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Fetal Alcohol Spectrum disorders

Also known as: Fetal Alcohol Effects, Fetal Alcohol syndrome

Background

The terms Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE) were first named in 1973.  More recently the term Fetal Alcohol Spectrum Disorders (FASD) has been adopted. This is not a diagnosis but rather describes a range of features from the severe end of the spectrum, FAS, to the minor individual anomalies that are associated with pre-natal alcohol exposure.  The latter may not be identified until the children begin to develop behavioural problems as they get older.

Debate continues as to whether light drinking in pregnancy is risky for the fetus.  However given individual sensitivities to alcohol the wisest course is not to drink during pregnancy. Official UK guidelines are now moving towards the position of "no drinking in pregnancy".

Credits

Medical text written May 2016 by Dr Moira Plant, Emeritus Professor of Alcohol Studies, Alcohol and Health Research Unit, University of the West of England, Bristol, UK.

Although great care has been taken in the compilation and preparation of all entries to ensure accuracy, we cannot accept responsibility for any errors or omissions. Any medical information is provided is for education/information purposes and is not designed to replace medical advice by a qualified medical professional.

 

 

What are the symptoms?

The use of the word fetal in FASD has led to the misunderstanding that children will 'grow out of it'. In fact FASD are life-long conditions and, although the difficulties for these children will change over time, those at the severe end of the spectrum with full blown FAS will always struggle with life and learning. The severity of the struggle depends largely on the frequency of maternal alcohol consumption during pregnancy.

The clinical features of FAS are grouped into four areas known as the 4-Digit Code:

  • pre and post-natal growth retardation - children are light in weight, short in length and have a smaller than normal head circumference
  • facial features: including mid-facial flattening, smaller than normal opening to the eye (the measurement of the eye opening from one corner to the other), absent philtrum (the ridges between the nose and the upper lip) and thin upper lip
  • moderate-to-severe learning difficulties (see entry Learning Disability)
  • a history of heavy maternal alcohol consumption. This information is not always readily available but a diagnosis of partial FAS can be made without knowledge of maternal drinking.

Sleeping and feeding problems, sensory-motor problems, hearing/visual abnormalities along with social and emotional deficits, adaptive functioning deficits and mental health issues such as depression are common.

 

What are the causes?

FASD occur when babies are exposed to maternal drinking during pregnancy.  The severity of the syndrome relates to the frequency of drinking, the amount drunk on each occasion and the stage of pregnancy.  The first trimester where organ development and brain growth occur is the most sensitive time for the fetus.  Factors that influence how seriously the baby may be affected include poor nutritional status, use of tobacco or other drugs, socioeconomic status (SES) and poor ante-natal care.

How is it diagnosed?

The use of the 4-Digit Code (the clinical features of FAS are grouped into four areas known as the 4-Digit Code as described in what are the symptoms) is the most recognised means of diagnosis with the severity of the facial features being a marker to the severity of brain damage.  However more than 70% of children born with pre-natal alcohol exposure do not have the classic facial features.  Added to this as the children get older many of them lose the characteristic facial features. This can be a difficult diagnosis to make and is often a diagnosis of exclusion. 

How is it treated?

Treatment of FASD relate mainly to addressing the learning and behavioural problems which may change over time but will persist into adulthood and beyond. A stable environment and a consistent approach is important and support for the child, the parents and siblings can be of great benefit.

 

Inheritance patterns and prenatal diagnosis

Inheritance patterns
None known at this time.

Prenatal diagnosis
A clear drinking history from the mother and advice to stop drinking is important. Monitoring for general pre-natal growth may help diagnose FAS, but there is no diagnostic test at this time.

 

Is there support?

NOFAS-UK

Helpline: 020 8458 5951
Email: info@nofas-uk.org
www.nofas-uk.org

The Organisation is a Registered Charity in England and Wales No. 1101935, established in 2003. It provides information on Fetal Alcohol syndrome (FAS) and Fetal Alcohol Spectrum disorder (FASD), links families where possible, runs family activity days, conferences and training sessions, has a library of resources and publishes a regular newsletter.

Group details last updated May 2016.

FASD Trust

Helpline: 01608 811599
Email: Via website
www.fasdtrust.co.uk

The Trust is a Registered Charity in England and Wales No. 1125212. They provide information and support, training for carers and professionals and all those affected by Fetal Alcohol Spectrum disorders. They also operate a network of local support groups.

Group details last updated June 2016.

Talk to other families about your child's condition

Visit our online Fetal Alcohol Spectrum disorders group

Visit our online advice and support or read all about diagnosis.


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