Alcohol alternatives during pregnancy

How do the options compare?

Each option is judged on the ethanol it actually contains, what its label is legally allowed to mean, and whether anyone has studied it in pregnancy.

• The recommendation is to avoid all alcohol use in pregnancy, with no amount identified as carrying no risk, and daily drinking and binge drinking are associated with the highest chance of fetal alcohol spectrum disorders. 1
• Fetal alcohol spectrum disorders cover a range of effects, and the most severe form involves specific facial features, smaller head and body size, and effects on brain development. 1
• In the United States and much of Europe a product can be labeled no-alcohol at 0.5% ABV or below, while the United Kingdom sets its threshold at 0.05% and France and Italy allow up to 1.2%, so the same word means different things on different labels. 2
• Kombucha can continue fermenting in the bottle, pushing ethanol above the 0.5% ABV non-alcoholic threshold between production and the moment you drink it, and commercial samples have been measured across a range from roughly 0.006% up to 1.52% ABV. 3
• Herbal mocktail ingredients are not automatically a safe default: chamomile is likely safe in ordinary tea amounts, yet little is known about its safety specifically during pregnancy. 4

Which option makes sense?

Read the ABV number rather than the word on the front, because in the US non-alcoholic can legally mean anything up to 0.5% and commercial kombucha has tested well above that.

Disclosure: Pregnancy Smart makes pregnancy supplements, though not in this category. This comparison is a plain description of the pregnancy evidence, not a sales page.