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Fetal alcohol syndrome

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 3 minutes read

Fetal alcohol syndrome (FAS) is a condition which occurs as a consequence of women drinking alcohol during their pregnancy. It covers a wide range of symptoms and affects each baby differently. Examples include facial changes and learning disabilities, trouble with coordination or attention and hyperactivity. It can also affect the kidneys, bones, and the heart, and cause growth problems.

The term fetal alcohol spectrum disorder is often used interchangeably, but more specifically describes certain collections of symptoms related to damage by alcohol during pregnancy, of which FAS is the most severe end of the spectrum.

Symptoms may be subtle and there may be no physical signs, but it’s thought to be underdiagnosed, and numbers have risen in recent years along with alcohol abuse.

What causes the damage?

By definition, the cause is due to alcohol being consumed in pregnancy. This is often at an excessive level but there is no safe level of alcohol consumption in pregnancy so it’s safest to avoid drinking completely while pregnant.

Alcohol during pregnancy affects the unborn baby because the liver is underdeveloped and therefore cannot break it down, as it can for adults. The developing brain is particularly sensitive to the effect of alcohol.

Along with FAS, high alcohol levels lead to many complications of the brain and body such as birth defects, and it risks stillbirth and early labor.

What are the symptoms?

A baby with FAS looks quite characteristic in that they have a small head and brain, small eyes, a short nose with a low nasal bridge and a thin upper lip with an indistinct ridge between the upper lip and the nose. FAS can also cause deformities of the joints and hands, and affect eyesight and hearing.

The baby can grow up with developmental delays, learning difficulties, and difficulty regulating emotions. There may also be problems with memory, coordination and reasoning. It can affect children in a variety of ways which may make it hard for them to socialize, make friends and thrive at school.

How is FAS diagnosed?

It is a clinical diagnosis, which means that there are no special tests or investigations that confirm it but a doctor will be able to examine their features and their behavior and correlate it with their mother’s account of drinking during pregnancy.

How is FAS treated?

Unfortunately, there is no cure for FAS but the earlier it is diagnosed, the earlier it can be managed, and the better the outcome for the child. There are also 'protective factors' that appear to help a child with FAS reach their fullest possible potential including having a diagnosis before the age of 6, having a loving and stable home environment (including the absence of violence) and involvement of the special education and social services. Support and therapy for both the parents and child in how to manage difficulties in behavior or ability are also very important.

Medications can help manage the symptoms and because FAS presents in a similar way to attention deficit hyperactivity disorder (ADHD), stimulants can be one option. Other neurological medications can be used to treat mood symptoms, behavioral difficulties and anxiety. Complementary therapies and relaxation techniques are often deployed to help with behavioral symptoms.

Mothers may require help if they are still abusing alcohol, therefore a drug and alcohol program is the right place for support and guidance.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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