Drinking During Pregnancy: Fetal Alcohol Spectrum Disorder

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Fetal alcohol spectrum disorder (FAS) is a group of conditions that results in a newborn baby when a pregnant mother consumes alcohol. It is unknown how much alcohol is considered harmful during pregnancy. As a result, researchers and physicians are not sure how much alcohol is needed for a baby to develop fetal alcohol syndrome. Drinking while pregnant is not only harmful to the mother but can be devastating for the unborn baby.

“By 1973, sufficient research evidence had accrued to devise basic diagnostic criteria such that FAS became established as a diagnostic entity. The US Surgeon General issued the first public health advisory in 1981 (reissued in 2005) that alcohol during pregnancy was a cause of birth defects. In 1989, Congress mandated that alcohol product labels include a warning about potential birth defects”, according to the American Academy of Pediatrics

Fetal alcohol syndrome varies drastically from child to child but is generally characterized as irreversible brain damage that results in stunted growth, behavioral problems, and cognitive delays.

Fetal alcohol syndrome (FAS) can be difficult to diagnose and may not be apparent at birth, especially if it is mild.  This may be even more difficult to diagnose in children who were adopted at birth with an unknown prenatal history. Many pediatricians may voice concerns when these babies or toddlers are not meeting their developmental milestones. These children also usually present with behavioral problems in both the home and the classroom.

Signs and symptoms

Since fetal alcohol syndrome is a spectrum, symptoms can range from mild to severe and present in multiple types of combinations. Unfortunately, the signs and symptoms of fetal alcohol syndrome are irreversible. The following are signs and symptoms associated with fetal alcohol syndrome:

Small eyes
Thin upper lip
Joint, limb, and finger deformities
Stunted physical growth resulting in short stature
Small head circumferences resulting in small brain size
Heart defects
Kidney malfunctions
Bone deformity
Poor coordination and balance
Delayed development
Learning disabilities
Poor attention span
Rapidly changing moods
Hyperactivity
Poor problem-solving skills
Academic decline
Poor social skills
Difficulty getting along with others
Trouble adapting to change
Impulsive behavior
Increased prevalence of tantrums

Complications associated with fetal alcohol syndrome

Children who have fetal alcohol syndrome are at an increased risk for further complications. Although there is no treatment for this disorder, and most signs and symptoms are irreversible, most children with FAS are encouraged to enroll in a comprehensive treatment plan in order to prevent complications.

A typical treatment plan includes psychotherapy, physical therapy, speech therapy, occupational therapy, and attending regular doctor visits to assess if they can benefit from medication.

Additionally, these individuals are encouraged to enroll in special education classes and participate in social workshops where they can learn to improve their social and developmental skills. Without therapy and proper care, the following complications may arise:

Attention deficit hyperactivity disorder/ADHD
Aggression/violent behavior that can result in legal trouble
Mental health disorders including depression, anxiety, and bipolar disorder
Eating disorders
Alcohol and substance abuse disorders

Living with fetal alcohol syndrome

Individuals with Fetal alcohol spectrum disorder have a different way of learning and processing emotions, behaviors, and events. These children often do not learn from harsh corrections or negative reinforcement. They can also be very emotionally fragile. As a parent or teacher, it is essential to understand that these individuals think in concrete, black, and white patterns and therefore, may not understand why other individuals are distressed by their actions.

These children usually need strict routines, repetition, and positive reinforcement. Often, the caregivers and teachers must learn to adapt to the child with FAS, as opposed to the other way around. Below are a few resources to help understand how to care for a child with FAS:

National Organization of Fetal Alcohol Syndrome
Center for Disease Control
FAScenter

Kristen Fuller, M.D., is a clinical content writer and enjoys writing about evidence-based topics in the cutting-edge world of mental health and addiction medicine. She is a family medicine physician and author, who also teaches and contributes to medicine board education. Her passion lies in educating the public on preventable diseases including mental health disorders and the stigma associated with them. She is also an outdoor activist and spends most of her free time empowering other women to get outside into the backcountry.