Like any syndrome, fetal alcohol syndrome (FAS) is a group of signs and symptoms that appear together and indicate a certain condition. In the case of FAS, the signs and symptoms are birth defects that result from a woman's use of alcohol during her pregnancy. Among their symptoms, children with FAS may grow less quickly than other children, have facial abnormalities and have problems with their central nervous systems, including mental retardation.
In the United States, FAS is one of the leading causes of birth defects and is thought to be the most common cause of preventable mental retardation. Each year between 5,000 and 12,000 American babies are born with the condition. FAS is sometimes called fetal alcohol abuse syndrome.
Usually, FAS is diagnosed only when a child has the following major clinical manifestations, or signs:
- Growth retardation
- Characteristic facial features, such as:
- Small eyes with drooping upper lids
- Short, upturned nose
- Flattened cheeks
- Small jaw
- Thin upper lip
- Flattened philtrum (the groove in the middle of the upper lip)
- Central nervous system problems, including:
- Mental retardation
- Delayed development of gross motor skills such as rolling over, sitting up, crawling and walking
- Delayed development of fine motor skills such as grasping objects with the thumb and index finger, and transferring objects from one hand to the other
- Impaired language development
- Memory problems, poor judgement, distractibility, impulsiveness
- Problems with learning
However, children affected by FAS may have any or all of the signs and symptoms listed above, along with the following:
- Decreased birth weight
- Small skull
- Hearing disorders
Studies have shown that the more severe the physical characteristics of FAS are in a child, the more severe his or her mental impairment tends to be.
Children born with FAS may develop secondary conditions as a result of their syndrome. These secondary conditions can include the following:
- Mental health problems such as attention deficit disorder, conduct disorder, depression and psychotic episodes.
- Problems in school, including higher rates of suspension and expulsion due to difficulty getting along with others, disobedience and truancy.
- Trouble with the law. Those born with FAS may have problems controlling anger and frustration, and problems understanding the motives of others. This may lead to violent behavior. As a result, teenagers and adults with FAS are more likely to be involved with the criminal justice system than their peers are. Also, those with FAS can be especially susceptible to persuasion and manipulation, which may lead to unwitting involvement in illegal activities.
- Drug and alcohol abuse. More than one-third of those with FAS have problems which require inpatient treatment for drugs and/or alcohol abuse at some time in their lives.
- Difficulty holding a job and living independently.
FAS is caused by a woman's use of alcohol during her pregnancy. The alcohol that a pregnant woman drinks travels through her bloodstream and across the placenta to her fetus, or developing baby. A fetus's small body breaks down alcohol much more slowly than an adult's body does. So the alcohol level in the fetus's blood is higher than in the mother's blood, and the alcohol remains in the fetus's blood longer. This exposure of the fetus to alcohol causes FAS.
Women who drink frequently (four or five alcoholic beverages or more per day) greatly increase the chances that their babies will have FAS. However, no amount of alcohol use during pregnancy has been proven safe. The effects of FAS may also be seen in children whose mothers drank moderately or lightly during pregnancy. An average of only one drink per day increases a baby's risk of FAS.
Diagnostic and Test Procedures
No definitive diagnostic tests exist to identify FAS. Diagnosis depends on a caregiver's expertise with the specific characteristics associated with FAS. Experts think that, as a result, FAS is widely underdiagnosed.
Although there is no cure for FAS, children who are diagnosed early -- preferably by preschool age -- have a better chance of overcoming the condition because from early on their education can be designed to maximize their potential.
Once a child's FAS-related developmental delays are documented, the child is eligible for curriculum modifications, special education classes, supplemental classroom aids and other services through the federal Individuals with Disabilities Education Act.
Because children with FAS are especially sensitive to disruption, a stable, loving home environment is important. However, caring for a child with FAS can be enormously stressful for a family because of the learning and behavioral problems associated with the syndrome. Social services, such as respite care and stress- and behavior-management services, may help families cope.
Prevention of the secondary conditions associated with FAS may be possible with educational, health and psychological services for both the child and the family. This often means working with a variety of professionals, including teachers, social workers, psychologists, physicians and nurses.
Pregnant women can prevent FAS by abstaining from alcohol throughout their pregnancies. A woman who drinks alcohol only lightly and occasionally before she realizes she is pregnant might or might not harm her developing baby. Because no amount of alcohol use during pregnancy has been proven safe, any woman who suspects that she might be pregnant should stop drinking immediately. Women who are trying to get pregnant should also avoid alcohol. This applies to all types of alcoholic beverages, including beer, wine, wine coolers and liquor (such as whiskey, vodka, tequila, gin and rum).
There is no proof that drinking by a father can cause FAS in his child. However, men who stop drinking during their partner's pregnancy may be better able to help their partners avoid alcohol.
Call Your Doctor If:
- You are or think you might be pregnant.
- You think you have an alcohol problem or you cannot stop drinking despite your efforts to abstain.
- You drank alcohol during your pregnancy and think your child might have FAS.