How does fetal alcohol syndrome affect a child
Fetal Alcohol Spectrum Disorders | Kids' Quest | NCBDDD
What should you know?
Fetal alcohol spectrum disorders (FASDs) are a group of conditions that can occur in a person who was exposed to alcohol before birth. These effects can include physical problems and problems with behavior and learning. Often, a person with an FASD has a mix of these problems. Let’s learn more…
Follow the 8 steps below for your Web Quest.
Step 1: See what you think about kids who may have FASDs. Take the Fact Checkup!
Step 2: Think about some questions to ask. Let’s see…
Step 3: Check out some quick facts.
Step 4: Check out some great websites to help you learn more.
Step 5: Find out about people you can read about to help with your Quest.
Step 6: Learn about movies and books that can give you information.
Step 7: Check out your school and neighborhood.
Step 8: Now see if your attitudes have changed. Take the Fact Checkup again.
Let’s see…
What are fetal alcohol spectrum disorders (FASDs) and why is it important for me to know about them? What does a kid with an FASD look like? Do we know what causes fetal alcohol spectrum disorders? How can fetal alcohol spectrum disorders be prevented?
Some things to think about…
- How are families affected by fetal alcohol spectrum disorders?
- How can I talk with my parents about fetal alcohol spectrum disorders?
- How many people in the United States have fetal alcohol spectrum disorders?
Can you think of more questions to help you in your Quest?
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Quick Facts
Here are some facts that may help you answer some of your Web Quest questions. Remember, these facts will only give you basic information.
- When a baby is exposed to alcohol before birth, he or she can be born with an FASD.
- Children with FASDs often have problems with learning, attention, memory, and problem solving, along with poor coordination, impulsiveness, and speech and hearing impairments.
- As kids with FASDs grow up, school behaviors, emotional, and social problems often get worse.
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World-Wide Web Search
KidsHealth Organization: What Kids say about drinking alcohol
The grownups in your life have probably told you that you aren’t allowed to have alcoholic drinks, such as beer or wine. But what do kids think about this issue? KidsHealth wanted to know, so they asked 690 kids ages 9 to 13.
Facts about FASDs
Learn facts about FASDs like signs and symptoms, and how children are treated.
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People
Read about people who have fetal alcohol spectrum disorders.
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Movies and Books
The Best I Can Be: Living with Fetal Alcohol Syndrome or Effects
Authors: Jodee Kulp, Liz Kulp
Publisher: Better Endings New Beginnings (March 24, 2009)
Ages 9-12
A young teen with an FASD challenges the world to peer inside her life and brain.
Through her own writings the reader is taken on a life changing journey that will impact his or her thinking about how to help and understand children with brain damage due to alcohol exposure during pregnancy.
Forgetful Frankie, The World’s Greatest Rock Skipper, Fetal Alcohol Spectrum Disorder
Authors: Jill Bobula, Katherine Bobula
Publisher: Wildberry Productions Inc.; 1st edition (June 30, 2009)
Forgetful Frankie helps to teach children to be tolerant and understanding of those who are different and those who are living with FASDs. Frankie creates a wonderful world full of fun and forgets about the rules and consequences. He shares the challenges and joys of living with an FASD. Join Frankie as he brings you along on his exciting journey.
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My School and Neighborhood
National Organization on Fetal Alchohol Syndrome has developed a K-12 FASD Education and Prevention Curriculum for teachers to implement with students. The curriculum provides age-appropriate information about the consequences that alcohol can have on human development while also encouraging youth to be tolerant and accepting of all individuals regardless of the person’s individual capabilities or disabilities.
Talk with your teachers and see if they would help you get this curriculum for your school.
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We provide links to other web pages if you want to learn more about a topic. Some of these pages are on the CDC web site and others are on outside websites. Links to organizations and companies outside of CDC are included for information only. CDC has no control over the information at these sites. The views and opinions of these organizations are not necessarily those of CDC, the Department of Health and Human Services (HHS), or the U.S. Public Health Service (PHS).
Fetal Alcohol Syndrome (for Parents)
What Is Fetal Alcohol Syndrome?
Babies whose mothers drank alcohol during their pregnancy can be born with birth defects and developmental disabilities. The problems that can happen when babies are exposed to alcohol are grouped together and called fetal alcohol spectrum disorders (FASDs). These include a wide range of physical, behavioral, and learning problems.
The most severe type of FASD is fetal alcohol syndrome (FAS).
How Does Fetal Alcohol Syndrome Affect Children?
