes…, and increased incidence of attention-deficit hyperactivity disorder (ADHD)… Some of these effects are specific to fathers who had active AUD compared to those who were in remission.

    Of course, there are many confounding factors in these studies that make it hard to say whether it’s the actual consumption of alcohol by the dads that causes these problems. But there is also an experimental literature in which randomly selected rats are dosed with alcohol and then mated.

    Rodent studies provide clearer evidence for transmission of acquired effects of ethanol, since sires do not contribute to offspring rearing and isogenic strains minimize potential genetic effects… Several groups have found that paternal ethanol induces physiologic abnormalities in offspring in the absence of maternal ethanol exposure, including low birth weight…, increased number of runts…, altered organ weights…, thickening of layers of the cerebral cortex…, and low testosterone levels. Several behavioral abnormalities have also been noted, including decreased spatiotemporal learning…, decreased novelty seeking behavior.., increased immobility…, increased anxiety- and impulsivity-like behaviors.

    Do we know how much alcohol a father has to drink to put his child at risk? I doubt it, but of course the same is true for the child’s mother.

    Moreover, paternal drinking post-conception and post-partum poses many risks to children. Unintentional injuries are the leading cause of death for children from their first birthday on. Many of these are car accidents. Men have substantially higher rates of fatal accidents then women, both in terms of deaths per 100,000 population and deaths per 100 million miles driven. In 2013, 38% of male drivers who died in accidents had blood alcohol levels higher than 0.8%, compared to only 21% of female drivers. I don’t have data on children who died in accidents in which a drunk father was driving, but it’s not a great stretch to infer that their father’s drinking puts them at risk.

    One of the primary psychological effects of alcohol is disinhibition, which is wonderful for romance, but it also means that alcohol consumption increases the risk of violence. Men (and women) who drink are more likely to abuse children and to be involved in intimate partner violence, exposure to which harms children.

    Both drinking per se and high volume drinking are more prevalent among men, across cultures. It’s strange, then, that discussion of parental alcohol consumption and risks to children is focused so often on women. Does the CDC have a campaign with the message, “You’re a dad now. Time to think about your drinking, for the sake of your kids.”? Or, “If you’ve had a drink, here’s another reason to wear a condom.” (Or even, “She’s had a drink. You really, really, ought to put on a condom.”) If the CDC doesn’t have these campaigns, they should.

    Women and men ought to think about children when they make lifestyle choices. Unfortunately, the world seems to believe that worrying about risks to children is women’s work.


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