Fetal Alcohol Syndrome
There is no safe time or amount to drink during pregnancy!
Ann P. Streissguth, Ph.D.
Alcohol is an agent that
causes birth defects (a teratogen).
Teratogens have four effects:
Ways alcohol causes damage in the developing fetus:
The dosage and timing of the pregnant woman's drinking is important: A daily glass of wine is not as bad as drinking seven drinks in one night.
There are times when the fetus is not as susceptible as others. Some women seem not to be as sensitive to alcohol and some fetuses are resistant to the alcohol's effects. But since none of these factors are predictable, the only safe course for the pregnant woman is to refrain from drinking.
The behavioral effects on children whose mothers drank during pregnancy have been replicated in animal studies. The importance of these controlled studies is the ability to isolate the effects of alcohol from other factors such as smoking, using pot, not eating well, etc. These studies have given proof that alcohol is a teratogen.
the first three months of fetal development . . . alcohol causes
physical damage. In the second trimester . . . alcohol increases
the risk of spontaneous abortion. And in the last trimester . . .
alcohol can cause growth deficiency.
Since the central nervous system - which includes the brain - is developing throughout the pregnancy, this underlines the fact that there is no safe time or amount to drink during pregnancy.
Public education about Fetal Alcohol Syndrome (FAS) is extremely important. In 1979-1980, more women believed in abstaining totally from alcohol during pregnancy than did their obstetricians, who were providing them with prenatal care. In 1981 the U. S. Surgeon General declared there was no safe amount of alcohol a prgenant woman could consume.
Today attention deficit is receiving a great amount of attention. All the causes are not yet known, but one is prenatal alcohol exposure.
Studies of FAS children conducted in Seattle at the University of Washington have shown the following results. In the first day of life FAS babies have poor sucking skills; poor sleep and wake patterns; crying more easily and trembling; and neurotransmission was delayed. At age four tests were given to measure motor speed and ability to solve mazes. The more alcohol exposure to the fetus, the longer it took to correct the mistakes in the maze. Attention deficit was very measurable.
Alcohol produces dysfunctional families. A study showed that 80% of FAS children did not live with their biological mother. As FAS children grew it was apparent that they were highly impulsive, failed to perform well under stress, and were poorly organized.
It is harder for individuals with FAS to receive services, particularly if their IQ is not below 70. Such individuals may not be properly diagnosed. IQ is frequently the determinant, yet children with a higher IQ often are in need of services. Arithmetic is their hardest subject, but few schools assist them with it. These individuals need help with daily living skills, socialization, adaptive behavior, and communication.
By age 14, more anti-social and delinquent behavior surfaced. As FAS adolescents develop into adults they have no goal in life. They have difficulty holding the simplest job. In general, the more alcohol consumed by the mother, the worse the outcome for the child.
During adolescence 60% FAS teens experience a major disruptive school experience - being suspended, expelled, or dropping out - and 60% get in trouble with the law; 50% are confined at some time.
FAS adults are frequently suicidal. This is the biggest cause of death for individuals with FAS. The smarter they are, the more likely they are to commit suicide because they realize they are not like other people.
More than 90% of FAS individuals have mental health problems and most of them seek professional help. However, the authoritative guide for social workers, psychologists, and psychiatrists, the DSM IV (Diagnostic and Statistical Manual, 4th ed., 1994) does not even mention FAS or Fetal Alcohol Effects (FAE). These professionals are not trained to ask about the mothers' drinking patterns or to recognize these conditions.
How many persons are directly afflicted by these preventable syndromes? In a Seattle population-based study conducted in 1974-1975, 3 per 1,000 births were diagnosed with full FAS, while 6 per 1,000 were determined to have FAE. Adding these groups together means that 9 out of 1,000 were affected.
What is the community solution? IPIP, a cycle of intervention/prevention/intervention/prevention is urgently needed!
Each community needs to intervene with high-risk mothers to prevent more alcohol-affected babies. Further, the community needs to intervene with high-risk babies to prevent secondary disabilities.
The situation is not totally hopeless. In Seattle a model of paraprofessional advocacy (now state-funded) called P-CAP (Parent-Child-Assistance Program) has been developed. Advocates are trained to work with high-risk mothers and their babies starting within a month after birth and continuing through the third year. The cost to care of high-risk babies at birth is higher.
To solve the problem of alcohol-affected babies women must either be motivated not to drink during pregnancy or, if they can't stop drinking, to avoid pregnancy.
The five P's of prevention are:
We need communities totally committed to not having any more FAS babies! Continual awareness is required through public service announcements, posted signs about the danger of drinking during pregnancy, and other educational endeavors.
This is the message. FAS is only a small part of alcohol-related disabilities.
FAS lasts a lifetime, BUT -- FAS is preventable.
For more information on fetal alcohol disorders: