Fetal Alcohol Syndrome

An infant born to a mother who drinks alcohol during pregnancy can have problems included in a group of disorders called fetal alcohol spectrum disorders (FASDs).  FASDs include the following:

• Fetal alcohol syndrome (FAS). These are the most severe effects that can occur when a woman drinks during pregnancy, and include fetal death. Infants born with FAS have abnormal facial features and growth and central nervous system (CNS) problems, including intellectual disability.

• Alcohol-related neurodevelopmental disorder (ARND). Children with ARND may not have full FAS but have learning and behavioral problems due to prenatal exposure to alcohol. These problems may include mathematical difficulties, impaired memory or attention, impulse control and/or judgment problems, and poor school performance.

• Alcohol-related birth defects (ARBD). Birth defects related to prenatal alcohol exposure can include abnormalities in the heart, kidneys, bones, and/or hearing.

There is no cure for FASDs, but children who are diagnosed early and receive appropriate physical and educational interventions, especially those in a stable and nurturing home, are more likely to have better outcomes than those who are not.

Many drugs can pass from the mother's blood stream through the placenta to the fetus. Alcohol is no exception. Alcohol is broken down more slowly in the immature body of the fetus than in an adult's body. This can cause the alcohol levels to remain high and stay in the baby's body longer.

The full picture of FAS usually occurs in babies born to alcoholic mothers, or to those who drink regularly or binge-drink. However, no amount of alcohol is safe. Even light or moderate drinking can affect the developing fetus.

Alcohol use in pregnancy has significant effects on the fetus and the baby. Dependence and addiction to alcohol in the mother also cause the fetus to become addicted. At birth, the baby's dependence on alcohol continues. But since the alcohol is no longer available, the baby's central nervous system becomes over stimulated, causing symptoms of withdrawal. Alcohol withdrawal may begin within a few hours after birth, and symptoms may last up to 18 months.

In addition to the acute effects of withdrawal, babies often suffer the teratogenic (causing physical abnormalities) effects of alcohol. Specific deformities of the head and face, heart defects, and intellectual disability are seen with fetal alcohol syndrome (FAS).

According to the CDC, the following characteristics or behaviors may occur in children with FASDs:

• Small for gestational age at birth or small stature compared with their peers

• Facial abnormalities such as small eyes and thin mouth 

• Poor physical coordination

• Hyperactive behaviors

• Learning disabilities

• Developmental disabilities (for example, speech or language delays)

• Intellectual disability or low IQ

• Problems with daily living

• Poor reasoning and judgment skills

• Sleep and sucking problems in infancy

Long-term problems in children with FASDs may include psychiatric problems, gang and criminal behavior, poor socialization, unemployment, and incomplete education.

The symptoms of FASDs may resemble other medical conditions or problems. Consult a doctor for a diagnosis.

Most often, FASDs are diagnosed based on the mother's history and the appearance of the baby, based on a physical examination by a doctor.

The FDA has designated specific drugs for treating the symptoms of withdrawal from alcohol in babies. However, there is no treatment for lifelong birth defects and intellectual disability. Babies and children with alcohol-related damage often need developmental follow-up and, possibly, long-term treatment and care.

Fetal alcohol spectrum disorders are 100 percent preventable. However, this requires that a mother stop using alcohol before becoming pregnant. Because no amount of alcohol is proven safe, women should stop drinking immediately if pregnancy is suspected.