What are Fetal Alcohol Spectrum Disorders?

Prevention and Treatment of Fetal Alcohol Spectrum Disorders

Yearly, thousands of children are born with the adverse effects of prenatal exposure to alcohol, or fetal alcohol spectrum disorders.

Women who consume alcohol while they are pregnant grow the risk that their babies would have learning, physical, and/or behavioral problems, like Fetal Alcohol Spectrum Disorder. Fetal Alcohol Spectrum Disorders is an umbrella diagnosis that includes three different conditions. The common thread among them all is that they are all conditions that babies are born with that are the result of the mother’s drinking behaviors while pregnant.

This can include regular drinking as well as binge drinking.

The most commonly known condition would be Fetal Alcohol Spectrum Disorders, also known as FAS.

Despite being the most known and talked about, Fetal Alcohol Spectrum disorder is not the only condition that can result from the mother drinking while pregnant.

There are three conditions that fall under the Fetal Alcohol Spectrum Disorder diagnosis umbrella:

• •  Fetal Alcohol Syndrome (FAS)
  •  Alcohol-Related Birth Defects (ARBD)
  • Alcohol-Related Neurodevelopmental Disorder (ARND)

Some women believe that having “one or two” drinks occasionally when pregnant will not have an impact on their baby. However, the alcohol in the mother’s blood is then passed to the fetus via the umbilical cord. The challenging part with this thought is that we don’t know if there is in fact a safe level of alcohol consumption when pregnant.

Every pregnancy is different, which means that every pregnancy can be influenced differently by alcohol.

It is important to note that Fetal Alcohol Spectrum Disorders can have a  varying level of impact on the child, which is believed to be connected to the amount of alcohol consumed.

Studies done by the Center of Disease Control, CDC, have looked at the prevalence of alcohol use among pregnant women ages 18-44. States that fall into the higher percentage, approximately 59.8%- 68.3%, includes the following States:

· Colorado

· Iowa

· Maine

· Massachusetts

· Minnesota

· Montana

· New Hampshire

· North Dakota

· Pennsylvania

· South Dakota

· Vermont

· Washington D.C.

· Wisconsin

It is important to note that the statistics listed above did not look at the amount of alcohol that a pregnant woman consumed while pregnant, rather only if alcohol was consumed. Further research is needed to investigate reasons contributing to why some states have higher rates than others.

When looking at the prevalence of binge drinking among pregnant women, there are states with a higher prevalence than others. Binge drinking is recognized as drinking 4 or more drinks on one occasion at least once per month.

The following states had a reported prevalence between 38% and 43.4 % for binge drinking among pregnant women:

· Delaware

· Hawaii

· Illinois

· Iowa

· Maine

· Minnesota

· North Dakota

· South Dakota

· Utah

· Washington D.C.

· Wisconsin

As mentioned above, research has not been able to identify a level of alcohol that is “safe” for pregnant women to drink which is why the current recommendation is to not drink if you think you may be or are currently pregnant.

Some women do drink before knowing that they are pregnant, however the important piece is that they are honest with their doctor about how much and how often the drank while pregnant and that they have since stopped consuming alcohol.

It is important to note that every pregnancy is different, which means that every baby can be impacted differently. Some may show some signs of FASD while others may not even with the same amount of alcohol consumed.

Fetal Alcohol Spectrum Disorders are not hereditary and are 100% preventable.  

If you learned that you are pregnant, and have been struggling to stop drinking alcohol, know that there is help for you.

Talk to your doctor about your concerns, and they can help provide you with resources that are available for you.

What is Fetal Alcohol Syndrome?

Fetal Alcohol Syndrome, also known as FAS, is the most commonly known condition within the Fetal Alcohol Spectrum Disorder umbrella.

According to the Center for Disease Control (CDC), approximately 0.2-1.5 infants for every 1,000 births in the United States have Fetal Alcohol Syndrome.

