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What is Foetal Alcohol Syndrome?

Foetal Alcohol Syndrome (FAS) is a medical condition that occurs when babies are exposed to alcohol in the womb.

Foetal Alcohol Syndrome (FAS) is a medical condition that occurs when babies are exposed to alcohol in the womb.

It is part of a larger group of medical disorders called Foetal Alcohol Spectrum Disorders (FASDs).

Foetal Alcohol Syndrome is one of the more serious FASDs. Foetal Alcohol Syndrome can cause significant physical symptoms, learning difficulties, and behavioural problems.

Studies from the USA and Europe suggest that between 1-10% of children have Foetal Alcohol Syndrome. Researchers are calling for further research to establish how common FAS is in the UK. They believe that Foetal Alcohol Syndrome is more common than studies suggest1 and that the condition is underdiagnosed.2

What causes Foetal Alcohol Syndrome? 

Foetal Alcohol Syndrome develops when alcohol affects a developing baby in the womb.

How does the alcohol reach the baby?

Babies receive everything they need to grow from their mother’s blood. The blood reaches the baby by passing through the placenta and umbilical cord.

The placenta is a special organ that develops inside the womb during pregnancy.  The umbilical cord is a collection of blood vessels that connect the baby to the placenta. 

The placenta and the umbilical cord work together to:

  1. Deliver nutrients and oxygen from the mother’s circulation to the baby
  2. Remove waste products from the baby’s blood by delivering them to the mother’s circulation

This system is highly effective at delivering nutrients to the baby. Unfortunately, it also delivers certain toxic substances present in the mother’s bloodstream. This means that substances such as alcohol can reach the unborn baby. 

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What does alcohol do to the baby?

The adult body is capable of metabolising alcohol. When adults drink, the body breaks down the alcohol and removes it from the system. Developing babies cannot metabolise alcohol. They rely on the placenta and umbilical cord to slowly remove the alcohol by diffusion. This means that the alcohol circulates in the baby’s bloodstream for an extended time. During this time alcohol can cause a range of harmful effects.

Alcohol is a teratogen. A teratogen is a substance that interferes with the normal development of the baby during pregnancy. 

Alcohol alters the way certain structures develop. For example it:

  • Interferes with brain development leading to behavioural and learning difficulties
  • Affects the development of the face leading to facial abnormalities. 

How much alcohol is safe in pregnancy?

Even one alcoholic drink a day puts your child at risk of Foetal Alcohol Spectrum Disorders. The more alcohol consumed, the greater the risk.3

UK Chief Medical Officers recommend that if you are pregnant or planning a pregnancy, the safest approach is not to drink alcohol at all. This keeps risks to your baby to a minimum.4

What are the most common signs of FAS? 

The symptoms of Foetal Alcohol Syndrome will vary from child to child.

Foetal Alcohol Syndrome can cause the following symptoms:

Learning/Behavioural Problems

  • Difficulties with attention
  • Hyperactivity 
  • Speech and language delays
  • Difficulty solving problems
  • Problems with social skills
  • Poor coordination

Facial Abnormalities

  • Head small for child’s age 
  • Disproportionately small eyes
  • Drooping eyelids
  • Squint due to misaligned eyes
  • Short nose
  • Thin upper lip
  • Smooth skin between the nose and upper lip (usually there is a little groove called a philtrum)
  • Cleft lip or palate 

What are the other effects of drinking alcohol during pregnancy?

In addition to the features seen in FAS, consuming alcohol in pregnancy causes a range of other problems including increasing the risk of:

  • Pregnancy loss
  • Stillbirth
  • Premature birth
  • Low birth weight
  • Problems with the heart, liver and other organs

What are the effects of Foetal Alcohol Syndrome?

FAS causes a range of behavioural, cognitive and emotional problems. Children with FAS might:

  • Struggle to sit quietly and pay attention in school
  • Have difficulties with their schoolwork
  • Find it hard to make friends with peers

Foetal Alcohol Spectrum Disorders also create challenges in adulthood. Adults with FASD are more likely to develop psychiatric and personality disorders. They are also at increased risk of developing drug and alcohol problems.5

How is Foetal Alcohol Syndrome diagnosed?

Unfortunately, there is no way to test for FAS. Diagnosis in children is usually made based on the following principles:

  1. The child shows features typical of FAS
  2. It is known (or suspected) that the mother drank alcohol during the pregnancy
  3. Tests for other causes of symptoms are negative.

