FASD: Are you pregnant and still drinking?

Prenatal exposure to alcohol can cause a range of mental and physical disorders, known as fetal alcohol spectrum disorder (FASD). The most severe effects are diagnosed as fetal alcohol syndrome (FAS). FAS, characterized by irreversible abnormal facial features, growth deficiencies, and central nervous system (CNS) problems, is one of the leading known preventable causes of mental retardation and birth defects.

Children with FAS might have problems with learning, memory, attention span, communication, vision, hearing, or a combination of these. These problems often lead to difficulties in school and problems getting along with others. FASD is a permanent condition and it negatively affects the child, the child's family, and even the community (children with FASD grow up and are at risk for problems with the law, high-risk behavior and mental disorders).

Fetal Alcohol Syndrome (FAS) effects at least 2 percent of all births in the United States, with research suggesting the subclinical effects of prenatal exposure to alcohol effect 1 in 100 births.

What is the difference between FAS and FASD?

Unlike FAS, FASD is not a clinical diagnosis. According to Gregor, a board member for FASTeam, a nonprofit dedicated to raising FASD awareness, FASD includes diagnoses of FAS, Fetal Alcohol Effects (FAE), Partial Fetal Alcohol Syndrome (PFAS), Alcohol-Related Neurodevelopment Disorder (ARND), and Alcohol-Related Birth Defects (ARBD). These conditions differ in terms of physical, mental and behavioral disabilities.

These conditions are on a spectrum and children prenatally exposed to alcohol can have some but not all of the clinical signs of FAS. In some cases, parents are not even aware of their baby having alcohol-related damage until the child gets older. However, with FAS, the signs are distinct and present early on.

What are the effects of FASD?

According to the Center for Disease Control and Prevention (CDC), the most extreme outcome of FAS is fetal death. Women who drink during pregnancy are also at higher risk of miscarriage, premature birth, still birth, placental abruption, and amniotitis.

Children with FASDs might have the following characteristics or exhibit the following behaviors:

Small size for gestational age or small stature in relation to peers
Facial abnormalities such as small eye openings
Poor coordination
Hyperactive behavior
Learning disabilities
Developmental disabilities (e.g., speech and language delays)
Mental retardation or low IQ
Problems with daily living
Poor reasoning and judgment skills
Sleep and sucking disturbances in infancy

Drinking during pregnancy is so detrimental because your unborn child is being exposed to the same amounts of alcohol as you (yet they are far smaller) and studies have demonstrated equivalent fetal and maternal alcohol concentrations (this means your baby's blood alcohol level is equivalent to yours).

Worse, studies suggest that the amniotic fluid actually acts as a reservoir for alcohol, prolonging fetal exposure to alcohol (you may no longer feel the effects of the alcohol you drank but your baby still does and your baby does not have the metabolic capacities like an adult).

Can only a few drinks during pregnancy cause FAS or FASD?

"Yes, drinking any amount of alcohol at any time during the pregnancy has the potential of damaging the fetus and leading to a FASD disorder," says Gregor. "No amount of alcohol consumption can be considered safe during pregnancy and alcohol can damage a fetus at any stage of pregnancy."

According to Gregor, the latest research suggests that as little as two drinks in early pregnancy can kill developing brain cells. She adds, "It is also important to know that some of the more severe effects of alcohol occur with woman who binge drink (four or more drinks on an occasion). Of course this is of great concern since we know that college women and many other women of child-bearing age often engage in binge drinking [and do not take birth control]. So, these women may not drink on a regular basis, but have had instances of binge drinking and maybe did not even know that they were pregnant."

Why can some women drink and have healthy babies?

Every pregnancy is different and every fetus is different. A mother may drink with one pregnancy and have a healthy child and drink during another pregnancy and have an unhealthy child.

Gregor warns, "It is a grave mistake to assume that if you had a healthy child and drank during that child's pregnancy that you can drink with another pregnancy and again have a healthy child. One fetus may be more compromised or more sensitive to the effects of alcohol than another fetus." There is no way of knowing, so why risk it?

What are the treatments or course of care for children born with FAS and FASD?

The recommended course of care for children diagnosed with a FASD is a family-based, individualized, multidisciplinary approach. Gregor explains, "Children with FASDs often have lower IQs and need special education services and/or speech-language therapy for learning disabilities. These children may require physical therapy and/or occupational therapy for motor deficits and coordination. Due to behavioral, emotional, and social problems, it is important that they work with a psychologist or counselor that can assist them in these areas. They may also require treatment with a psychiatrist for medication management of behavioral and/or emotional problems. "

She adds, "It is also advisable that the family get counseling to help them understand the expectations and limitations of their child, and to learn how to best bolster their child's abilities. Finally, children with FASDs should be routinely followed by a pediatrician that is knowledgeable about FASDs."

If you are pregnant and drinking, stop today. Your child deserves to be born alcohol-free. That beer, wine or cocktail will taste just as good when you are post-partum and your baby is born without the irreversible effects of prenatal exposure to alcohol. If you know someone who is pregnant and drinking, send her this article.

For more information on FASD, visit The Center for Personal Development.

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