Fetal Alcohol Syndrome (FAS) is a serious condition that affects thousands of children each year. This preventable condition can cause delays in development that can affect lifelong learning. Most OB/GYN doctors recommend complete abstinence from alcohol while pregnant because so little is known about what amount of alcohol crosses the threshold of what is safe for baby.
Alcohol is a Teratogen (monster maker in Greek) a Teratogen is any substance that can cause harm to an unborn fetus. Alcohol is now the most likely Teratogen that a fetus will come in to contact with while in utero in societies where alcohol is a prominent feature of the culture. In the US Fetal Alcohol Syndrome is considered to be one of the most preventable forms of birth defects.
Gathering the statistics is dependent on so many variables but here is what the Department of Health and Human Services has published:
1. Women between the age of 15-44 report at the rate of 1 in 20 of binge drinking (15-44 is considered child bearing age.
2. 1 in 9 women report binge drinking in the first trimester of pregnancy.
3. 1 in 5 women report drinking during their first trimester.
4. Between .05-2 per 1000 live births are children born with FAS.
5. 40,000 children born each year (it is estimated) have FAS it may be as many as 80,000 with half going undiagnosed.
6. It is estimated that a child born with FAS will cost $2 million over their lifetime between treatment and disability.
7. The cost to the nation is about $6 Billion per year.
A child with FAS may not develop an IQ beyond 60 which is considered “educable retardation” in the US.
Overview of Fetal Alcohol Syndrome
FAS was first identified in the 1960’s when a French Medical Journal published a report about the effects of alcohol on a newborn. Unfortunately the article did not get much attention but the syndrome was revisited about 15 years later in the US and more research was conducted to confirm the suspicions that alcohol did in fact effect the development of a newborn.
One of the key problems with prevention is that much of the damage can be caused during the first trimester when the mother is unaware that she is pregnant. Many women may stop drinking once they find that they are pregnant but the damage may already be done.
It can be very difficult to study disorders in newborns when they are directly linked to a mothers behavior because of course it would be unethical to “feed” a pregnant woman alcohol to see what the limit is before damage is done.
Largely the medical community depends on self-reporting to gather statistics about FAS which can be a bit undependable. The problem is that thanks to a public service announcement campaign most people are aware that drinking alcohol while pregnant puts the fetus at risk so many women will not admit to drinking while pregnant. Collecting data can be difficult and the signs of FAS in a newborn can also be variable but typically if two or more of the variables are present and other causes can be ruled out than a diagnosis can be made with confidence. A combination of the mother’s history and the child’s physical features and developmental milestones can help to conclusively determine the diagnosis.
One of the key signs of a child with FAS is low birth weight when compared to children that have reached the same gestational age. A smaller skull size is also a sign of FAS. While the child may appear healthy to family and friends a smaller head size when compared to that of other children of the same age can point to FAS when combined with a low birth weight. As the child grows their overall height will be shorter than other children. This lag is never resolved.
Both in utero development and after birth development that is retarded compared to both fetuses of the same gestation period and children of the same age may also be considered signs of FAS. Some facial anomalies may also present such as smaller/shorter eye sockets, absence or noticeable smoothing of the philtrum (crease between upper lip and nose) flattened cheek bones are also considered a physical symptom of FAS.
Making a diagnosis of FAS in some cases is very difficult because the symptoms can be confused with other disease. Cognitive impairment and other delays in development like delays in motor skills, sitting, walking, standing and vocabulary use are also considered flags for FAS when combined with the mother’s history.
In severe cases the diagnoses may still be difficult because the defects may be blamed on other disease. Spina Bifida, Hydrocephalus, Cleft Lip, narrowing of the aorta heart valve all can be a part of fetal alcohol syndrome.