What is Fetal Alcohol Syndrome?
Fetal Alcohol Syndrome (FAS) isn't a single illness, it's a catch-all term for a number of serious conditions, defects and disfigurements suffered by babies that can be caused by exposure to alcohol during development in the womb. A pattern of these symptoms usually helps lead to a diagnosis of FAS, rather than a diagnosis of only the individual conditions. Babies born with FAS have a relatively high mortality rate and those who do survive face a lifetime of difficulties and discomfort. Besides the physical defects with which a child may have to cope, learning and behaviour problems put them at higher risk of performing poorly in school, dropping out of school early, substance abuse and consequent social problems.
Signs of FAS include:
- Heart defects
- Mental retardation and delayed development leading to learning difficulties
- Facial deformities and distinguishing characteristics which may include a flattened midface, a thin upper lip, flattened skin between the nose and upper lip and small eyes
- Abnormally small head and brain
- Problems with vision and hearing
- Low birth weight and slow physical growth after birth
- Physical deformities of limbs and joints
- Delayed development of motor skills may include problems riding with skills such as writing, riding a bicycle etc.
- Behaviour problems such as Attention Deficit Disorder, hyperactivity, high anxiety, poor impulse control, difficulties in making decisions and poor judgement
- Poor social skills including poor anger management, inability to read social clues
- Difficult patterns of sleep and waking
Where mental and behaviour problems are evident but there are no physical symptoms of FAS, a child may be diagnosed with Fetal Alcohol Effects (FAE). FAE is not necessarily less serious just because there are no physical signs of alcohol damage - the impact on a child's life can still be enormously damaging.
What causes Fetal Alcohol Syndrome?
Quite simply, drinking alcoholic drinks during pregnancy. Every time you have an alcoholic drink, alcohol enters your bloodstream and when you are pregnant the alcohol in your blood crosses over the placenta to your baby. Because it takes your developing baby at least twice as long to process the alcohol as it does you, the concentration of alcohol is higher for your baby. This alcohol can damage your baby's developing organs, bones, facial features and central nervous system, particularly during the crucial developmental phase of the first trimester. However, while the first trimester is thought to be the most critical stage to limit alcohol exposure, your baby's development, including that of the brain, can be affected by alcohol throughout pregnancy.
Diagnosing and treating FAS
While there is no cure for FAS, the long-term impact of the condition may be limited by proper care, treament and support from the earliest days, so diagnosing the condition as early as possible is important. If your baby shows any signs of the physical deformities or mental and behaviour disorders outlined above, then speak to your doctor about it as soon as possible, being sure to mention whether you drank alcohol during your pregnancy.
If you did drink regularly during your pregnancy then you should let your doctor know so that s/he can be alert to symptoms of FAS form your baby's earliest weeks. Some physical defects caused by FAS, such as heart defects, may require surgery.
A proper diagnosis of FAS can help you, your doctors and your child's teachers, understand and manage the condition. Medical treatment will vary according to the child's individual difficulties. At home a child with FAS may benefit from a strong routine and the laying out of clear ground rules, at school the behaviour and learning problems of FAS children can be taken in context of their condition and they may be able to receive special assistance and teaching. Proper diagnosis can make all the difference to the way a child with FAS is seen and to how they are supported through FAS-related difficulties and parents may also benefit from FAS support groups and counselling.
How much alcohol causes Fetal Alcohol Syndrome?
This is a tricky question. There's no doubt that regularly drinking large amounts of alcohol - five or six units in a day - during pregnancy carries a very high risk that the baby will suffer some degree of FAS. For that reason it's essential that if you drink heavily or are an alcoholic you seek help from your doctor as soon as you know you are pregnant. If you have an alcohol problem and are considering starting a family then you should get medical help with your addiction before coming off contraception.
While it's clear that high levels of drinking are unsafe, what isn't clear is what level of alcohol consumption is safe, and even moderate levels of alcohol consumtion - one or two units a day - is associated with a higher risk to your baby of developmental and behaviour problems. What's more, there's evidence that occasional binge drinking during pregnancy - more than 5 or 6 units of alcohol at one sitting - also raises the risk of FAS to your baby.
While most doctors believe that very light drinking - a couple of units of alcohol a week - is unlikely to affect the developing fetus, there are no definitive studies guaranteeing this. In order to give an clear and simple guideline to pregnant women in the UK, the Department of Health has recently changed its advice to recommend that pregnant women avoid alcohol altogether. So, if you're pregnant and considering whether or not to drink, or how much, then don't beat yourself up about that birthday glass of Pinot Noir, you won't give your baby FAS with just that, but do remember that the more you drink, the higher the risk to your baby will be. Or as our doctor more positively put it, 'the less you drink, the better'.