FAS syndrome – causes, symptoms, treatment. Childcare with FAS

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Alcohol can harm your baby at any stage of pregnancy. You may not know that you are pregnant yet, and alcohol can already cause serious changes in a developing fetus. Drinking alcohol during pregnancy can contribute to the development of a group of conditions known as fetal alcohol spectrum disorder (FASD). Babies born with FASD can have a variety of problems, such as medical, behavioral, educational, and social problems. The types of problems they have depends on the type of FASD – one of them is Fetal Alcohol Syndrome (FAS). What is FAS? What are its symptoms? Can it be treated?

Can I drink alcohol while pregnant?

There is no specific safe amount of alcohol for a pregnant woman to consume. Any amount of alcohol in pregnancy can harm a developing fetus and increase the risk of miscarriage.

Alcohol crosses the placenta easily, the organ that nourishes the baby during pregnancy. The body of a developing fetus does not process alcohol in the same way as an adult does. Alcohol is more concentrated in the fetus and can prevent enough food and oxygen from getting into the vital organs of the fetus.

Exposure to alcohol during the first trimester of pregnancy – possibly before a woman knows she is pregnant – can cause serious birth defects. Later in pregnancy, drinking alcohol can cause poor growth and brain damage, which can lead to learning and behavior problems.

Spectrum of Fetal Alcohol Disorder – FASD

Spectrum of Fetal Alcohol Disorder (FASD) is a generic term used to describe the range of effects that can occur in a child exposed to alcohol prenatally.

These effects can have lifelong ramifications, including physical, mental, behavioral, and / or study problems.

The term Spectrum of Fetal Alcohol Disorder includes:

1. Fetal Alcohol Syndrome – Fetal Alcohol Syndrome (FAS),
2. incomplete FAS (partial FAS),
3. Alcohol-related Neurodevelopmental Disorders (ARDN).

The exact number of children with FASD is difficult to establish. Some experts estimate that approximately 40 babies with FASD may be born in the United States each year.

The scale of the occurrence of FAS in Poland may be in the range of 1-3 cases per 1000 births (0,3%), which means that even 900 children a year are born with full symptoms of this disease, probably the disorder described as FASD has 20 children per year. 1000.

FAS is an incurable disease which, according to scientific knowledge, can be avoided if pregnant women do not consume alcohol.

Read: Did you know that drinking alcohol when pregnant reduces the quality of sperm in the offspring?

Fetal Alcohol Syndrome – FAS

Fetal Alcohol Syndrome (Fetal Alcohol Syndrome, FAS, FAS Syndrome) is a characteristic pattern of mental and physical birth defects that result from a mother drinking alcohol during pregnancy.

The extent and severity of related failures may vary considerably from case to case. However, characteristic features may include pre- and postnatal growth retardation (prenatal and postnatal growth retardation), cranial and facial (craniofacial) malformations, brain abnormalities, and / or additional physical abnormalities.

FAS can also be associated with varying degrees of mental retardation, learning disabilities, and / or behavioral problems, which in some cases can occur in the absence of obvious physical abnormalities.

See: Drinking alcohol during pregnancy increases the risk of premature birth

FAS syndrome – diagnosis

The diagnosis of FAS is made only if the child in question meets all 3 diagnostic criteria:

1. prenatal and / or postnatal growth deficiency,
2. 3 cardinal features of the face (reduced length of the eyelid fissure, smooth nasal groove and thin upper lip edge),
3. any of a number of identified structural, neurological and / or functional deficits in the central nervous system. 

The diagnosis of FAS also marks an extensive history in which all other exposures to toxic substances in the womb, including tobacco, drugs or illicit drugs, have been documented, and other possible genetic and environmental etiologies have been ruled out, in particular Williams deletion syndromes, Noonan 22q, trisomy 21 as some dysmorphological features are in common with FAS.

Establishing a history of alcohol consumption is one of the most difficult issues in diagnosing FAS. A pregnant woman who drinks alcohol is not always easy to identify. Patients are usually not honest about their drinking habits, nor are they necessarily able to recall the exact amount and timing of alcoholic beverages. However, due to the lack of a specific biomarker to detect alcohol exposure, history remains crucial to diagnosis.

The physician’s challenge is to identify the women who drink alcohol during pregnancy. Problem drinkers cannot be identified by appearance or socio-economic characteristics.

A systematic history of drinking is essential and should be obtained from all patients during the initial interview and subsequent prenatal care.

See also: Can you drink alcohol-free beer while pregnant?

FAS syndrome – symptoms

Prenatal exposure to alcohol can have multiple effects, including miscarriage, growth failure, mental retardation, or a specific pattern of malformations at the severe end of the spectrum known as Fetal Alcohol Syndrome (FAS). It can be said that infants and children with milder symptoms develop fetal alcoholism (FAE).

