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Everything You Need to Know About Fetal Alcohol Syndrome

by Dr. Karen Reed Ph. D. Wednesday, December 19, 2018

Pregnant women have a lot to deal with from their bodies changing to making modifications in their usual habits and diets. They do all of this in order to make sure that the baby developing in their womb is healthy and happy. However, some women aren’t as careful even though they already know that they’re pregnant. For one, some women drink alcohol even when they know that there’s a baby developing within them. In such cases, there’s a risk that the woman will give birth to a baby who has fetal alcohol spectrum disorders one of which is fetal alcohol syndrome or FAS.

Fetal alcohol spectrum disorders or FASD is the general term used for various disorders which range from mild to severe and all of these disorders may cause mental and physical birth defects. Other types of FASD are:

partial fetal alcohol syndrome
alcohol-related neurodevelopment disorder
alcohol-related birth defects
a neurobehavioral disorder associated with prenatal exposure to alcohol

Among all the various disorders, fetal alcohol syndrome is the most severe. Babies who have this condition may grow up having memory, vision, attention span, and hearing problems as well as problems in their abilities to communicate and to learn. Although the defects aren’t the same for everyone who has FAS, the damage is usually permanent.

Causes and Risk Factors for Fetal Alcohol Syndrome

Whenever a pregnant woman consumes a drink which contains alcohol, some of it passes easily through her placenta and into the fetus. Unfortunately, the body of a fetus that’s still developing isn’t able to process alcohol the same way as adults do. Also, when alcohol reaches the fetus, it’s more concentrated and it can hinder the oxygen and nutrition from reaching the little one’s vital organs.

Even in the first few weeks of pregnancy, alcohol may already cause damage to the fetus. This can occur if the woman doesn’t know that she’s pregnant yet. As time goes by, the risk increases especially if the woman drinks heavily. According to studies, drinking alcohol causes the most harm during the first trimester. But it’s still dangerous to consume alcoholic beverages at any time during a woman’s pregnancy.

Alcohol gets quickly transported to the fetus through the placental blood flow and it can cause birth defects or even miscarriages. Within 1-2 hours after the mother ingests the alcohol, the blood alcohol levels of the fetus are similar to those of his mother. However, there’s no established connection between how much alcohol the mother consumes and the side effects the infant sustains. This is a confusing observation which may depend upon how fast the mother’s liver can break down the alcohol she consumes.

The fact is, when a woman consumes alcohol any time while she’s pregnant, this may be linked to severe consequences which are permanent. Generally, ingesting alcohol during the first trimester is associated with the facial abnormalities in babies with fetal alcohol syndrome along with a reduction in the growth rate of the fetus. Drinking alcohol during the second trimester may contribute to a low IQ, growth retardation in terms of birth weight and length, and even cognitive deficits in math, spelling, and reading. Consuming alcohol in the third trimester may amplify retardation in the infant’s birth length as well in his potential height as an adult.

Any doctor would recommend that pregnant women abstain from alcohol any time during their pregnancy to prevent the occurrence of fetal alcohol syndrome and any other FASD. There is no “safe level” of alcohol consumption so it’s best to just stay away from any kind of alcoholic beverages. Although drinking alcohol is the biggest risk factor for fetal alcohol syndrome, there are also other risk factors to be aware of. These include:

Binge drinking. This is more harmful than consuming the same amount of alcohol spread out over a specific amount of time.
If the woman is more than 35 years of age at the time she’s pregnant.
Those who belong to the Native-American or African-American ethnic groups.
Those who have a lower socioeconomic status,
Those who smoke or use illicit drugs.
Those who have family members or partners who drink heavily.
Those who are unmarried, experience high levels of psychological stress or have mental health disorders.

Symptoms and Signs of Fetal Alcohol Syndrome

Doctors have specific diagnostic criteria they use to determine whether or not the infant has fetal alcohol syndrome. Such criteria include:

Facial Characteristics

small head
thin upper lip
smooth “philtrum” or the ridge between the nose and the upper lip
small space between the lower and upper eyelids
small, wide-set eyes

Delay in Growth

weight and length that’s below average
smaller head circumference both during intrauterine as well as post-birth growth

Abnormalities of the Central Nervous System

structurally small brain with a slow growth rate
functional brain delays

Other Abnormalities

hyperactivity
poor focus and coordination
delays in development and problems in movement, speech, social skills, and in thinking.
vision and hearing problems
learning disabilities, mood swings, poor judgment, and intellectual disability
deformed fingers or limbs
kidney abnormalities and defects
heart problems

Since this condition comes with a lot of different problems, the infant or child may manifest various symptoms as well. And these symptoms may range from mild to severe.