Children with fetal alcohol syndrome have facial features such as small eyes, a thin upper lip, and a smooth philtrum (the groove between nose and upper lip).
They also can have:
- Poor growth. Newborns may have low birth weights and small heads. They may not grow or gain weight as well as other children.
- Birth defects. FAS can cause heart, bone, and kidney problems. Vision problems and hearing loss are common.
- Seizures and other neurologic problems, such as learning disabilities, and poor balance and coordination.
- Delayed development. Kids may not reach milestones at the expected time.
- Behavioral problems. Babies may be fussy or jittery, and have trouble sleeping. Older children and teens may have:
- a lack of coordination and poor fine-motor skills
- trouble getting along with friends and relating to others
- learning problems (especially in math), poor memory, and poor problem-solving skills
- behavior problems such as hyperactivity, poor attention and concentration, and impulsiveness
Children with other FASDs have many of the same problems, but usually to a lesser degree.
How Is Fetal Alcohol Syndrome Diagnosed?
Doctors can diagnose the condition based on a baby’s symptoms, especially if they know that the mother drank during pregnancy. In children with milder problems, FASD can be harder to diagnose. No blood test or other medical test can diagnose FASD.
The child may go to see a team of specialists who can help make the diagnosis. They might include a developmental pediatrician, neurologist, genetic specialist, speech therapist, occupational therapist, and psychologist.
How Is Fetal Alcohol Syndrome Treated?
There is no cure for fetal alcohol syndrome or other FASDs. But many things can help children reach their full potential, especially if the problem is found early.
Kids can benefit from:
- early intervention services and special education in school
- speech-language therapy, occupational therapy, and physical therapy
- classes that teach kids social skills
- counseling with a mental health professional
Doctors may prescribe medicines to help with related problems, such as attention deficit hyperactivity disorder (ADHD), depression, aggressive behavior, sleep problems, and anxiety.
Parent training can help caregivers learn how to best care for a child with FAS and handle any problem behaviors.
Can Fetal Alcohol Syndrome Be Prevented?
Alcohol use (beer, wine, or hard liquor) during pregnancy is the leading cause of preventable birth defects and intellectual disabilities in the United States.
Fetal alcohol syndrome and other FASDs can be prevented by not drinking any alcohol during pregnancy. A woman shouldn’t drink if she’s trying to get pregnant or thinks she may be pregnant. If a pregnant woman does drink, the sooner she stops, the better it will be for her baby’s health.
Alcohol easily passes through the placenta, the organ that nourishes a baby during pregnancy. So no amount of alcohol is safe to drink during pregnancy. Even a little bit of alcohol can harm a developing fetus and increase the risk of miscarriage.
How Can Parents Help?
Children with FASD tend to be friendly and cheerful and enjoy social interaction.
But caring for a child with this syndrome can be a challenge. Kids will have lifelong physical, learning, and behavioral problems.
Besides early intervention services and support from your child's school, providing a stable, nurturing, and safe home environment can help reduce the effects of an FASD. Don't be afraid to get help, if needed. Talk to your child's doctor or other members of the care team.
Caregivers should take care of themselves too. Support groups and counselors can help. It's also important to get help for a parent or caregiver who struggles with alcohol addiction.
For more information, visit:
- National Organization on Fetal Alcohol Syndrome
Reviewed by: Mary L. Gavin, MD
Date reviewed: November 2020
What is fetal alcohol syndrome and how it threatens
March 31, 2021 Likbez Health
Lifehacker has figured out why even a can of beer is dangerous during pregnancy.
You can listen to this article. If it's more convenient for you, turn on the podcast:
What is fetal alcohol syndrome
Fetal alcohol syndrome is a complex of abnormalities in a child that occurs due to exposure to alcohol during its intrauterine development. Alcohol damages the nervous system of the fetus, disrupts normal growth and development. These deviations are different in different children, but in most cases are irreversible.
Why fetal alcohol syndrome occurs
The main cause of the pathology is the negative effect of alcohol on the developing fetus. Therefore, every woman should remember that during pregnancy there are no safe doses of alcohol. No one can predict how a glass of wine or a bottle of beer will affect a child.
But to make it easier to calculate the risks, scientists have defined what counts as one serving of alcohol. They are:
- 12 ounces (about 355 ml) of beer;
- 5 ounces (or 150 ml) of wine;
- 1.
5 oz (approximately 45 ml) liqueur.
