Fetal alcohol syndrome, now often called fetal alcohol spectrum disorders (FASD), because it is better described as a group of related conditions, is a result of harm caused to a developing fetus when the mother drinks alcohol. Even before a woman knows she is pregnant, she can cause harm to the developing child by drinking.
FASDs can cause a variety of symptoms in a child, including physical, behavioral, emotional, and even cognitive disabilities. The severity of the symptoms also varies and may depend on several factors, including how much the mother drank during pregnancy. The most severe of the conditions is fetal alcohol syndrome, or FAS, which is characterized by facial abnormalities, developmental delays, and other symptoms. There is no cure for FASDs, but treatments can help.
FASD and Fetal Alcohol Syndrome
FASD is a spectrum of conditions, which means that they range from mild to severe and every individual affected is unique and has his or her own symptoms. Fetal alcohol syndrome, or FAS, is on the extreme end of the spectrum, causing specific characteristic symptoms that are the most severe. All of these conditions are caused by alcohol use by the mother during pregnancy, and can cause symptoms that are physical and behavioral. All types of alcohol are harmful and there is no amount that is considered safe for a pregnant woman to consume.
Types of FASDs
FASDs can be diagnosed as one of several types. Fetal alcohol syndrome is the most severe diagnosis. It is associated with the greatest amount of drinking during pregnancy and can be damaging enough to cause the death of a fetus or baby. Babies that survive will live the rest of their lives with FAS and have abnormal facial features, growth problems, and problems with the central nervous system, such as a smaller or underdeveloped brain. A child may also be diagnosed with partial fetal alcohol syndrome, or pFAS, a slightly less severe form of FAS.
Another possible diagnosis is alcohol-related neurodevelopmental disorder, or ARND. This condition causes intellectual disabilities, learning disabilities, and behavioral challenges. These children tend to do poorly in school and may find it challenging to get along with others. They tend to struggle with attention, appropriate behaviors, and impulse control.
Alcohol-related birth defects, or ARBD, is another possible diagnosis a baby may receive if the mother drank alcohol during pregnancy. This an include any number of birth defects, including those that affect he heart, the bones, the kidneys, or the ears or eyes, causing vision or hearing problems. These children may also have reduced immune system function. ARBD often co-occurs with FASDs.
Cause and Risk Factors
The cause of FASDs is well known to be alcohol consumption by the mother during pregnancy. Alcohol is a toxin and its effects are much more significant in a baby or child, and certainly in a developing fetus, than in an adult. Alcohol interferes with the development of the brain and other organs. When a pregnant woman consumes alcohol, it passes from her bloodstream into the blood of the baby through the umbilical cord. In addition to FASDs, drinking during pregnancy can lead to miscarriages and stillbirths.
Although the cause is known, there are still risk factors for FASDs. Not every mother who has some alcohol during pregnancy will have a child with an FASD, but certain factors and behaviors increase the risk. A baby’s diagnosis and the severity of symptoms depend on the quantity of alcohol the mother drinks on each occasion, the frequency with which she drinks, and the timing. Timing refers to when during the pregnancy she drinks. Drinking any amount and at any frequency is considered risky
There are also factors in the mother that can worsen the effects of alcohol on the developing fetus: poor nutrition, being a smoker, being older, having a lower weight, height and body mass index than average, having had multiple pregnancies or births, and having a family history of heavy drinking. Environmental factors can also worsen the damage, including stress, isolation, or lack of support. Finally, genetics may play a role in how and to what extent a baby is impacted by alcohol.
Symptoms of FASDs
The symptoms and complications that FASDs cause in a baby and child are varied. Some children may develop only a few of these, while others experience more. The severity also ranges from mild to severe, depending on each individual. Some of the possible symptoms and complications that may occur are:
- Hearing and vision problems
- Sucking problems or sleeping difficulties in babies
- Heart, kidney, or bone defects
- Small head size
- Short height and low body weight
- Abnormal facial features, characterized by wide-set eyes and a flattened philtrum, the ridge between the nose and upper lip
- Difficulty with coordination
- Learning disabilities
- Delays in speech and language
- Low IQ
- Poor judgment
- Attention and memory difficulties
- Academic challenges, particularly in math subjects
Interventions for FASDs
There is no cure for the damage that alcohol causes a developing fetus. Once the damage is done it cannot be reversed. However, there are many treatments, interventions, and therapies that can limit the negative consequences of FASDs, reduce symptoms, and give a child the tools needed to be successful in spite of having an FASD.
The most important thing parents can do is get a diagnosis as quickly as possible. Early diagnosis followed by early interventions is proven to have the greatest impact on treating a child with an FASD. Other protective factors, those factors that most reduce the negative effects of FASDs are getting involved with special education and other social and educational services, having a home environment for the child that is stable, loving, and supportive, and not being exposed to violence. Those children with FASDs that are exposed to violence and lack support and stability have the worst outcomes and are more likely to develop secondary complications and conditions.
Early educational and behavioral interventions are among the most important treatments for FASDs. These children often suffer deficits in cognition and behavioral responses and need more support than other children. These kinds of interventions can help a child learn better social skills, strategies for learning in spite of learning disabilities, and learn appropriate behaviors.
Medical Treatment and Medications
A child with an FASD may also need medical treatment or even drugs to manage the condition. The kind of treatment needed depends on a child’s individual needs and limitations. For instance, a child with an FASD may need an ophthalmologist to treat eye problems or a plastic surgeon to correct severe deformities.
There are no specific medications that are approved for treating FASDs, but there are several types of drugs that are often used for these children. Stimulants, for instance, help manage behavioral problems like hyperactivity or impulse control. Antidepressants can be used to treat mood issues and sleeping problems. Antipsychotics may be used to control aggression and other behavior problems and anti-anxiety drugs are used to treat anxiety.
Dangers of Medications Used to Treat FASD
Using medications in a child always comes with risks. Both doctors and parents must balance the risks with the possible benefits when deciding if and what drugs to use. Antidepressants, for instance, could help a child feel better, but these drugs are proven to increase the risk of suicidal thoughts in anyone under the age of 24. Drugs like Prozac, Paxil, Celexa, and others carry serious warning labels because of this risk.
Some antipsychotics have also proven to be risky for children. Risperdal, for example, has been shown to cause gynecomastia, or breast growth, in some boys. Stimulants like Ritalin and Adderall have been useful for a lot of children struggling with impulse control, attention, and hyperactivity, but these drugs are amphetamines and they come with serious risks. These include severe aggression, mania, paranoia, and hallucinations, sudden death related to increases in blood pressure and heart rate, and the potential for abuse and addiction.
Fetal alcohol spectrum disorders and FAS are very serious conditions that are completely preventable. A child should not have to live with one of these lifelong disabilities and the medications and treatments that come with them, when refraining from alcohol is all a mother needs to do to prevent it. If you are thinking of getting pregnant, remember that no amount of alcohol is safe or risk-free.