“It must be five o’clock somewhere.” Most cultures use alcohol in social celebrations and have developed social habits or customs related to alcohol consumption. While it wasn’t a “medical diagnosis” until the 1970’s, it has been observed for thousands of years that alcohol can have harmful effects on babies. Check out Judges 13:3-4 or Plato’s Laws or Hogarth’s “Gin Lane” or Charles Dickens’ character, Betsy Martin or Aldous Huxley’s Brave New World.
April is Fetal Alcohol Awareness Month. It is important to be aware of the toxic consequences of alcohol on babies before birth. When a pregnant mother drinks alcohol it passes through the placenta to the baby. The toxic effects are many. By several biochemical reactions it can cause disruption of multiplying cells, even cell death, problems with microRNA and other cellular functions. These toxic effect can result in abnormal facial features (changes in the upper lip, ears, midface) and abnormal growth both of the body and the brain. The disruption of brain growth/formation can effect puberty, mental health, intellectual development and the immune system. These problems are not outgrown.
Children with prenatal alcohol exposure come from every social, economic, racial and ethnic group. In the United States nearly 1 in 7 pregnant women report alcohol use in the past 30 days. It is important to not drink alcohol if one is trying to get pregnant as a woman may not know she is pregnant for 4 to 6 weeks. Damage from prenatal alcohol exposure can occur even in the earliest weeks of pregnancy. There is some evidence that the malformations vary depending on the timing of the alcohol exposure. Because of the wide variety of the timing of the exposure, the amount of alcohol, the genetic differences of the unborn child there is a broad group of conditions that have a combination of physical, developmental, behavioral and learning challenges. These can range from mild to serious. Every person with fetal alcohol spectrum disorder (FASD) has their own unique combination of signs and symptoms.
Infants with the described abnormal facial features and a known exposure to alcohol are more easily recognized but there is no test that can confirm the diagnosis. Children with FASD can have brain abnormalities that lead to problems in day-to-day functioning in spite of a normal IQ. Some common issues for these children are learning and memory impairment, poor self-regulation and trouble planning and organizing.
FARD’s will last a lifetime. There is no cure but treatment with therapy, education, behavior modifications, social skills training, appropriate medications can help these children reach their highest potential.
There is no evidence that FASDs are genetic or hereditary. A person with FASD will not have a child with FASD unless they drink alcohol. However people with FASD are at increased risk for substance abuse and because of this at increased risk to have a child with FASD.
Fetal Alcohol Spectrum Disorders are 100% preventable. There is no amount of any kind of alcohol during pregnancy that is risk free.
Dr. Sally Robinson
Clinical Professor, Dept. of Pediatrics
Keeping Kids Healthy
Published 04/2023
Also See:
UTMB Pediatrics - Pediatric Primary Care
UTMB After Hours Urgent Care
UTMB Clear Lake Hospital - Pediatric ER & Inpatient Unit