How much alcohol the mother drinks and how often this happens is important for the development of the disorder. A woman who regularly drinks 2 servings of drinks is very likely to give birth to a child with fetal alcohol syndrome. One-time large doses are also dangerous. So, if a pregnant woman consumes more than 5 servings at a time, the risk of fetal damage increases significantly.
It happens that a woman gets drunk at a time when she does not yet know about her pregnancy. In this case, if she plans to give birth to a child, she needs to give up bad habits and register before the 12th week, regularly see a doctor and follow all his recommendations. It is possible that there will be no serious violations in the embryo.
How fetal alcohol syndrome manifests itself
Symptoms can be expressed in different ways, sometimes more or less. In some children, characteristic features of appearance are already noticeable at birth.
Someone develops neurological disorders or social behavior disorders, but they are noticed only when the child grows up.
Doctors distinguish three groups of signs of fetal alcohol syndrome.
Physical defects
These can be:
- Altered facial features. The newborn has a very thin upper lip, a short and sharp nose, smooth skin between the nose and upper lip, small eyes.
- Deformity of joints, limbs and fingers.
- Delayed physical development before and after birth. The child is not gaining weight well.
- Small head circumference.
- Heart defects, kidney dysfunction.
- Strabismus, nystagmus (trembling of the eyes), amblyopia (one eye sees worse than the other).
- Hearing pathology.
Pathologies of the nervous system
The neonatologist will notice the first signs immediately after birth. The baby may have tremors (muscle tremors), hyperexcitability of the nervous system. Later, the following symptoms will appear:
- mental retardation and developmental delay;
- poor learning ability;
- reduced attention and thinking;
- insufficient reasoning skills;
- quick change of mood.
Social and behavioral problems
Children with fetal alcohol syndrome experience difficulties in school. They are worse than healthy guys, switch from one task to another, it is difficult for them to build social relationships. They can be rude to others or withdrawn and uncommunicative. Often the behavior of the child is impulsive, uncontrollable.
How alcohol syndrome is diagnosed
There are no laboratory tests that can help confirm the disease. During pregnancy, the gynecologist observes the woman and can guess by her behavior whether she drinks alcohol. Indirectly, the alcohol syndrome can be judged by the results of a planned ultrasound scan at the 11th, 20–21st and 32–34th weeks. But the main diagnosis is made after the birth of the child.
What to do if ultrasound showed pathology
As we have already said, the first ultrasound screening for pregnant women is done at 11 weeks. If the doctor sees severe malformations that are incompatible with life, for example, the fetus lacks some structures or organs, the woman will be offered an abortion.
But the choice is hers.
If the woman decides to keep the baby or the deviations are minor, the next ultrasound will be done earlier than planned, at 17 weeks. At 15-20 weeks, it is recommended to perform an amniocentesis - a study of amniotic fluid. It will show if the unborn baby has chromosomal abnormalities.
Another ultrasound will be done at 20-21 weeks. If, according to its results, the child remains severely impaired, the pregnancy can be terminated for medical reasons up to 22 weeks.
There is no specific treatment for fetal alcohol syndrome. Doctors only use vitamins and drugs to maintain blood flow in the placenta and nourish the fetus.
What to do after childbirth
If a child is born with fetal alcohol syndrome, physical and mental disabilities will remain forever. But some of them can be corrected with the help of doctors. For example, strabismus and other mild visual impairments are corrected by an ophthalmologist.
Speech therapists, psychologists, social pedagogues work with children with fetal alcohol syndrome, they are observed by neurologists.
If necessary, doctors prescribe medications that relieve some of the symptoms. For example, they reduce the excitability of the nervous system, remove anxiety or aggression, and help improve behavior.
How to prevent the development of fetal alcohol syndrome
Women who are planning a pregnancy should stop drinking alcohol in advance. For those who did not know about their situation, it is better to get rid of the bad habit as soon as the test showed two strips.
And if the expectant mother thinks that she has problems with alcohol, it is worth finding a good drug specialist. It will help you overcome alcohol addiction.
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Fetal alcohol syndrome.
What is Fetal Alcohol Syndrome? IMPORTANT
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
Fetal alcohol syndrome is a set of congenital malformations caused by the teratogenic effects of ethyl alcohol on a developing fetus. Fetal alcohol syndrome is characterized by prenatal malnutrition, a child's lag in physical and neuropsychic development, mental retardation, manifestations of craniofacial dysmorphism, congenital heart defects, impaired skeletal development, and other anomalies. Diagnosis of fetal alcohol syndrome is based on the presence of an alcoholic history in the mother, multiple developmental disorders in the child. Treatment of fetal alcohol syndrome is aimed at correcting severe anatomical defects, organizing medical, psychological and pedagogical support for the child.
