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Fetal Alcohol Spectrum Disorder (307)


The facts

Fetal alcohol spectrum disorder (FASD) is a term used to describe a number of problems that can result in people whose mothers drank alcohol during pregnancy. FASD includes a variety of mental, physical, behavioural and learning disabilities.

If a pregnant person drinks any alcohol at any time during pregnancy, the alcohol crosses the placenta to the fetus. Alcohol damages the developing cells of the fetus. The brain and central nervous system are particularly sensitive to alcohol and can suffer permanent damage.

Any amount of alcohol can have some effect, so there is no minimum amount of alcohol in pregnancy that is safe. The developing fetus can't break down the alcohol as quickly as an adult, so its exposure to alcohol is actually higher than the parent's.

Causes (1,2)

FASD is caused during pregnancy by the birth parent drinking alcohol. Alcohol damages the developing brain and nervous system of the baby, leading to mental, physical, and developmental problems.

The following factors affect whether FASD will occur and how severe the condition may be:

  • timing of alcohol use during the pregnancy
  • amount and frequency of alcohol consumption
  • the birth parent's general health
  • the birth parent's age
  • nutrition of the birth parent
  • smoking or other drug use
  • resources available to the birth parent

Consuming alcohol in any form during pregnancy is dangerous to the fetus. Alcohol is officially classified as a known teratogen, which means it can cause birth defects in the fetus. The more alcohol a pregnant person drinks, the greater the risk of the fetus developing FASD. Drinking early in pregnancy may cause changes in the facial features, heart and other organs, bones, and the central nervous system.

In Canada, about 10% of peopole use alcohol during pregnancy, and it is estimated that FASD affects about 4% of the population. Though that figure is still debated, and the prevalence may in fact be higher in some demographic groups. The lack of awareness of the effects of alcohol as a teratogen on a developing fetus is one reason for the high incidence of FASD.

Symptoms and Complications

A child who has FASD displays defects at birth or during development. The most common physical effects of FASD are:

  • central nervous system abnormalities (problems with brain development and behaviour)
  • a particular pattern of facial features (see below)
  • slower than average growth

Signs of central nervous system abnormalities include delayed development, behavioural problems, or learning disabilities and intellectual impairment. For example, children with FASD may develop the ability to speak or walk later than normal. Behavioural problems may include hyperactivity, nervousness, anxiety, and short attention spans.

Typical facial malformations features include short eye slits or drooping eyes, a thin upper lip, flattened cheekbones, and the absence of a distinct groove between the upper lip and nose.

A child with FASD may be smaller for their age than normal. At birth, the baby may be undersized or have a small head. Other defects include malformation of internal organs such as the heart, liver, and kidneys. Visual impairment and hearing problems may also exist.

Behavioral difficulties, including substance abuse, may occur in adulthood.

Making the Diagnosis

Diagnosis of a child with FAS includes the birth parent's drinking history, a physical examination of the child and observation. The doctor or psychologist may also test the child for learning disabilities. This will help direct the child to school programs and early developmental intervention services to help them learn. To rule out a possible genetic disorder, a doctor may also request genetic testing.

Treatment and Prevention

Fortunately, FASD is a completely preventable condition. A pregnant person can prevent FASD in their baby by not drinking any alcohol at any point while they are pregnant or might be pregnant.

If a person discovers that they are pregnant after consuming alcohol, abstaining from drinking alcohol from that point on is the best solution. By doing so, further damage to the baby is prevented.

The main things a person can do to prevent FASD include:

  • not drinking any alcohol at all during pregnancy
  • not drinking any alcohol if you are trying to become pregnant
  • seeking medical or professional help if you drink regularly and can't stop while pregnant

There is no way to reverse the damage of prenatal alcohol exposure. The mental and physical deficiencies associated with FASD last a lifetime. However, there are ways to help people with FASD or related conditions.

Children with FASD require good nutrition to help them grow and develop. As the child grows, parents can manage behavioural problems associated with FASD by:

  • learning as much as possible about the condition
  • seeking help from trained professionals
  • educating teachers and family members
  • finding support groups in the community
  • setting rules for the child and enforcing those rules
  • rewarding acceptable behaviour
  • providing the child with set daily routines

Medication is available to treat certain behavioural problems such as hyperactivity and attention deficit disorders (ADD) in children with FASD. Medications such as dextroamphetamine sulfate* and methylphenidate treat attention deficit and attention deficit hyperactivity disorders (ADHD).

*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.


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