FAS can look different with every child, however there are some common characteristics that the parents and/or Pediatricians may notice. These include:

•  Physical defects: small eyes, thin upper lip, deformities with limbs, slow growth, vision and hearing difficulties, small head circumference, heart defects, kidney problems, and concerns with their bones 
•  Brain and/or Central Nervous System Problems: Poor balance and coordination, learning disorders, memory difficulties, attention problems, poor judgment skills, hyperactivity, quick mood changes, and difficulties with problem-solving
•  Social and Behavioral Concerns: hard time getting along with others, poor social development skills, difficulty with change, not understanding time, attention difficulties, not goal orientated

You may be able to guess that the physical defects are usually the first warning signs that a baby was born with Fetal Alcohol Syndrome. Unfortunately, there is no cure for FAS which means that the baby will likely develop some of the other concerns mentioned.

Since there is no cure for FAS, early treatment is often recommended by children’s Pediatricians to help manage the concerns that arise. For example, hyperactivity and social impairment can be addressed with counseling and varying therapies, while physical therapy can help with the physical deformities that a child has.

Babies who are born with Alcohol- Related Birth Defects, ARBD, will likely have problems with their bones and major organ systems.

This can include problems with their kidneys, heart, and ability to hear.

The Diagnostic and Statistical Manuel 5, DSM 5, is a tool used by mental health and other health professionals to diagnosis a variety of mental health concerns. When published, the DSM 5 included a new diagnosis, Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE).

The purpose of this diagnosis would be to identify the impairments a child faces that are the result of being exposed to alcohol while their mother was pregnant. This diagnosis requires that the child has social and behavioral problems as well as difficulties with day-to-day life. There is also a requirement for the amount of alcohol that was consumed.

You may suspect that children who are born with Alcohol-Related Neurodevelopmental Disorder, ARND, are more likely to have intellectual difficulties as well as behavioral concerns.

As mentioned above, these concerns can often be better managed when treated early and appropriately. This is another reason as to why it is important for a mother to be honest with her doctor and her child’s doctor about her alcohol consumption while pregnant.

Recommended Interventions

Alcohol misuse in pregnancy is a significant public health issue and the focal point of extensive media attention. We mentioned earlier in the article that there are resources available to women who struggle to stop drinking when they learn about their pregnancy.

The first step to an intervention would be screening and assessments done throughout pregnancy as well as if there is a direct concern about a mother who is suspected of drinking. This can be done by the woman’s primary physician or their OBGYN.

Screenings can be brief, and often include asking questions and having a conversation with the mother about their drinking behaviors and any concerns they have. The Center for Disease Control, CDC, has developed a plan to help health professionals complete screenings with patients.

Another intervention approach would be to address the drinking behaviors among women who are not pregnant. This would be appropriate for women who would like to conceive in the near future and are looking to stop drinking.

This work can be done with a mental health professional such as a counselor or an addictions specialist.

It is important to note that many treatment options that work to address concerns associated with Fetal Alcohol Spectrum Disorders are often available even if the child has not been officially diagnosed with an FASD.

Early interventions are recognized as treatment options available from birth to three years. These interventions tend to address talking, walking and social interactions with others. Resources available to you may be dependent on where you live, so do your research and ask questions!

Other treatment options include:

• medical care for physical defects, 
• medications, 
• behavior and educational support and parent training.

Medical treatments that used are going to be dependent on the defects that the child has.

Medications can help manage concerns such as hyperactivity and anxiety.

Many children with Fetal Alcohol Spectrum Disorders benefit greatly from additional support at schools regarding learning and socializing.

Parent training can be helpful for parents who have a child with FASD. Many of the defects associated with FASD can make parenting a child with them more difficult than children who may not have FASD.

This means that the parents will likely need to have a different parenting approach with their child, such as being consistent, concrete, and using repetition.

The take away from this article is that Fetal Alcohol Spectrum Disorders are completely preventable. By not drinking, mother is ensuring that there is no risk for the disorders as the baby has no exposure to alcohol while developing.

For mothers who have drank alcohol while pregnant, and those who have been unable to stop drinking, there is help available for her as well as for the baby when it is born. Despite having defects and difficulties, children born with Fetal Alcohol Spectrum Disorders can live a meaningful and purposeful life.

Early interventions for children who are born with Fetal Alcohol Spectrum Disorders can help make it easier for them to manage the defects and other impacts that their diagnosis has on them. Some children will require lifelong medical treatment if they have significant defects on their organs and bones.

Alcoholism is not only dangerous to the mother, but to the unborn fetus as well. If you or someone you love is in need of alcoholism treatments, please don’t hesitate to reach out to a dedicated treatment provider today.