Fetal alcohol syndrome
What is it?
- Fetal alcohol syndrome (FAS) is a condition that results from prenatal alcohol exposure. If you drink during pregnancy, you place your baby at risk of fetal alcohol syndrome.
- The defects that are part of fetal alcohol syndrome are irreversible and can include serious physical, mental and behavioral problems, though they vary from one child to another.
- If you suspect that your child has fetal alcohol syndrome, talk to your doctor as soon as possible. Early diagnosis may reduce the risk of problems associated with fetal alcohol syndrome, including troubles at school, with substance abuse and with the law.
Fetal alcohol syndrome isn't a single birth defect. It's a cluster of related problems and the most severe of a group of consequences of prenatal alcohol exposure. Collectively, the range of disorders is known as fetal alcohol spectrum disorders (FASD).
Fetal alcohol syndrome is a common — yet preventable — cause of mental retardation. The severity of mental problems varies, with some children experiencing them to a far greater degree than others.
Signs of fetal alcohol syndrome may include:
- Distinctive facial features, including small eyes, an exceptionally thin upper lip, a short, upturned nose and a smooth skin surface between the nose and upper lip
- Heart defects
- Deformities of joints, limbs and fingers
- Slow physical growth before and after birth
- Vision difficulties or hearing problems
- Small head circumference and brain size (microcephaly)
- Poor coordination
- Sleep problems
- Mental retardation and delayed development
- Learning disorders
- Abnormal behavior, such as a short attention span, hyperactivity, poor impulse control, extreme nervousness and anxiety
The facial features seen with fetal alcohol syndrome may also occur in normal, healthy children. Distinguishing normal facial features from those of fetal alcohol syndrome requires expertise.
Doctors may use other terms to describe some of the signs of fetal alcohol syndrome. Alcohol-related neurodevelopmental disorder (ARND) refers to the mental and behavioral impairments that occur as a result of fetal exposure to alcohol. Alcohol-related birth defects (ARBDs) refer to the physical defects that occur from fetal alcohol exposure.
When you drink alcohol, it enters your bloodstream and reaches your developing fetus by crossing the placenta. Because a fetus metabolizes alcohol more slowly than an adult does, your developing baby's blood alcohol concentrations are higher than those in your body. Alcohol also interferes with the delivery of oxygen and optimal nutrition to your baby's developing tissues, organs and brain.
The more you drink while pregnant, the greater the risk to your unborn baby. The risk is present at any time during pregnancy. However, impairment of facial features, the heart and other organs, bones, and the central nervous system may occur as a result of drinking alcohol during the first trimester, when these parts of the fetus are in key stages of development. In the early weeks of the first trimester, many women may not be aware that they're pregnant. Alcohol may affect the brain of the fetus at any time during pregnancy.
Although doctors aren't sure how much alcohol you'd have to drink to place your baby at risk, they do know that the more you drink, the greater the chance of problems. Because there's no known safe amount of alcohol consumption during pregnancy, don't drink alcohol if you are or think you are pregnant or you're attempting to become pregnant. You could put your baby at risk even before you realize you're pregnant.
Although doctors can't diagnose fetal alcohol syndrome before a baby is born, they can assess the health of mother and baby during pregnancy. If you report the timing and amount of alcohol consumption, your obstetrician or other health care provider can help determine the risk of fetal alcohol syndrome.
If you let your child's doctor know that you were drinking while you were pregnant, he or she can be on the lookout for signs and symptoms of this syndrome in your child's initial weeks, months and years of life. To make a diagnosis, doctors will assess:
- Facial features
- Heart defects
- Cognitive ability
- Language development
- Motor skills
Doctors may refer children with possible fetal alcohol syndrome to a medical genetics specialist to rule out other disorders with similar signs and symptoms.
If one child in your family is diagnosed with fetal alcohol syndrome, it's important to evaluate his or her siblings to determine whether they also have fetal alcohol syndrome.
Treatments and drugs
There's no cure or specific treatment for fetal alcohol syndrome. The physical defects and mental deficiencies typically persist for a lifetime. Heart abnormalities may require surgery. Learning problems may be helped by special services in school. Parents often benefit from counseling to help the family with a child's behavior problems.
Coping and support
The psychological and emotional problems associated with fetal alcohol syndrome can be difficult to manage. Families and children with fetal alcohol syndrome may benefit greatly from the support of professionals and other families who have experience with FAS. Ask your doctor or public health nurse for local sources of support for families and children with FAS.
As a parent of a child with fetal alcohol syndrome, you may find the following suggestions helpful in dealing with behavioral problems associated with the syndrome:
- Implement daily routines to which your child can become accustomed.
- Create and enforce simple rules and limits.
- Point out and use rewards to reinforce acceptable behavior.
- Because many children with fetal alcohol syndrome are vulnerable, guard against their being taken advantage of by others.
- Teach your child skills for daily living.
A stable, nurturing home is the single most important factor in protecting children with FAS from some of the problems they're at risk of later in life, including drug abuse, dropping out of school and encounters with the juvenile justice system.
If you've given birth to a child with fetal alcohol syndrome, you may benefit from substance abuse counseling and treatment programs that can help you conquer your misuse of alcohol.
Doctors haven't identified a safe level of alcohol that a pregnant woman can consume. But, experts do know that FAS is completely preventable if women don't consume alcohol during pregnancy.
These guidelines can help prevent fetal alcohol syndrome:
- Stop drinking alcohol altogether if you're planning to become pregnant, because your baby's brain, heart and blood vessels begin to develop in the early weeks of pregnancy. If you haven't already stopped drinking, stop as soon as you know you're pregnant or if you even think you might be pregnant. It's never too late to stop drinking during your pregnancy, but the sooner you stop, the better it is for your baby.
- Continue to avoid alcohol throughout your pregnancy. Fetal alcohol syndrome is completely preventable in children whose mothers don't drink during pregnancy.
- Consider giving up alcohol during your childbearing years if you're sexually active and you're having unprotected sex. Many pregnancies are unplanned, and damage can occur in the earliest weeks of pregnancy.
- If you have an alcohol problem, get help before you get pregnant. Get professional help to determine your level of dependence on alcohol and to develop a treatment plan.