Overview

A baby born to a mother who drinks alcohol during pregnancy can have many problems. This is called fetal alcohol spectrum disorder (FASD). FASDs include:

  • Fetal alcohol syndrome (FAS). This is the most severe effect of drinking during pregnancy. It may include fetal death. Infants born with FAS have abnormalities of the face. They also have growth and central nervous system (CNS) problems. This includes learning and mental disabilities.
  • Partial fetal alcohol syndrome (pFAS).  This refers to children who have only 2 of the physical aspects of fetal alcohol syndrome. They have slow growth and CNS problems. 
  • Alcohol-related neurodevelopmental disorder (ARND). Children with ARND may have learning and behavior problems. These may include problems with math, memory or attention, and impulse control or judgment. They may also do poorly in school. 
  • Alcohol-related birth defects (ARBD). This can include defects in the heart, kidneys, bones, or hearing.

Causes

FASDs happen when a mother drinks alcohol during pregnancy. Like other drugs, alcohol can pass from the mother's blood through the placenta to the fetus. Alcohol is broken down more slowly in the fetus than in an adult. Alcohol levels can stay high in the baby's body. This affects development. No amount of alcohol during pregnancy is safe. There is no safe time to drink in pregnancy. Even light or moderate drinking can affect the growing fetus. 

Symptoms

Babies or children with FASDs may have:

  • Slow fetal growth and low birth weight
  • Alcohol withdrawal symptoms in newborns (such as high-pitched cry, jitteriness, and seizures)
  • Sleep and sucking problems in infancy
  • Abnormalities of the face (such as small eyes and thin mouth)
  • Shorter height than other children of the same age
  • Poor physical coordination
  • Hyperactivity
  • Learning or thinking problems or low IQ
  • Speech or language delays
  • Problems with daily living, reasoning, and judgment

The symptoms of FASDs may look like other health conditions or problems. Make sure your child sees his or her healthcare provider for a diagnosis.

Diagnosis

Most often, a healthcare provider can diagnose FASDs based on the mother's history and how the baby looks. The healthcare provider will examine the baby to look for changes in the face, eyes, and upper lip. A newborn may show signs of alcohol withdrawal. These include shaking and a high-pitched cry. Older children may have learning tests. The provider will check for development problems. There is no single test to diagnose FASDs. 

Treatment

Newborns may need special care in the newborn intensive care unit (NICU). A newborn may get medicine to help with alcohol withdrawal. 

The physical problems seen in FASDs last throughout life. But programs can help improve a child's development. Such programs may focus on improving a child's behavior with early education and tutoring. Programs also help parents with parenting skills. Medicine may help a child's attention problems or hyperactive behaviors. Over time, your child may get help from special education programs and social services.

Complications

Complications of FASDs can range from mild learning disabilities to more severe behavior and mental problems. Physical disabilities or birth defects in children with FASD do not get better. Long-term problems may include:

  • Mental health problems
  • Poor social skills
  • Unemployment
  • Not finishing school

Prevention

FASDs are 100% preventable. But this means the mother must stop using alcohol before getting pregnant. No amount of alcohol is safe. A woman should stop drinking at once if she thinks she could be pregnant.

Living with

FASD are life-long disorders. Most states have early intervention programs. Public school systems can also offer support to children with FASDs. State and local social services can help families with special education and social services. Studies have shown that getting help early is best. Children with FASDs also are helped by being in a loving, nurturing, stable home. Parents may also need respite care. This means that someone else takes over the care of the child for a short time. This gives the parents a break so they can take care of other family needs. Ask your child's healthcare provider about services in your area.

Key Points

  • Fetal alcohol spectrum disorders are a group of physical, mental, and social problems in a child that are caused when a mother drinks alcohol during her pregnancy.
  • The problems include abnormalities of the face. They also include problems with the central nervous system and poor growth. FASD can also cause mental health, behavior, and development problems. 
  • There is no cure for FASD. But getting help early can help improve a child's behavior.
  • Medicine may help a child's attention difficulties or hyperactive behaviors.
  • Families may also get help by learning parenting skills and having access to respite care.

Next Steps

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
  • Ask if your child’s condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if your child does not take the medicine or have the test or procedure.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.