Campaigners and doctors are calling for stronger warnings about drinking during pregnancy, ahead of a legal test case on foetal alcohol syndrome.
The case will decide if a child born with serious disabilities caused by her mother's alcohol consumption should be compensated as a victim of crime.
Some estimates suggest thousands are born every year in the UK with serious health defects caused by alcohol.
Senior health officials have said there are mixed messages on the issue.
NHS guidance states "women who are pregnant or trying to conceive should avoid alcohol altogether".
But it continues: "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."
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A mother explains how drinking during pregnancy hurt her daughter
The Royal College of Obstetricians and Gynaecologists has said "current scientific opinion points to there being no hard evidence that very small amounts of alcohol consumption during pregnancy are harmful".
But advice and research can seem inconclusive.
'Safest option'According to the Foetal Alcohol Spectrum Disorder (FASD) Network, which supports families affected by the problem, health defects caused by alcohol include learning difficulties as well as behavioural and emotional problems.
Pregnant mothers need to be educated to steer clear of alcohol, said Maria Catterick, FASD Network's founder. "We are told that alcohol is a poison on the one hand, but on the other hand we are told that maybe it's OK to drink one or two units."
Alcohol-related pregnancy risks
- Foetal Alcohol Spectrum Disorder (FASD) - umbrella term covering a range of neurological, physical and behavioural impairments caused by exposure to alcohol in the womb. Many can be hard to diagnose.
- Foetal Alcohol Syndrome (FAS) - a serious form of FASD that is associated with distinctive facial features that make it easier to recognise.
Dr Shonag MacKenzie, lead obstetrician at Northumbria Healthcare NHS Trust, believes the advice can be confusing: "A small amount can lead to more drinks," she said, "we do know that actually the only absolutely safe policy is no alcohol at all in pregnancy."
In September, 12 directors of public health in the North East of England wrote an open letter complaining that there were "a lot of mixed messages about how much alcohol is 'safe' during pregnancy".
"We want to send a clear message to parents-to-be that alcohol and pregnancy don't mix - the safest option is an alcohol free pregnancy," they said in the letter.
"This needs to be the advice given during all stages of pregnancy from conception to birth by all healthcare professionals," they added.
A Department of Health spokesman said the chief medical officer for England was reviewing alcohol guidelines, with new draft guidelines expected next year.
One woman who lives in the North East and asked not to be identified adopted baby girls who were later diagnosed with Foetal Alcohol Syndrome (FAS).
"Due to the brain damage both my children have problems with ADHD, bits of autism, sensory dysfunction, memory problems," she said.
She said there was a shortage of support services for children with FAS, and her girls would need help into adulthood. "When they are both around 18 to 20 years old chronologically, they are only going to be like a 10-year-old socially."
Criminalising women?The Court of Appeal will decide later this month whether a seven-year-old with FAS and now in local authority care is entitled to a payout from the government-funded Criminal Injuries Compensation Scheme.
End Quote Maria Catterick FASD NetworkMost women would never drink alcohol, knowingly harming their baby"
Neither the council, which is in the North West of England, nor the child can be named for legal reasons.
Solicitor Neil Sugarman, who represents the council that is taking the claim on behalf of the child, said the mother "had been warned on a number of occasions that if she continued to drink excessively the child would be harmed".
"It's for the court of appeal now to decide whether recklessly taking alcohol was tantamount to poisoning the foetus," Mr Sugarman said.
He said his firm, Bury-based GLP Solicitors, represented about 80 other children damaged by foetal alcohol.
But campaigners fear the compensation claim could end up labelling mothers as criminals.
"I don't believe at all it is worth going down this route to criminalise women," said FASD Network's Maria Catterick.
"Most women would never drink alcohol, knowingly harming their baby. The messages have been totally unclear," she added.
Mr Sugarman denies the compensation claim will criminalise women.
He said the case was "simply about proving that if there was recklessness and it has resulted in damage, the child is then entitled to an award which will improve their lives".
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