ICD-10
Q86.0 Fetal alcohol syndrome (dysmorphia)
- Causes
- Pathogenesis
- Classification
- FAS symptoms
- Hypotrophy
- Craniofacial anomalies
- CNS lesion
- Congenital malformations
- Complications
- Diagnostics
- Treatment of fetal alcohol syndrome
- Prognosis and prevention
- Prices for treatment
General
Fetal alcohol syndrome (FAS, fetal alcohol syndrome, alcoholic embryofetopathy) is a symptom complex that develops in children born to mothers suffering from chronic alcoholism. The frequency of birth of children with fetal alcohol syndrome in different countries ranges from 0.2 to 7 cases per 1000 births. These data indicate a high prevalence of fetal alcohol syndrome among congenital disorders.
Fetal alcohol syndrome is the most common cause of mental retardation in children (more often than Down syndrome).
Given the polymorphism of manifestations of alcoholic embryopathy, the observation of children with fetal alcohol syndrome is carried out by specialists in the field of neonatology, pediatrics, pediatric neurology, pediatric surgery, pediatric traumatology and orthopedics, pediatric cardiology, psychology, speech therapy, special pedagogy.
fetal alcohol syndrome
Causes
The main and only reason leading to the development of fetal alcohol syndrome is the use of alcohol by a woman in any trimester of pregnancy. Being the strongest chemical teratogen, ethyl alcohol causes severe and multiple damage to the fetus. Ethanol quickly crosses the placental and blood-brain barriers, so its concentration in the blood of the fetus reaches the same level as in the blood of the mother, and sometimes even higher.
Due to the immaturity of the enzyme systems involved in the metabolism of ethanol, it circulates unchanged for a long time in the blood and tissues of the fetus, in the amniotic fluid, causing the development of fetal alcohol syndrome.
It is believed that the dose of ethyl alcohol equal to 30-60 ml per day is critical for the fetus, although many researchers are inclined to believe that there is no safe dose of alcohol during pregnancy. Risk factors for the development of fetal alcohol syndrome are:
- mother's alcohol "experience";
- quantity and frequency of alcohol abuse;
- adverse social conditions;
- malnutrition in pregnancy;
- no monitoring of pregnancy, etc.
Pathogenesis
The damaging effect of alcohol on the fetus appears in various ways. The main role in the pathogenesis of fetal alcohol syndrome is assigned to a violation of the molecular structure of cells (including sex cells) by alcohol and its metabolites, in particular, acetaldehyde. Other damaging mechanisms may be associated with a deficiency of vitamins and microelements in the mother's diet, a violation of the transplacental transport of essential amino acids, fetal hypoglycemia, a decrease in placental blood flow and fetal hypoxia, etc.
The fetus is susceptible to the embryotoxic effects of alcohol throughout pregnancy. Thus, the use of alcohol by a woman in the first trimester of pregnancy causes a high risk of birth defects and intrauterine death of the fetus; in the second trimester - structural disorders of the central nervous system and malformations of the musculoskeletal system; in the third trimester - functional disorders of the central nervous system, fetal growth retardation, etc.
Classification
The existing classifications of fetal alcohol syndrome are based on the principles of the severity of the lesion and the predominance of certain manifestations.
According to the degree of developmental disorders, there are:
- Fetal alcohol syndrome I (mild) degree (about 44% of cases). It is characterized by pre- and postnatal malnutrition, microcephaly; hidden or mild signs of craniofacial dysmorphism; minor manifestations of disorders of mental development.
- Fetal alcohol syndrome II (medium) degree (about 34% of cases). All the main symptoms of FAS are expressed, including violations of the structure of the face and skull.
- Fetal alcohol syndrome III (severe) degree (about 23% of cases). There are gross violations of intellectual development, severe somatic defects, pronounced craniofacial dysmorphism.
Some authors consider the number of detected dysembryogenies in a child as criteria for the severity of fetal alcohol syndrome: severe degree - 8-10, medium - 6-8, mild - 4-6 stigmas of dysembryogenesis.
FAS symptoms
Manifestations of fetal alcohol syndrome are diverse and in most cases are represented by the following groups of symptoms: prenatal and postnatal malnutrition, craniofacial dysmorphism, brain damage and somatic deformities.
Hypotrophy
At birth, a child with fetal alcohol syndrome has insufficient weight (average 2200 g) and body length (average 44-46 cm).