Diagnosis of Fetal Alcohol Syndrome

Doctors establish the potential risk for fetal alcohol syndrome during the woman’s first prenatal visit. The pregnant woman would be asked some questions regarding the behavioral risk factors such as alcohol consumption, smoking, using illicit drugs, and other behaviors which are considered as high-risk. The doctor may interview the pregnant woman or provide her with a screening questionnaire which is more comprehensive. Also, there is a number of laboratory tests which may point to a recent, repeated or excessive alcohol consumption.

The prenatal indicators for alcohol use would be a smaller-than-expected growth in head measurements, length, and weight. The slower growth in head measurements is also a reflection of a delay in the brain growth. Once the infant is born, there are some facial abnormalities which will help the doctor determine whether the child has fetal alcohol syndrome or not. There are also some cognitive and developmental delays which will make the doctors consider that the child has this condition.

Usually, fetal alcohol syndrome and other FASDs get diagnosed based on the infant’s symptoms. It’s more likely if the doctor knows that the mother drank alcohol while she was pregnant. For those who manifest mild symptoms, the condition is more difficult to diagnose. Therefore, the doctor may require additional testing and evaluation in order to rule out other medical conditions. Children who are thought to have fetal alcohol syndrome may receive a referral for a developmental pediatrician, a genetic specialist, or other specialists who can better identify the condition and make a confirmed diagnosis.

Treatment for Fetal Alcohol Syndrome

Although there’s no known cure for fetal alcohol syndrome, early intervention may lessen the impacts of the condition especially in terms of motor, cognitive, and language impairments. There are aggressive programs which make use of occupational therapy, educational therapy, physical therapy, and speech therapy to maximize all the benefits. Adolescents, as well as adults, can benefit a lot from such programs which deal with legal, psychiatric, and academic problems.

Even if doctors cannot cure fetal alcohol syndrome, there are several things one can do to help his child reach the full potential. This is especially true if a doctor can diagnose the condition early on. Children who suffer from fetal alcohol syndrome will benefit a lot from a loving and stable home. This is because children with the condition tend to be very sensitive when it comes to interruptions or disruptions in their routine more than average children. Also, these children have a higher likelihood of developing problems with substance abuse and violence in their adulthood if they experience the same at home. Therefore, it would be ideal for them if they have a regular routine at home, they have simple rules to adhere to, and receive rewards whenever they perform positive behavior. Also, children with fetal alcohol syndrome can benefit from therapies and services such as:

occupational, physical, and speech-language therapy
early intervention
their parents or primary caregivers attend adult classes which can help them learn how to handle the child’s problematic behaviors and other issues
classes which teach the child proper social skills
counseling with a professional

Education and behavior therapies can be a vital part of the treatment for children with fetal alcohol syndrome. There are various types of therapies for children who have developmental disabilities but only a couple of them are appropriate for children with fetal alcohol syndrome. Such therapies include:

Friendship Training. A lot of children who suffer from fetal alcohol syndrome find it difficult to make friends, keep friends, and socialize with other people. This type of training can teach children how to properly interact with others, how they can join a group of children who are already playing with each other, how to set and deal with play dates at home, and how to handle or avoid conflicts. Friendship training can dramatically improve the social skills of children with fetal alcohol syndrome and reduce any problematic behaviors.

Specialized Tutoring for Mathematics. Research shows that there are special tools and teaching methods which may help improve the math skills and knowledge in children with fetal alcohol syndrome.

Executive Functioning Training. This training can teach children with fetal alcohol syndrome about self-control and behavioral awareness in order to improve their executive functioning skills. These skills include cause and effect, planning, problem-solving, reasoning, and even memory.

Parent and Child Interaction Therapy. The goal of this type of therapy is to improve the relationships between parents and children with fetal alcohol syndrome. Also, it aims to create a program for positive discipline and reduce behavioral problems in children suffering from the condition. Parents will be able to learn the skills they need from a coach so that they can deal with their children in a more beneficial manner.

