Fetal Alcohol Syndrome

(Alcohol in Pregnancy; Drinking Alcohol During Pregnancy; FAS)

Definition

Definition

Fetal alcohol syndrome (FAS) belongs to a group of disorders called fetal alcohol spectrum disorder. It is caused when a woman drinks alcohol during pregnancy. The alcohol can cause birth and developmental defects in the baby. These defects make up FAS.

Causes

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. It is not known how much alcohol it takes to cause defects. Social, binge, moderate, and heavy drinking all have a negative effect on fetal development.

All types of alcohol, including beer and wine, 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.
Copyright © Nucleus Medical Media, Inc.

Risk Factors

Risk Factors

Factors that increase your baby’s chance of FAS include:

  • Unplanned pregnancy or failing to recognize pregnancy and continuing to drink
  • Alcohol use disorder
  • Lack of knowledge about the risks of drinking while pregnant
  • Low socioeconomic status

Symptoms

Symptoms

Birth and developmental defects depend on when the fetus was exposed to alcohol and how much alcohol was consumed.

Babies with FAS may have the following physical symptoms:

  • Low birth weight
  • Small size and delayed 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
  • Vision problems
  • Ear infections

As the infant grows, other symptoms may develop, including:

  • Difficulty eating and sleeping
  • Delayed speech
  • Learning disabilities
  • Intellectual disability
  • 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

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 as:

  • Fetal alcohol effect
  • Alcohol related neurodevelopmental disorder

An early diagnosis can help your child get the proper services.

Treatment

Treatment

There is no specific medical treatment for this condition. Early intervention is helpful, as well as a supportive, nurturing home. The doctor may recommend hearing and vision testing, as well as testing for any other medical problems related to FAS.

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 behavioral problems and stress management techniques.

Special Education

Programs designed to meet your child’s needs can help improve learning. For example, messages may need to be repeated. Tasks may need to be broken down into smaller steps.

Supportive Environment

A supportive environment includes:

  • Providing consistent direction and structure.
  • Keeping to routines.
  • Establishing simple rules, limits, and consequences.
  • Praising desired behaviors.
  • Lack of threats and violence. 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

Prevention

Efforts to prevent fetal alcohol syndrome are important.

  • 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 http://www.pregnancy.org

CANADIAN RESOURCES:

Greater Toronto Area Intergroup http://aatoronto.org

Women’s Health Matters http://www.womenshealthmatters.ca

References:

Chaudhuri JD. Alcohol and the developing fetus—A review. Med Sci Monit. 2000;6(5):1031-1041.

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 July 26, 2013.

Fetal alcohol spectrum disorder. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated December 12, 2012. Accessed July 26, 2013.

Nayak RB, Murthy P. Fetal alcohol spectrum disorder. Indian Pediatr. 2008;45(12):977-983.

Prenatal exposure to alcohol. Alcohol Res Health. 2000;24(1):32-41.

Thackray H, Tifft C. Fetal alcohol syndrome. Pediatr Rev. 2001;22(2):47-55.

Treatment and support. National Organization on Fetal Alcohol Syndrome website. Available at:
http://www.nofas.org/treatments-support

Last reviewed June 2015 by Michael Woods, MD
Last Updated: 5/11/2013

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