Fetal Alcohol Syndrome

Drinking alcohol during her pregnancy can cause a woman's baby to be born with birth defects and developmental disabilities. In fact, alcohol (beer, wine, or hard liquor) is the leading cause of preventable birth defects and developmental disabilities in the United States.

Babies exposed to alcohol in the womb can develop fetal alcohol spectrum disorders (FASDs). These disorders include a wide range of physical, behavioral, and learning problems. The most severe type of FASD is fetal alcohol syndrome (FAS). It is caused by heavy drinking during pregnancy.

How Much Alcohol Is Too Much?

There is no known safe amount of alcohol to drink during pregnancy. Any amount of alcohol can harm a developing fetus and increase the risk of miscarriage.

Alcohol easily passes through the placenta, the organ that nourishes a baby during pregnancy. Alcohol exposure during the first trimester — perhaps before a woman even knows she is pregnant — can cause major birth defects. Later in the pregnancy, drinking alcohol can cause poor growth and brain damage that could lead to learning and behavioral problems.

These problems can be prevented by not drinking any alcohol during pregnancy. Do not drink if you are trying to get pregnant or think you may be pregnant.

How FAS Affects Kids

Kids with fetal alcohol syndrome share certain facial features such as small eye openings, a thin upper lip, and a smooth philtrum (the groove between nose and upper lip). Other problems include:

• Poor growth. Newborns may have low birth weights and small head sizes. They may not grow or gain weight as well as other children and may be short as adults.
• Birth defects. Developing babies may have heart, bone, and kidney problems. Vision problems and hearing loss are common.
• Seizures and other neurologic problems, such as poor balance and coordination.
• Delayed development. Kids may not reach milestones at the expected time.
• Behavioral problems. Babies may be fussy or jittery, and have trouble sleeping. Older children and teens may have:

* a lack of coordination and poor fine motor skills
* poor social skills (difficulty getting along with friends and relating to others, etc.)
* learning difficulties, including poor memory, difficulty in school (especially math), and poor problem-solving skills
* behavioral problems such as hyperactivity, poor attention and concentration, stubbornness, impulsiveness, and anxiety

Children with other FASDs have many of the same problems, but usually to a lesser degree.

Diagnosis

FASDs are diagnosed based on the symptoms (facial features, poor growth, and brain involvement), especially if it is known that the mother drank during the pregnancy. In children with milder problems, FASD can be harder to diagnose. Further evaluation and testing might be needed to rule out other conditions.

A child who is thought to have an FASD may be referred to a developmental pediatrician, genetic specialist, or another specialist who can help identify the problem and confirm a diagnosis.

Treatment

There is no cure for FAS or FASDs. But many things can be done to help a child reach his or her full potential, especially when the condition is diagnosed early on.

Children can benefit from services and therapies such as:

• speech-language, occupational, and physical therapy
• early intervention education services
• adult classes that help parents and other caregivers handle problem behaviors or other issues
• classes that teach kids social skills
• counseling with a mental health professional

Doctors may prescribe medicines to help with some of the problems associated with FAS, including attention deficit hyperactivity disorder (ADHD), depression, aggressive behavior, sleep problems, and anxiety.

Sometimes families want to try alternative treatments for FASDs, such as biofeedback, yoga, herbal supplements, and creative art therapy. Although some may be helpful — such as using relaxation techniques for anxiety — others have not been tested and may be harmful. Check with your child's doctor before starting any alternative treatment.

Caring for a Child With an FASD

Children with an FASD tend to be friendly and cheerful and enjoy social interaction, but caring for a child with this syndrome can still be challenging at times. Many kids will have lifelong learning and behavioral problems.

Besides early intervention services and support from your child's school, providing a stable, nurturing, and safe home environment can help reduce the effects of an FASD. Don't be afraid to seek help, if needed. Talk to your child's doctor or other members of the care team.

Finally, a caregiver of a child with FAS should make sure to take care of himself or herself as well. Support groups and counselors can be helpful. It's also important to get help for a parent or caregiver who continues to struggle with alcohol addiction.