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2.2.3 Safeguarding Children of Alcohol Misusing Parents


NICE: Postnatal Care Guidance


In May 2015, a link was added to NICE Postnatal Care Guidance in the Related Guidance section.


  1. The Child
  2. Concerns
  3. Referrals
  4. Assessment and Initial Child Protection Conference

1. The Child

The effects on children of the misuse of alcohol by one or both parents or carers are complex and may vary in time, which is why a thorough assessment of needs and risk of harm is important. In some cases the misuse of alcohol may be one factor which, when linked to domestic violence or mental illness, may increase the risks to the child. See also Safeguarding Children of Drug Misusing Parents Procedure and Safeguarding Children at Risk because of Domestic Abuse Procedure.

It is estimated that up to 1.3 million children are affected by parental alcohol problems in England (Strategy Unit 2004). Cited in Working Together to Safeguard Children 2010, para 9.48 (now archived).

The circumstances of children must be carefully assessed not only to consider immediate risks but also the long term effects on the child of their parents’ alcohol misuse.

The children of parents who misuse alcohol are at increased risk of developing alcohol problems themselves and of being separated from their parents. Research demonstrates that children who themselves start drinking at an early age are at greater risk of unwanted sexual encounters and injuries through accidents and fighting.

2. Concerns

The health and development of an unborn child may be affected by the parents alcohol misuse and newborn babies may suffer foetal alcohol syndrome which as a result may interfere with the parent/child bonding process. 

Babies may experience a lack of basic health care and poor stimulation and older children may experience poor school attendance, anxiety about their parents’ health and taking on a caring role for the parent or siblings.

The parents parenting capacity can be affected by the misuse of alcohol in the following ways:

  • Lack of attention to basic physical needs;
  • Lack of control of emotions;
  • Impaired judgement;
  • Lack of ability to recognise and respond to the emotional needs of the child;
  • Financial problems;
  • Current mental state and personality;
  • Experience and tolerance of alcohol;
  • Lack of supervision;
  • Behave in an inconsistent or unexpected ways.

For the child/ren or an unborn baby, the affects of living with a parent/s or carer who abuses alcohol can have a devastating affect on their development and well-being:

  • For the foetus most damage is associated in the first three months, non-attendance for ante-natal care or avoidance by the mother to book herself for ante-natal care will increase the risk to the unborn baby;
  • Ongoing drinking by the mother may lead to Foetal Alcohol Syndrome;
  • Limited or confused contact with the parent;
  • Lack of stimulation and warmth can affect the early attachment relationship between the mother and baby leading to insecurity;
  • If associated with violence the child is at greater risk of physical injury;
  • Delays in seeking medical attention and poor concentration;
  • Poor educational attainment, struggling with reading and writing;
  • May experience behavioural and emotional difficulties;
  • Older children are more likely to use alcohol, cannabis and tobacco.

Also refer to: Referring Safeguarding Concerns about Children Procedure.

3. Referrals

Professionals, when confronted with a child in an alcohol-misusing environment must ask themselves “What is it like for a child in this environment?”.

The Family Common Assessment Framework will assist in determining the level of vulnerability of the child and at what point a referral is made to Children’s Social Care Services – see Referring Safeguarding Concerns about Children Procedure.

Use of the Early Intervention Procedure will assist staff determining risk thresholds and the need to gather and share information in the interests of the child/ren.

Information gathered during a Family Common Assessment, can assist with a referral to Children and Young People's Services and for referring to other relevant agencies.

4. Assessment and Initial Child Protection Conference

Children’s Social Care Services will consider whether it is appropriate to undertake a Child's Assessment in relation to all referrals. 

The Assessments will consider and take account of whether the person concerned is hiding or denying their alcohol misuse; whether they are engaged in any rehabilitation programme; whether they receive support from a partner, family or friends; the impact of the alcohol misuse on the quality of care given to the child and the day-to-day environment of the child as well as the long term impact on the child. 

Throughout the assessment process and where it is decided to call a Strategy Discussion, undertake a Section 47 Enquiry and convene an Initial Child Protection Conference, those agencies who have worked with the parents in relation to their alcohol misuse must be asked to contribute and invited to participate in and attend relevant meetings.

If the concerns are in relation to an unborn child, the maternity services must be invited to attend the Strategy Discussion, and involved in any Section 47 Enquiry, Initial Child Protection Conference and, where appropriate, the Core Group.