and gynecologists, the national health service, and the dietary guidelines for americans. it found that the current scientific evidence does not support moderate caffeine consumption during pregnancy as safe, and advised pregnant women and women contemplating pregnancy to avoid caffeine. alcohol fetal alcohol spectrum disorders are a group of conditions that can occur in a person whose mother drank alcohol during pregnancy. the most severe form of the condition is known as fetal alcohol syndrome. problems may include an abnormal appearance, short height, low body weight, small head size, poor coordination, low intelligence, behavior problems, hearing loss and vision problems. those affected are more likely to have trouble in school, legal problems, participate in high-risk behaviors, and have trouble with alcohol and recreational drug use. fetal alcohol syndrome usually occurs when a pregnant woman has more than four drinks per day. milder symptoms have been found with two drinks per day during the early part of pregnancy. evidence of harm from less than two drinks per day or 10 drinks per week is not clear. the american academy of pediatrics established a conservative set of recommendations in 2015: "during pregnancy:no amount of alcohol intake should be considered safe; there is no safe trimester to drink alcohol; all forms of alcohol, such as beer, wine, and liquor, pose similar risk; and binge drinking poses dose-related risk to the developing fetus." the world health organization recommends that alcohol should be avoided entirely during pregnancy, given the relatively unknown effects of even small amounts of alcohol during pregnancy. fish and omega-3 fatty acids fish consumption during pregnancy is encouraged by european, australian, and american guidelines. the reason given is that fat-containing fish such as salmon and tuna contain eicosapentaenoic acid (epa) and docosahexaenoic acid (dha). these are termed long chain, omega-3, polyunsaturated fatty acids, and are considered as important for fetal neurodevelopment. additionally, fish are good sources of vitamins a, d, and b12, as well as the mineral iodine. due to risks of heavy-metal toxicity on fetal neurodevelopment, many mothers are concerned about eating fish during pregnancy. overall, current research favors the notion that the benefits of fish consumption during pregnancy outweigh the risks; however, the type of fish is important. current research suggests that 2-3 servings of low-methylmercury containing fish per week in pregnancy is both safe and beneficial. mercury accumulates in fish through their own diet (bioaccumulation). a general rule of thumb is that fish higher up on the food chain, and with longer life spans will contain higher levels of mercury. fish lower on the food chain and with shorter life spans will have lower metal content. however, it is important to note that the bioaccumulation of metals in fish is also dependent on geographical location, so it is hard to make global recommendations on specific fish species. an alternative to consuming fish is to use fish oil dietary supplements containing both epa and dha, or algae-derived dha-only oils. the new york times reported on a laboratory evaluation of 30 popular fish oil supplements. some of those had less than the label claimed amounts of dha. as for safety, "all of the products tested contained only very low levels of mercury, ranging from one to six parts per billion per serving. that range is far below the upper safety limit of 100 parts per billion set by the global organization for epa and dha omega-3s, an industry trade group." nutrition after pregnancy proper nutrition is important after delivery to help the mother recover, and to provide enough food energy and nutrients for a woman to breastfeed her child. women having serum ferritin less than 70 µg/l may need iron supplements to prevent iron deficiency anaemia during pregnancy and postpartum. during lactation, water intake may need to be increased. human milk is made of 88% water, and the iom recommends that breastfeeding women increase their water intake by about 300 ml/day to a total volume of 3000 ml/day (from food and drink), approximately 2,400 ml/day from fluids.