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. 

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