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Original studies that contained reasons for alcohol consumption in pregnancy and while breastfeeding were included. The Mixed Methods Appraisal Tool (MMAT) and the Confidence in the Evidence of Reviews of Qualitative Research (CerQUAL) approach were utilised. The review protocol is available on PROSPERO (registration number: CRD42018116998).<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Findings<\/jats:title><jats:p>Forty\u2010two eligible studies comprising women from 16 countries were included. Most commonly reported reasons of alcohol use in pregnancy were societal pressure and the belief that only \u201cstrong\u201d alcohol and alcohol in large quantities is harmful. Other reasons were: a lack of awareness of adverse effects on the fetus; coping with adverse life experiences; consumption based on intuitive decision\u2010making and influenced by personal\/peer experiences; belief in the beneficial properties of alcohol; advice from medical practitioners; unwanted or unplanned pregnancy; alcohol dependence; and consumption as a cultural\/traditional custom. Reasons for alcohol use during breastfeeding included the belief that alcohol stimulates breast milk production, unclear advice from medical practitioners, unawareness of the risks of infant exposure and to improve mood and celebrate events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Implications<\/jats:title><jats:p>Understanding the context of reasons for alcohol use in pregnancy is crucial for implementing prenatal health education, and preventing FASD and other adverse maternal and child health outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Individual beliefs, knowledge\/advice, culture and personal circumstances influence alcohol use in pregnancy. Data are limited for reasons surrounding alcohol use while breastfeeding.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dar.13425","type":"journal-article","created":{"date-parts":[[2021,12,28]],"date-time":"2021-12-28T17:02:32Z","timestamp":1640710952000},"page":"759-777","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":85,"title":["Why do women consume alcohol during pregnancy or while breastfeeding?"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6308-1157","authenticated-orcid":false,"given":"Svetlana","family":"Popova","sequence":"first","affiliation":[{"name":"Centre for Addiction and Mental Health Institute for Mental Health Policy Research  Toronto Canada"},{"name":"Institute of Medical Science, Faculty of Medicine University of Toronto  Toronto Canada"},{"name":"Dalla Lana School of Public Health University of Toronto  Toronto Canada"},{"name":"Factor\u2010Inwentash Faculty of Social Work University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2144-4607","authenticated-orcid":false,"given":"Danijela","family":"Dozet","sequence":"additional","affiliation":[{"name":"Centre for Addiction and Mental Health Institute for Mental Health Policy Research  Toronto Canada"},{"name":"Institute of Medical Science, Faculty of Medicine University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahela","family":"Akhand Laboni","sequence":"additional","affiliation":[{"name":"Center for Clinical and Translational Science, School of Medicine University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krista","family":"Brower","sequence":"additional","affiliation":[{"name":"Edmonton Oliver Primary Care Network  Edmonton Alberta Canada"},{"name":"Department of Educational Research Lancaster University  Lancaster UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Temple","sequence":"additional","affiliation":[{"name":"Surrey Place Centre  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,12,28]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"Guidelines for the identification and management of substance use and substance use disorders in pregnancy","author":"World Health Organization","year":"2014"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogc.2020.03.002"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(17)30021-9"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11065-011-9163-0"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh259"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2013-202934"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.2002.tb02460.x"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2011.03050.x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.reprotox.2017.08.004"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1139\/bcb-2017-0077"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000438"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/alcalc\/agv117"},{"key":"e_1_2_7_14_1","first-page":"e91","article-title":"The burden of prenatal exposure to alcohol: revised measurement of cost","volume":"16","author":"Stade B","year":"2009","journal-title":"Can J Clin Pharmacol"},{"key":"e_1_2_7_15_1","volume-title":"National Library of Medicine","author":"LactMed, Drugs and Lactation Database","year":"2006"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(15)30858-6"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1891\/2158-0782.10.2.81"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.reprotox.2016.05.002"},{"key":"e_1_2_7_19_1","volume-title":"Global status report on alcohol and health, 2018","author":"World Health Organization","year":"2018"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(18)30029-9"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1037\/adb0000476"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1037\/vio0000074"},{"key":"e_1_2_7_23_1","unstructured":"StanesbyO CookM&CallinanS. 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