Behavior Management and Parenting Training. The learning and behavioral problems that affect children with fetal alcohol syndrome can cause a lot of pressure and high-stress levels for their parents. Fortunately, this training can help out a lot. It can improve the comfort levels of parents and primary caregivers, meet the needs of the family, and reduce the behavioral problems of the child. In some cases, doctors might prescribe medications to help with some of the common problems that the condition comes with including aggressive behavior, anxiety, sleep problems, ADHD, and depression.

Alternative Forms of Treatment. Sometimes, parents seek alternative forms of treatment for their kids outside of the medical field. Such treatments may include acupuncture, massages, and even some movement techniques such as yoga or exercise. Also, parents may try biofeedback, creative art therapy, and even taking herbal supplements. While some of these may be very helpful, most forms of therapy haven’t been tested for fetal alcohol syndrome specifically and they may cause more harm than good. Therefore, it’s important for parents to check with their child’s doctor first before starting with any alternative forms of treatment.

How Does Fetal Alcohol Syndrome Affect Children?

Children who have fetal alcohol syndrome may share distinct facial features or facial abnormalities which we have discussed previously. Also, such children may experience other issues such as:

Poor or delayed growth. Usually, newborns would have smaller heads and low birth weights. Also, as time goes by, they might not gain weight or grow as well as average children. They may also be relatively shorter than others as they grow into adults.
Babies may have birth defects such as bone, kidney, and heart problems. Also, it’s common for these children to have vision problems as well as hearing loss.
Seizures or other types of neurologic problems like poor coordination and balance.
A delay in development which means that the children might not reach the milestones at the expected times.
Babies may display behavioral issues such as having trouble sleeping or being jittery or fussy. On the other hand, other children or even teenagers may have issues including:
poor coordination or fine motor skills
inadequate social skills
learning difficulties such as difficulty in school, poor memory, and problem-solving skills
behavioral issues such as poor concentration and attention, stubbornness, anxiety, impulsiveness, and hyperactivity

Long-Term Effects and Possible Complications of Fetal Alcohol Syndrome

A lot of the issues faced by babies and children who have fetal alcohol syndrome may continue until they grow into adolescents or adults. These issues include:

regulation issues including attention, arousal, and sleeping
learning disorders and mental retardation
problems with their hearing and vision
some deficits in reasoning and memory

Adolescents and adults with fetal alcohol syndrome would have to deal with more unique issues. These include substance abuse, legal problems, and sexual behavior. Usually, the characteristic facial features of those with fetal alcohol syndrome may “soften” as the person ages. However, the short stature and smaller-sized head are still observed even in adulthood. As aforementioned, a person who was born with fetal alcohol syndrome might experience a lifelong series of intellectual and physical challenges. The good news is that multi-therapy or early intervention programs may help lessen the effects of the condition.

How Does One Prevent Fetal Alcohol Syndrome

Drinking alcohol while pregnant is one of the main causes of birth defects, learning disabilities, and developmental disabilities which can be prevented. When it comes to fetal alcohol syndrome and FASD, the only way to prevent it from happening to the developing fetus is for the woman to avoid consuming alcoholic beverages during their pregnancy.

Also, women shouldn’t drink alcohol if they’re sexually active and they aren’t using any type of effective birth control. The reason for this is that it can take up to 6 weeks before women realize that they’re pregnant and at this time, the developing fetus might get exposed to the alcoholic beverages she drinks.

If the woman has already consumed alcoholic beverages during her pregnancy, it would be best for her to stop as soon as she finds out that she’s with a child. The growth and development of the fetus’ brain continue all throughout the pregnancy which means that stopping as soon as possible is always better than never stopping at all.

Another thing to keep in mind is that once the mother gives birth to her baby, she should still abstain from drinking alcohol while she’s breastfeeding. The reason for this is that the alcohol will appear in the mother’s breast milk and it can also be harmful to the baby. It can cause problems with learning, sleep, and the infant’s overall development.

