Indiana University Bloomington

Indiana Prevention Resource Center (IPRC)

Fetal Alcohol Syndrome

January is Fetal Impact of Substance Abuse Awareness Month.  Two articles will address the effects of alcohol, tobacco, and other drugs on fetal development.  This first article will focus on the effects of alcohol.  The second article will look at the influences of tobacco and other drugs.

Fetal alcohol syndrome (FAS) is part of a group of disorders, collectively known as fetal alcohol spectrum disorders (FASDs). FASDs are only caused by women drinking alcohol while they are pregnant. “FASDs only occur when a woman drinks alcohol during pregnancy.” This disorder is 100% preventable; however, there are still about 40,000 newborns born each year affected by some form of FASD (National Organization on Fetal Alcohol Syndrome, 2014). When a pregnant woman drinks alcohol, the baby is exposed to it through the umbilical cord and bloodstream, since they do not yet have a fully formed liver to absorb it (Fetal Alcohol Spectrum Disorders (FASD) – Pregnant? Think! Don’t Drink, 2010). The alcohol then typically affects the brain, organs, and other aspects of the baby’s development, such as facial abnormalities.

FASDs can result from alcohol use during any stage of pregnancy. The damage can occur in the first four to six weeks of a pregnancy, even before the woman is aware that she is pregnant. FASDs are challenging to prevent in these cases since, in the United States, nearly half of pregnancies are unplanned (CDC, 2014). Because of this, it is recommended that sexually active women who are not on some form of birth control stop drinking to eliminate the risk of another child born with FASD. Brain growth for the baby takes place all throughout pregnancy, so if a woman stops drinking after a couple months in her pregnancy, the child will be better off. Research cannot pinpoint how much alcohol needs to be consumed in order for the child to experience any of the conditions associated with FASD; therefore, the recommended level of alcohol intake at any stage of pregnancy is zero (Fetal Alcohol Spectrum Disorders (FASD) – Pregnant? Think! Don’t Drink, 2010). Additionally, every type of alcoholic beverage has a risk on the baby whether it is a shot or a glass of wine or beer (National Organization on Fetal Alcohol Syndrome, 2014).

It is often difficult to diagnose a child with fetal alcohol spectrum disorder due to the overlap in symptoms between this disorder and others, such as attention deficit hyperactivity disorder (ADHD). However, there are differences between these similar disorders. Three of the main characteristics of FAS include growth problems, facial dysmorphia, and central nervous system abnormalities. Common characteristics of the growth problems consist of an unusually low birth weight and size. Facial dysmorphia can include a small head size, small eyes, underdevelopment of the upper lip, an indistinct groove between the lips and the nose, or flattened cheekbones.

The central nervous system abnormality includes delayed brain development and intellectual impairment, which could affect the child’s learning, memory, senses, or social skills (National Organization on Fetal Alcohol Syndrome, 2014). Unfortunately, these deficits persist throughout the child’s entire life and are a constant struggle for the child and the child’s family and friends.   

Source: http://fasdcenter.samhsa.gov/educationTraining/courses/FASDTheCourse/module2/mod2_ct_fas_pg1.aspx

Once the baby has been exposed to alcohol in utero, the damage cannot be cured or reversed. However, early intervention treatment can improve a child’s development (CDC, 2014). Some of these intervention treatments include behavior and education therapy for the child or parent training. Medication is also available to help manage some of the symptoms, but as the severity of FASDs varies so widely, not all treatments may work on every child. Certain factors that can have a more protective effect on the child include having a stable, nonviolent, and loving home. It is very important to get the best treatment for children with FASD, especially since it is more common for them to get into trouble with the law. This is mainly due to these children not being able to see the end result or wanting to go along with the crowd and not realizing their actions are not safe (What Corrections Need to Know about FASD, 2010).

While many people who are aware of FASD may blame the mother, it is important to recognize that not every woman has the same story. Additionally, it is vital to remember that a woman may have made one decision that negatively affected her baby, but she could also be an extremely attentive and loving mother who is trying to move past her mistake and give her child the best future possible. In the following video, Melissa explains her story giving insight into the reasons why FASD is so important. Melissa's Story

Even though FASD may seem like a disorder that only a pregnant woman can prevent, this is an issue that requires everyone’s help. Increasing awareness is key with a disorder such as this one. Spreading the word about the effects of alcohol on a baby is essential to eliminating as many cases of FASD as possible. We can prevent situations like Melissa’s by educating potential mothers about the lifelong consequences of their decisions.

In a more structural approach to this problem, the CDC lists a couple of suggestions in this area. Alcohol screening and brief intervention (SBI) is one method that has been effective in reducing drinking. If this could be implemented in more clinics, doctor’s offices, or other health care with every woman of childbearing age, many more women could be educated on the effects of alcohol on their unborn child and could have an opportunity to seek help. CHOICES is more of an extended intervention that strives to reduce the risk of an alcohol-exposed pregnancy among non-pregnant women who are drinking at risky levels and not using contraception effectively or consistently (CDC, 2014).

Awareness is one of the most effective ways to reduce FASD. If someone you know is pregnant or trying to become pregnant, please tell her about the risks associated with drinking while pregnant. Spreading the message through social media is also an excellent, quick, and easy way to get the word out to more people and potentially give some children a chance for a higher quality of life!

*[For more resources on the topics covered in this article, see the IPRC HOME library e-Resources accessible from IPRC homepage or at http://www.drugs.indiana.edu/search/home-library.aspx].

By Heather Dolne, 1/1/2015