Fetal Alcohol Syndrome
(Alcohol in Pregnancy; Drinking Alcohol During Pregnancy; FAS)
Definition
Fetal alcohol syndrome (FAS) belongs to a group of disorders called fetal alcohol spectrum disorder. It is caused when a women drinks alcohol during pregnancy. The alcohol can cause birth and developmental defects in the baby. These defects make up FAS.
Causes
Alcohol can cross from the mother's blood to the baby's blood. It is passed through the placenta. Even a small amount of alcohol can damage the fetus. Doctors do not know how much alcohol it takes to cause defects. The risk increases with moderate to heavy drinking and with binging. But even social drinking may pose a danger.
Any type of alcohol can cause birth defects.
Blood Traveling Through Mother's Placenta to Baby
Risk Factors
Factors that increase your baby's chance of getting fetal alcohol syndrome:
- Unplanned pregnancy
- Failure to recognize early pregnancy and continuing to drink
- Alcoholism
- Lack of knowledge about the risks of drinking while pregnant
- Advanced maternal age
- Low socioeconomic status
Symptoms
Birth and developmental defects depend on when the fetus was exposed to alcohol.
Babies with fetal alcohol syndrome may have the following physical symptoms:
- Low birth weight
- Small size and retarded growth
- Small head
- Small eyes
- Short, flat nose
- Flat cheeks
- Small jaws
- Unusually shaped ears
- Thin upper lip
- Shaking or tremors
- Sight and hearing problems
- Heart defects
- Small, abnormally formed brain
- Minor joint defects that may restrict movement
- Teeth prone to cavities
- Vision problems
- Ear infections
As the infant grows, other symptoms may develop, including:
- Difficulty eating and sleeping
- Delayed speech
- Learning disabilities
- Attention deficit hyperactivity disorder
- Lower IQ
- Mental retardation
- Poor coordination
- Behavior problems
- Poor ability to control impulses
- Problems getting along with other children
Children do not outgrow these effects. Teens and adults often experience social and emotional problems. They may develop secondary conditions, which include:
- Problems at school
- Inability to hold a job
- Trouble living independently
- Mental health problems
- Alcohol or drug dependence
- Anxiety disorders
- Difficulty controlling anger
- Legal problems
Diagnosis
The doctor will ask you about your alcohol intake while pregnant. The child's growth will be assessed. A physical exam will be done. The diagnosis is based on:
- History of alcohol use
- Characteristic facial appearance
- Slow growth
- Nervous system problems
Some children with this condition do not have the typical physical features. Their condition is described:
- Fetal alcohol effect
- Alcohol related neurodevelopmental disorder
An early diagnosis can help your child get the proper services.
Treatment
There is no specific medical treatment for this condition. Early intervention is helpful, as well as a supportive, nurturing home.
Social Services
Professional support helps a family cope with caring for a child with birth defects. Services include respite care and parent training. You can learn ways to handle behavior problems and stress management techniques.
Special Education
Programs designed to meet your child's needs improve learning. For example, messages may need to be repeated. Tasks may need to be broken down into smaller steps.
Supportive Environment
- Provide consistent direction and structure.
- Keep to routines.
- Establish simple rules, limits, and consequences.
- Praise desired behaviors.
- Do not threaten. Violence or abuse increases the risk the child will learn to react in a similar fashion. Your child may need special training to learn ways to handle anger.
Prevention
- Avoid drinking alcohol if you are pregnant or trying to get pregnant. Also, take folic acid to prevent other birth defects.
- Avoid heavy drinking when not using birth control. Damage can occur before you even know you are pregnant.
- Seek help from a doctor if you cannot stop drinking.
- Use birth control until you are able to quit drinking.
RESOURCES:
National Organization on Fetal Alcohol Syndrome
http://www.nofas.org/
Pregnancy.org
http://www.pregnancy.org/
CANADIAN RESOURCES:
Alcoholics Anonymous (Canada)
http://www.aacanada.com/
Women's Health Matters
http://www.womenshealthmatters.ca/index.cfm/
References:
Chaudhuri JD. Alcohol and the developing fetus—a review. Med Sci Monit . 2000;6:1031-1041.
Drinking alcohol during pregnancy. March of Dimes Birth Defects Foundation website. Available at: http://www.marchofdimes.com/ . Updated January 2005. Accessed June 18, 2008.
Drinking and your pregnancy. National Institute on Alcohol Abuse and Alcoholism website. Available at: http://pubs.niaaa.nih.gov/publications/DrinkingPregnancy_HTML/pregnancy.htm . Accessed June 18, 2008.
Fetal alcohol syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated April 2008. Accessed June 18, 2008.
Nayak RB, Murthy P. Fetal alcohol spectrum disorder. Indian Pediatr. 2008;45(12):977-983.
Treating individuals affected with FASD. National Organization on Fetal Alcohol Syndrome website. Available at: http://www.nofas.org/healthcare/treatment.aspx .
Prenatal exposure to alcohol [review]. Alcohol Res Health . 2000;24:32-41.
Thackray H, Tifft C. Fetal alcohol syndrome. Pediatr Rev . 2001;22:47-55.
Last reviewed January 2009 by Kari Kassir, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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