Tips for Raising a Child with Fetal Alcohol Syndrome

Parents of children with fetal alcohol syndrome should think of raising their child as a journey. At times, it can be extremely challenging but it can also be very rewarding. When parents have children with fetal alcohol syndrome, it will change their lives and more often than not, for the better. Parents will have the opportunity to meet amazing people, build lifelong friendships, and watch their child work hard to reach his potential with their support and love. When parents are faced with challenges, they should know how to deal with them and always remember how much they love their child. Here are some tips that may help out:

Parents should know that there will always be times when they will have to deal with periods of grief. The brain damage that comes with fetal alcohol syndrome is permanent which means that the child’s future will always be uncertain. It will be very hard for parents to watch their child struggle and this reality will often hit them when they least expect it.
Parents should learn as much as they can about the condition. Read articles and books, attend conferences and training, and join support groups. They shouldn’t just do this at the beginning of the child’s life but all throughout. Also, the parents may have to share their experiences and educate others about their child’s condition as it’s highly misunderstood.
Fetal alcohol syndrome is considered as a spectrum disorder which means that children, adolescents, and adults with it may function at varying levels. One can take his child’s age then cut it in half and this is the age one can expect his child to act.
Mothers should never blame themselves if their child has fetal alcohol syndrome. This condition is generally a result of different things such as addiction issues or a lack of understanding and knowledge about how prenatal alcohol exposure can affect the developing fetus. After all, no mother would willfully intend to hurt her child by drinking alcohol while pregnant.
It’s always important to be patient when it comes to dealing with children with fetal alcohol syndrome. For instance, when it comes to setting rules, parents may have to re-teach things over and over again. They might not learn as quickly as average children but that doesn’t mean they never will. Also, the conventional parenting and disciplinary techniques won’t always work with children who have the condition. Because of this, parents have to think of alternative and creative ways to teach, discipline or even reward their children.
Routine is very important for children with fetal alcohol syndrome. As much as possible, stick to a routine. If one is planning to make any changes, he should inform the child ahead of time so as not to cause problems. It would also be very helpful to post a calendar each day and review the routine with the child every morning.
Transitioning from one activity to another can also be a challenge for those with fetal alcohol syndrome. Usually, they don’t have the ability to easily transition from one activity level or emotional state to another. Because of this, parents will have to keep helping them every step of the way.
Never give tasks which are too complex. When assigning tasks to a child with fetal alcohol syndrome, it’s better to break those tasks up and introduce them step-by-step. Often, children with this condition aren’t able to understand sequences or even the parts of a whole so parents have to explain things more.
Time is another concept that children with fetal alcohol syndrome may have a hard time understanding. They don’t usually know what a minute or half an hour feels like and so they can’t really tell the difference. To help with this, parents may use sand timers or audible countdown timers for their children.
Also, parents should learn how to distinguish between chaos and flexibility. Yes, it’s best to stick to a schedule but they should also know when to be flexible.
When it comes to diet, it’s best to keep specific foods on-hand to keep their blood sugar levels stable. These include proteins and complex carbohydrates. The blood sugar levels of the child can have an effect on his mood so parents need to keep the levels stable.
Children with fetal alcohol syndrome need a lot of exercise. Parents can let their children try some individual sports such as biking or swimming. These can help with their large muscle development while staying away from team sports which might create peer alienation or confusion.
If parents send their child to school, they have to communicate openly with their child’s teacher. They can make negotiations for a non-existent or at least a reduced homework load. This will help reduce the child’s stress and also respect the exhaustion level of the child.
Parents of children with fetal alcohol syndrome should get used to the feeling of being judged by the people around them. Often, other people will give them advice which, most of the time, may seem extremely condescending. The best things parents can do is learn how to smile back and keep in mind that these people are only trying to be helpful.
Sometimes, some of the relationships that the parents have with others might change. This is especially true for people who aren’t comfortable when they meet children who have disorders such as fetal alcohol syndrome. This lack of understanding might result in getting invited to fewer social gatherings, other parents not wanting their child to play with them, and more. As much as they can, parents should try to educate their family members and their friends about the condition and hope that others will respond with understanding and patience.
Apart from joining support groups, parents can also find other families who are raising children with fetal alcohol syndrome and start forming relationships with them. This would be very beneficial since these families would understand the situation and be able to provide helpful advice to each other.
Taking care of a child with fetal alcohol syndrome doesn’t mean that parents will experience nothing but heartache and challenges. In fact, it would also be a good idea to plan some fun activities to do each day. The symptoms of the condition may generate a lot of stress and tension in the household that’s why parents should search for something fun and positive to lighten the mood and keep the spirits up.
Also, just like any other children, those who have fetal alcohol syndrome deserve a lot of hugging and cuddling. The physical contact will reinforce the attachment of the child to his parents and the other members of his family.

