Fetal alcohol syndrome refers to one or more birth and developmental defects in the children of pregnant women who consume alcohol during pregnancy. When a pregnant woman drinks alcohol, so does her unborn baby. There is no known safe amount of alcohol to drink while pregnant and there also does not appear to be a safe time to drink during pregnancy either. Therefore, it is recommended that women abstain from drinking alcohol at any time during pregnancy. Women who are sexually active and do not use effective birth control should also refrain from drinking because they could become pregnant and not know for several weeks or more.
Causes
Fetal alcohol syndrome is caused by alcohol that has crossed over the placenta into fetal blood.
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Alcohol crosses from the mother's blood to the baby's blood through the placenta.
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Even a small amount of alcohol can damage a developing fetus. Doctors do not know how much alcohol it takes to cause defects. The risk increases with heavy drinking and with binging, but may still be significant for “social drinking” during pregnancy.
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Any type of alcohol can cause birth defects, including beer and wine.
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
Symptoms
Birth and developmental defects may differ, depending at what time during development the fetus was exposed to alcohol.
Babies born with fetal alcohol syndrome may experience the following physical symptoms:
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Low birth weight
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Small size and retarded growth
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Small head
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Small eyes
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Short, flat nose
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Flat cheeks
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Small jaws
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Unusually shaped ears
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Thin upper lip
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Shaking or tremors
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Sight and hearing problems
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Heart defects
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Small, abnormally formed brain
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Minor joint defects that may restrict movement
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Teeth prone to cavities
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Vision problems
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Ear infections
As the infant grows, other symptoms may develop, including:
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Difficulty eating and sleeping
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Delayed speech
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Learning disabilities
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Hyperactivity
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Lower IQ
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Mental retardation
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Poor coordination
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A short attention span
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Behavior problems
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Poor ability to control impulses
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Problems getting along with other children
The effects of fetal alcohol syndrome last forever. Children do not grow out of them. Teens and adults often experience social and emotional problems. They often develop what are referred to as secondary conditions, which include:
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Problems at school
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Inability to hold a job
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Trouble living independently
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Mental-health problems
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Alcohol or drug dependence
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Anxiety disorders
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Difficulty controlling anger
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Confrontations with the legal system
Diagnosis
The doctor will ask the mother about her alcohol intake while pregnant, assess the child's growth and perform a physical exam. There are no other tests for fetal alcohol syndrome. The diagnosis is based on the history of alcohol use, characteristic facial appearance, slow growth, and nervous-system problems. Prompt diagnosis allows earlier access to services and help with learning. Some children who have been exposed to alcohol during pregnancy lack the changes in the appearance of their face which allow the diagnosis of fetal alcohol syndrome to be made. These children may be described as having “fetal alcohol effect” if a reliable history of alcohol consumption during pregnancy can be obtained.
Treatment
There is no specific medical treatment for fetal alcohol syndrome. Children with the syndrome should receive special help with learning and social support. Families and children benefit from early intervention. Knowing what is wrong helps in understanding why the child acts differently than other children. Growing up in a supportive, nurturing, home may help prevent social and mental health problems.
Supportive Environment
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Provide consistent direction and structure. These children do not handle disruption well.
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Keep to routines.
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Establish simple rules, limits, and consequences.
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Praise desired behaviors.
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Do not threaten. Violence or abuse increases the risk the child will learn to react in a similar fashion. These children often need special training to learn other ways to handle anger.
Special Education
Programs designed to meet the fetal-alcohol child's special needs improve the odds of learning. Messages may need to be patiently explained over and over again. Tasks may need to be broken down into smaller steps.
Social Services
Professional support helps a family cope with caring for a child with birth defects. Services might include respite care, or baby-sitting, which can give the parent a break. Parent training may include ways to handle behavior problems and stress-management techniques.
Prevention
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Abstaining from alcohol during pregnancy and when trying to become pregnant will prevent fetal alcohol syndrome.
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Avoid heavy drinking when not using consistent effective contraception. Damage can occur before you even know you are expecting a baby. If you are trying to get pregnant do not use alcohol, and take daily supplements of folic acid to prevent other birth defects.
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Seek help from a doctor if you cannot stop drinking.
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Use birth control until you are able to quit drinking.
RESOURCES:
National Organization on Fetal Alcohol Syndrome
http://www.nofas.org
References:
Chaudhuri JD. Alcohol and the developing fetus--a review. Med Sci Monit. 2000;6(5):1031-1041.
March of Dimes Birth Defects Foundation website. Available at: http://www.marchofdimes.com/.
National Institute on Alcohol Abuse and Alcoholism website. Available at: http://www.niaaa.nih.gov/.
National Organization on Fetal Alcohol Syndrome website. Availablea at: http://www.nofas.org/.
Prenatal exposure to alcohol. [Review].Alcohol Res Health. 2000;24(1):32-41.
Thackray H, Tifft C. Fetal alcohol syndrome. Pediatr Rev. 2001;22(2):47-55.
CDC