If you are worried your child may have Foetal Alcohol Syndrome you should speak to your GP. If appropriate, they can refer you to a paediatrician or specialist for assessment.6

To make the diagnosis the medical team might:

  • Ask for photos of the child at different ages
  • Ask questions about alcohol consumption during pregnancy
  • Ask detailed questions about the child’s development 
  • Ask to look at school reports or previous assessments
  • Carry out special assessments looking at how the child is able to function
  • Carry out a genetic test to rule out genetic causes of the symptoms

How is Foetal Alcohol Syndrome diagnosed in adults?

Sometimes Foetal Alcohol Syndrome can go undiagnosed until adult life. Diagnosing FAS in adults is based on the same principles as diagnosis in children. To make a diagnosis your health professional will need to identify features typical of FAS and rule out other causes.

If you suspect you have FAS speak to your GP about being referred to a specialist.

Can FAS be treated?

There is no cure for FAS. Alcohol alters the way in which babies develop and unfortunately, this cannot be undone. However, with the right management plan, it’s possible to limit the challenges children with FAS face.

The management plan will differ between children but may include:

  • Medical treatment of physical health problems such as cleft palate
  • Educational support
  • Speech and language support
  • Parent training to give parents the right tools to cope with the child’s symptoms and behaviour
  • Support groups for parents of children with FAS
  • Medication to manage associated conditions such as mood disorders

How to prevent Foetal Alcohol Syndrome

You can prevent Foetal Alcohol Syndrome by avoiding alcohol during pregnancy. 

What about prenatal alcohol exposure?

Prenatal alcohol exposure means drinking alcohol in the time before becoming pregnant. The NHS recommends avoiding alcohol if you are trying to get pregnant. This can help reduce any harm to your baby.

What if you were drinking alcohol before you knew you were pregnant?

Pregnancies aren’t always planned, so it’s not always possible to avoid alcohol in the prenatal period. Recent guidance issued by the UK government assures that the risk to your baby is low if you only drank small amounts before you knew you were pregnant.4

Once you know you’re pregnant you should avoid further drinking. If you are worried about how much alcohol you have been drinking, speak to your doctor or midwife.4

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Getting help for alcohol addiction

If you have an addiction, we know that stopping drinking can be challenging. But, it’s crucial that you seek help to protect your child from Foetal Alcohol Syndrome. If you are pregnant and struggling to quit drinking, speak to your midwife or medical team as soon as you can. Seeking help can protect you and your baby. 

If you need help with alcohol addiction, Castle Craig is here for you. Our team of specialists have helped thousands of people on their recovery journeys. To learn more, get in touch.

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    References

    1. McQuire C, Mukherjee R, Hurt L, et al. Screening prevalence of fetal alcohol spectrum disorders in a region of the United Kingdom: A population-based birth-cohort study. Prev Med. 2019;118:344-351. doi:10.1016/j.ypmed.2018.10.013

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6344226/

    1. Wozniak JR, Riley EP, Charness ME. Clinical presentation, diagnosis, and management of fetal alcohol spectrum disorder. Lancet Neurol. 2019;18(8):760-770. doi:10.1016/S1474-4422(19)30150-4

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995665/

    1. Chambers, C. D., Coles, C., Kable, J., Akshoomoff, N., Xu, R., Zellner, J. A., Honerkamp-Smith, G., Manning, M. A., Adam, M. P., & Jones, K. L. (2019). Fetal Alcohol Spectrum Disorders in a Pacific Southwest City: Maternal and Child Characteristics. Alcoholism, clinical and experimental research, 43(12), 2578–2590. https://doi.org/10.1111/acer.14213

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6904497/

    1. Dept of Health. How To Keep Health Risks From Drinking Alcohol To A Low Level. London: Alcohol Policy Team, Department of Health; 2016.

    https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/545911/GovResponse2.pdf

    1. Moore EM, Riley EP. What Happens When Children with Fetal Alcohol Spectrum Disorders Become Adults?. Curr Dev Disord Rep. 2015;2(3):219-227. doi:10.1007/s40474-015-0053-7

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4629517/

    1. Getting a diagnosis – National FASD. National FASD. https://nationalfasd.org.uk/about-fasd/getting-a-diagnosis/. Accessed February 22, 2022.

    https://nationalfasd.org.uk/documents/FASD%20in%20Focus%20Diagnosis%20and%20Assessments%20FIN.pdf

    About the Author

    Dr India Duane: Writer for Health and Wellbeing Brands | Medical Doctor living in Scotland. Her extensive medical knowledge and years of experience working with patients and professionals allow her to turn complex medical concepts into readable and interesting content.

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