FAS symptoms can vary from case to case. However, characteristic features often include growth retardation in the prenatal and / or postnatal periods, resulting in low body weight and height.

Many affected newborns may also show increased irritability, increased sensitivity to sounds (hypersensitivity to sounds), abnormal muscle tone, and fine motor dysfunction, including tremor, poor grip, and poor hand-eye coordination.

Evidence shows that FAS is the leading cause of mental retardation. The degree of intellectual disability can vary from mild to severe. The term “microcephaly” indicates that the head circumference is smaller than would be expected for age and gender. Microcephaly is a common feature of FAS which is believed to be caused by an overall reduction in brain growth.

In addition, specific brain abnormalities associated with FAS have been reported, including the absence of a strand of nerve fibers connecting the cerebral hemispheres (corpus callosum) and underdevelopment of the area of ​​the brain involved in the coordination of voluntary movements (cerebellar hypoplasia).

Children with FAS often have deficits in learning skills, difficulties with problem solving and memory, and / or a speech impairment. In addition, many people have some behavioral abnormalities, including hyperactivity, impaired judgment, easily distracted, impulsive, and impaired social and adaptive behavior. In some cases, such abnormalities may be present in the apparent absence of physical abnormalities.

FAS can also be associated with specific facial features, such as short eyelid folds (eyelid fissures), vertical skin folds that may cover the inner corners of the eyes (epidermal folds), and / or a short, snub nose with a broad bridge of nose. Additional distinctive features may include a thin upper lip, an abnormally long, smooth vertical groove (groove) in the center of the upper lip, a small jaw (micrognathia), and / or flattened areas of the midface (midface hypoplasia).

There may also be eye abnormalities such as unusually small eyes (microphthalmia), drooping upper eyelids (ptosis), and / or abnormal deviation of one eye from the other (strabismus). Reports indicate that related facial features can sometimes be relatively subtle and may also become less noticeable as a child reaches puberty.

In some cases, there may also be various heart defects, especially an abnormal opening in the septum between the lower or upper chambers of the heart (ventricular defects or atrial septum). Affected infants may also have joint defects, including misalignment and / or reduced range of motion. Additional physical disorders have also been reported in some people with the syndrome.

Read: Congenital heart defects in children

FAS syndrome – treatment

There is no cure or specific treatment that can treat Fetal Alcohol Syndrome. Physical defects and mental defects usually persist throughout life. However, early treatment can improve your baby’s development. Treatment options include:

1. medications to treat certain symptoms
2. behavioral and educational therapy,
3. parent training.

There are also some ‘protective factors’ that help reduce the negative effects of FAS on your baby:

1. diagnosis before the age of 6,
2. a loving, supportive, stable home environment,
3. no violence in the child’s life,
4. use of special education and social services.

Early diagnosis of FAS and early intervention can help reduce some effects and help to minimize some secondary disabilities.

As part of the above-mentioned intervention, the activities undertaken by the closest environment of the child with FAS, including, among others, schools, are very important. It will be beneficial for the child to be placed in appropriate educational classes, where educators know the specificity of the fetal alcohol syndrome – it will support the child and his parents.

See also: How many Polish women drank and smoked during pregnancy?

What does caring for a child with FAS look like?

Children with FAS are usually friendly and playful and enjoy social interaction, but caring for them can be difficult at times. Many children may have parenting, learning, and behavioral problems at home and at school.

In addition to early intervention and support from your child’s school, providing a stable, caring, and safe home environment can help reduce the effects of FAS. If necessary, don’t be afraid to seek help. Talk to your baby’s doctor or other members of the care team.

Finally, the guardian of a child with FAS should also take care of himself. Support groups and psychotherapists can help. It’s also important to get help from a parent or caregiver who is still struggling with alcohol dependence.

FAS team – how to prevent it?

Alcohol consumption during pregnancy is a major cause of birth defects, developmental disorders and preventable learning difficulties in a child. The only way to prevent FAS is to avoid a woman drinking alcohol during pregnancy.

Women should also not drink alcohol if they are sexually active and not using effective contraception. It may take 4 to 6 weeks for a woman to know she is pregnant, during which time the developing fetus may be exposed to the harmful effects of alcohol.

If a woman has already consumed alcohol during pregnancy, it is never too late to stop. After the baby is born, the mother should also not drink alcohol throughout the period of breastfeeding. This is because alcohol will appear in your breast milk. While not directly related to FAS, the alcohol in breast milk can interfere with your baby’s development and cause sleep and learning problems.