Each and every child is precious, even those who suffer from conditions such as fetal alcohol syndrome. Even though they’re highly frustrating, they can also be fun children who just want to be accepted and loved. Their families should accept them for who they are and understand them despite all the challenges. The important thing is to expect all the issues, challenges, and chaos that come with the condition. Aim to find the silver lining in any situation and always try to make the child feel like he’s loved, celebrated, and accepted for everything he is.

FAQs About Fetal Alcohol Syndrome

There truly is a lot to learn about fetal alcohol syndrome and it’s helpful to learn all about it. This is especially true for parents who have a child with the condition. Those who have family members or friends with fetal alcohol syndrome would also benefit a lot from learning about the condition so they can help raise the child and provide the love and support he needs. Let’s take a look at some of the most commonly asked questions about this condition:

When It Comes to Drinking, How Much Is Too Much? When a woman is pregnant, there’s no known “safe amount” of alcohol to consume. Any amount might cause harm to the fetus developing in the woman’s womb and even cause a miscarriage. The reason for this is that alcohol can easily pass through the placenta and into the fetus. When this happens, it can have various effects on the little one developing in the mother’s womb. The good news is that women can avoid all these problems simply by not drinking alcohol while they’re pregnant. Also, women who are trying to get pregnant or suspect that they’re pregnant should stay away from alcohol too.

How Can a Woman Prevent the Occurrence of Fetal Alcohol Syndrome? As aforementioned, there’s only one sure-fire way to prevent fetal alcohol syndrome. If a woman is trying to get pregnant, she should stop drinking alcohol right away. In doing this, she can make sure that her baby won’t acquire the condition. However, some women find it very hard to stop drinking. In such cases, the woman should seek help first before she plans to get pregnant. There are support groups and programs out there which can help women cut down on their alcohol intake or even stop drinking.

If the woman just discovers that she’s pregnant, she should stop drinking right away. If she can’t just stop drinking, then she should lessen her alcohol intake gradually. Women can also keep in mind that each time they choose to abstain from alcohol, they’re helping their baby immensely. Check out more info on how to pronounce hidradenitis suppurativa here

What Happens to the Developing Fetus When the Mother Drinks Alcohol? We’ve already discussed the symptoms of fetal alcohol syndrome but let’s reiterate the most common ones to emphasize them. When babies are exposed to alcohol while they develop in the mother’s womb, they may be born with:

a smaller size than average babies
slight facial differences
symptoms of withdrawal in the first few weeks
shaking or tremors
extreme fussiness or irritability
diarrhea and feeding problems

Some babies may also have issues with their digestion, heart rates, and breathing. Babies born with fetal alcohol syndrome are usually very fussy and have sleeping problems. The sad thing is, these issues may last for a couple of years.

Does Fetal Alcohol Syndrome Go Away? Most of the symptoms of this condition will last throughout the child’s life. However, some of these symptoms may change as the child grows older. Toddlers with this condition might be:

hyperactive
not able to follow even the simplest instructions
too friendly, even to those they don’t know
delayed in terms of their development

When the child goes to school, he may have:

learning difficulties in different subjects
difficulties in concentrating and in paying attention
behavioral problems in class
problems coping in school

What Should a Mother Do If She Suspects That Her Child Has Fetal Alcohol Syndrome? Certain territories and provinces have their own resources for identifying the children who have fetal alcohol syndrome. If a mother thinks that her child has the condition, it’s best to ask her doctor for a referral or an assessment. Then the doctor may ask the mother some questions such as:

whether the woman consumed alcohol while she was pregnant
if she did consume alcohol, how much did she consume
how the child behaves at home
how the child performs at school
if the child has any learning problems

Not all the children who get exposed to alcohol in the womb will have “full fetal alcohol syndrome,” but they might still experience these problems.

Will Children Who Have Fetal Alcohol Syndrome Have Problems All Their Lives? Sadly, the effects of fetal alcohol syndrome with last for the whole lifetime. But if the condition is diagnosed early and if the child gets the support he needs, there’s a lesser likelihood of him experiencing problems as he grows older. However, without intervention and support, adolescents and adults with this condition may experience problems including: