Fetal alcohol syndrome isn't a single birth defect. It's a cluster or pattern of related problems. The severity of symptoms varies, with some children experiencing them to a far greater degree than others. Signs and symptoms of fetal alcohol syndrome may include:
- Small head circumference and brain size (microcephaly)
- Facial malformations, including small eyelid openings, a sunken nasal bridge, an exceptionally
thin
- upper lip, a short, upturned nose and a smooth skin surface between the nose and upper lip
- Small teeth with faulty enamel
- Heart defects
- Deformities of joints, limbs and fingers
- Slow physical growth before and after birth
- Vision difficulties including nearsightedness (myopia)
- Mental retardation and delayed development
- Abnormal behavior such as short attention span, hyperactivity, poor impulse control, extreme
nervousness and anxiety
When you drink alcohol, it enters your bloodstream and can reach your developing fetus by crossing the placenta. Because a fetus metabolizes alcohol more slowly than an adult does, your developing baby's blood alcohol concentrations are higher than those in your body. The presence of alcohol can impair optimal nutrition for your baby's developing tissues and organs and can damage brain cells.
The more you drink while pregnant, the greater the risk to your unborn baby. The risks are greatest during the first 3 months of pregnancy.
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If your child exhibits some of the physical signs and symptoms that may accompany fetal alcohol syndrome, ask your child's doctor whether FAS or some other condition might be the cause. Sometimes, a referral to a medical genetics specialist is needed to diagnose FAS. Also, if your child demonstrates learning and behavioral problems, discuss this with your doctor so that the underlying cause might be identified.
Doctors can't diagnose fetal alcohol syndrome before a baby is born. Knowing that you had been drinking while pregnant, your doctor can look for signs and symptoms of this syndrome in your child's initial weeks, months and years of life. Doctors commonly rely on these manifestations — such as a growth deficiency, facial malformations and the presence of heart defects — to diagnose FAS. At times doctors use a variety of tests — including evaluations of IQ and language development — to help make a diagnosis.
It may be difficult for doctors to identify FAS. In some cases FAS may be very similar to other syndromes that have some of the same physical or behavioral characteristics. These conditions include Turner's syndrome, a chromosomal abnormality affecting girls that can impair intelligence and physical growth, and fragile X syndrome, a chromosomal mutation that causes a form of mild mental retardation. If one child in a family is diagnosed with FAS, it's important to evaluate the siblings to determine whether the same syndrome exists.
There's no cure for fetal alcohol syndrome. In general, the physical defects and mental deficiencies persist for a lifetime. Heart abnormalities may require surgery.
Doctors haven't identified a safe level of alcohol that a pregnant woman can consume. If you're in your childbearing years, be aware of the risks of FAS in your future offspring. These guidelines can help prevent FAS:
- Stop drinking alcohol altogether as soon as you know you're pregnant or even think you might be
pregnant. Your baby's brain, heart and blood vessels begin to develop by the third week of pregnancy.
- Continue to avoid alcohol throughout your pregnancy. FAS is completely preventable in children
whose mothers don't drink during pregnancy.
- Consider giving up alcohol during your childbearing years if you're sexually active and you're
having unprotected sex. Nearly half of all pregnancies are unplanned. At the least, don't engage in
binge drinking, which may expose the fetus to the highest amount of alcohol.
- If you're an alcoholic, don't get pregnant until you get help. Use birth control methods until
you're able to control your drinking.
The psychological and emotional problems associated with FAS are difficult to manage. Families and children with FAS may benefit greatly from the support of professionals and other families who have experience with FAS. Ask your doctor or public health nurse for local sources of support for families and children with FAS.
Advocacy groups and parents organizations that specialize in FAS recommend a number of steps to help parents manage behavioral problems of the syndrome. These include:
- Implement daily routines to which your child can become accustomed.
- Create and enforce simple rules and limits.
- Point out and reinforce acceptable behavior, using rewards.
- Because many children with FAS are naive, guard against them being taken advantage of by others.
Also, encourage them to make decisions in protected environments.
- Teach your child skills for daily living.
With constant support you can shield your child from some of the problems that often develop later in life, including drug abuse, teenage pregnancy and encounters with the juvenile justice system.
If you've given birth to an FAS child, you may benefit from substance abuse counseling and treatment programs that can help you conquer your misuse of alcohol.
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July 18, 2001 —
