Your Health - Fetal Alcohol Syndrome

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

Alcohol travels through this path and affects the baby's development, particularly the heart and brain.

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 September 2009 by J. Thomas Megerian, MD, PhD, FAAP

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.