After a year, the lag in terms of physical development is 35-40%. The degree of pre- and postnatal malnutrition/dystrophy correlates with the amount of alcohol consumed by the pregnant woman.
Craniofacial anomalies
The signs of craniofacial dysmorphism are so typical that they gave rise to a specific concept - "the face of a child with fetal alcohol syndrome." The appearance of children with fetal alcohol syndrome is characterized by blepharophimosis (often ptosis, strabismus), a smoothed nasolabial groove, a thin upper lip, micrognathia, microcephaly, a low forehead and bridge of the nose, deeply located auricles, etc. Children with fetal alcohol syndrome often have a violation bite, cleft lip ("cleft lip") and palate ("cleft palate").
CNS lesion
Dysfunction of the nervous system in a child with fetal alcohol syndrome in the first months of life is characterized by hyperexcitability syndrome, hydrocephalus, and in the long term - impaired attention, memory, motor coordination, ADHD, learning difficulties at school, mental retardation, speech disorders, epilepsy.
Congenital malformations
Approximately half of children with fetal alcohol syndrome have congenital heart defects - VSD, ASD, pulmonary artery stenosis, patent ductus arteriosus, tetralogy of Fallot. Relatively often, anomalies of the genitourinary system are found: in boys - hypospadias, one- or two-sided cryptorchidism; in girls - doubling of the vagina, hypoplasia of the labia, hypertrophy of the clitoris; in children of both sexes - hypoplasia or aplasia of the kidney, hydronephrosis, urogenital fistulas, bladder diverticula.
Among other somatic anomalies in children with fetal alcohol syndrome, there are:
- analyzer damage: hearing loss, severe myopia;
- disorders of the musculoskeletal system: chest deformities, hip dysplasia, syndactyly;
- pathologies of the gastrointestinal tract: diaphragmatic, inguinal, umbilical hernias, pyloric stenosis, anus atresia;
- dermatological diseases: cavernous angiomas, hirsutism, etc.
At an early age, anemia, rickets, atopic dermatitis, and frequent acute respiratory viral infections predominate in the structure of the general morbidity of children with fetal alcohol syndrome.
Complications
The death of a newborn with fetal alcohol syndrome can occur due to asphyxia, prematurity and functional immaturity, congenital malformations incompatible with life. Sometimes a child with fetal alcohol syndrome is born in a state of alcohol withdrawal, which is accompanied in the first hours of life by tremor, convulsive syndrome, episodes of tachypnea and apnea, muscle hypotension, and vomiting.
Diagnostics
The presence of fetal alcohol syndrome in a child may be obvious immediately after birth. In this case, the neonatologist must take all necessary measures for the early detection of severe malformations in the child and their correction. To make a diagnosis, you need:
It takes into account the presence of an alcohol history in the mother and typical anomalies in the child, the child's condition immediately after birth, height and weight indicators, the dynamics of the early development of the child according to anthropometry (weight gain, length, head circumference), etc. 
Follow-up care of a child with fetal alcohol syndrome is carried out by specialists of various specialties: pediatrician, pediatric neurologist, pediatric surgeon, pediatric orthopedic traumatologist, pediatric cardiologist, pediatric nephrologist, pediatric ophthalmologist, audiologist, etc. Manifestations of fetal alcohol syndrome must be differentiated from chromosomal abnormalities, intrauterine infections .
Treatment of fetal alcohol syndrome
The changes that occur in fetal alcohol syndrome are irreversible and there is no cure. However, children with FAS need symptomatic treatment and psychological and pedagogical support. With heart defects, genitourinary system, gastrointestinal tract, surgical treatment is possible. Treatment of psychopathological disorders is carried out by a child psychiatrist with the help of the appointment of neuroleptics and psychostimulants.
Habilitation and rehabilitation of persons with fetal alcohol syndrome provides for medical and pedagogical correction from an early age: classes with a child psychologist, speech therapist, correctional teacher. This allows the child to achieve a higher level of development in the motor, emotional, cognitive, speech sphere, to acquire the skills of social interaction in a team. Education of children with intellectual disabilities is carried out in special correctional schools.
Prognosis and prevention
Children with fetal alcohol syndrome often spend their entire lives in specialized orphanages, and then in neuropsychiatric boarding schools, because they are unnecessary to their parents and unable to take care of themselves in adulthood. Even mild forms of fetal alcohol syndrome can be accompanied by antisocial behavior, alcoholism, sexual deviations.
At risk for having a child with fetal alcohol syndrome are women who consume 4 or more standard drinks per week (1 dose = 42.
