Fetal Alcohol Syndrome – what are the risks?

Fetal Alcohol Syndrome

A woman who drinks alcohol during the pregnancy period can give birth to a baby with Fetal Alcohol Syndrome Disorder, commonly known as FASD. FASD is a collective term which includes a range of disorders. Hence, these disorders can cause growth problems and brain damage in the baby.

Types of FASDs:

Some common types of FASDs are:

• Fetal alcohol syndrome (FAS)
• Alcohol-related birth defects
• Alcohol-related neurological disorders
• Partial fetal alcohol syndrome
• Neurobehavioral disorders related to prenatal exposure to alcohol

However, among all these disorders, fetal alcohol syndrome is the most severe form of the condition. Babies suffering from this condition experience problems with their memory, vision, attention span, hearing, communication, and learning abilities. Hence, the problems may differ from child to child, but the defects are eternal.

Causes of fetal alcohol syndrome:

When a woman drinks alcohol during pregnancy, some of that alcohol passes to the fetus by way of the placenta. The developing fetus cannot process alcohol in the same way as an adult. Furthermore, alcohol is present in a more concentrated form in the fetus, which prevents the absorption of oxygen and nutrients by the vital organs. Unfortunately, the damage is done in the initial few weeks of pregnancy, when a mother might not yet know that she is expecting a baby. The risk enhances when the woman is a heavy drinker. According to research, alcohol consumption is most harmful during the first 3 months after conception. However, the American Academy of Pediatrics reveals that alcohol intake can cause damage to the fetus at any time during the conception period.

Fetal alcohol syndrome symptoms:

Fetal alcohol syndrome covers a large number of problems. Thus, there are several possible symptoms of this disorder. Since the severity of symptoms varies from individual to individual, some babies experience them to a far greater degree than others. Hence, the signs and symptoms of fetal alcohol syndrome may include a mixture of physical defects, cognitive or intellectual disabilities, and problems in following a normal work routine.

Defects of the central nervous system:

Problems with the central nervous system and brain may involve:

• Poor balance and coordination
• Hyperactivity and jitteriness
• Low judgment power
• Difficulty in solving a problem with reasoning
• A problem in identifying the consequences of choices
• Mood swings
• Poor memory
• Learning problems, delayed development, and poor intellectual abilities
• Problems with processing information and attention

Physical defects:

Physical problems in a fetal alcohol syndrome baby may include:

• Deformities of fingers, limbs, and joints
• Poor physical growth and development before and after birth
• Hearing problems
• Difficulty with vision
• Small brain size and head circumference
• Distinctive facial features, including an exceptionally thin upper lip, small eyes, upturned short nose, and smooth skin between the upper lip and nose

Behavioral and social problems:

Defects in functioning, interacting, and coping with others may involve:

• Poor social skills
• Troubles in school
• Difficulty in getting along with others
• Problems switching from one task to another
• Difficulty in staying on a task
• Problems planning and working towards a goal
• Trouble with controlling behaviors and impulses
• Problems adapting to change

Risk factors of fetal alcohol syndrome:

Thus, the more alcohol you consume during pregnancy, the higher the chance of problems appearing in your child. Hence, there is no safe limit on alcohol intake during the conception period. You may put your baby at risk even when you don’t know you’re expecting a baby. So avoid alcohol if:

• You are pregnant
• You are trying to conceive
• You think you might be expecting a baby

Diagnosis of fetal alcohol syndrome:

To avoid the severe outcomes of fetal alcohol syndrome (FAS), its early detection is very important. Hence, consult your specialist if you think that your baby might have FAS. Also, inform your health professional if you drank during pregnancy. Moreover, a physical examination of your baby may show a heart murmur (abnormal heart sounds) or other cardiac problems. Thus, as your baby grows the signs which confirm its diagnosis are:

• Low growth rate
• Abnormal facial features
• Small head size
• Poor language acquisition

Treatments for fetal alcohol syndrome:

While fetal alcohol syndrome (FAS) is not curable, but there are treatments for a few of its symptoms. Thus, the earlier the detection, the more progress that can be made. Depending on the signs and symptoms a fetal alcohol syndrome baby exhibits, they may need several doctor visits. However, social services and special education can also help the young child in learning how to talk, such as speech therapies.

At home:

Children suffering from FAS will benefit from a loving and stable home environment. They are more sensitive to disruptions in routine life as compared to a normal child. Thus, children with FAS are more expected to develop problems due to substance abuse and violence in later life if they are exposed to violence and abuse at home. However, these children do well when they get simple rules to follow, a routine, and rewards for positive behavior.

Medication:

Although no medicine can completely reverse FAS, some medicines can address the symptoms of this disorder. For example, some drugs can manage energy levels, depression, and the inability to focus. Some of these medicines are:

• Stimulants:

Stimulants can be used to treat some FAS symptoms, including trouble in paying concentration, low impulse control, hyperactivity, and other behavioral issues.

• Neuroleptics:

This type of medication can improve neurological problems such as anxiety, aggression, and some behavioral problems.

• Antidepressants:

Fetal alcohol syndrome majorly affects the central nervous system of your child. Thus, these medicines can help in treating brain issues, including loss of concentration, school disruption, mood swings, aggression, irritability, negativity, and anti-social behaviors.

• Anti-anxiety drugs:

Anxiety is common in FAS children. Hence, this medication can improve anxiety symptoms. Drugs can affect each child differently. However, one medicine may work better for one child, but not for another. Thus, to identify the accurate treatment, your doctor may use different drugs and doses. It is therefore vital to consult with your child’s doctor to discover the best treatment strategy for your baby.

Nutritional interventions:

Research suggests that nutritional factors influence the damage caused by alcohol in the developing fetus. However, it is expected that postnatal nutrition can also influence the behavioral and physical outcomes in children with FASD.

Prenatal nutritional interventions:

Studies show that women who drink alcohol during pregnancy have several nutritional deficiencies as compared to the control group. For example, in one study, May and colleagues examined the nutritional status of mothers who gave birth to babies with FASD compared with mothers who gave birth to babies without FASD. The results revealed that mothers of fetal alcohol syndrome babies were deficient in several nutrients such as choline, vitamin B6, A, C, E, and D, minerals including zinc, calcium, and iron, and omega 3 fatty acids. Hence, the deficiency of these nutrients can cause the abnormal development of the baby and exacerbate the damaging effect of alcohol. However, the research found that women consuming alcohol and also taking micronutrient supplements had a lower risk of FASD in babies than women who did not take supplements. These supplements can also reduce the oxidative stress caused by alcohol in the fetus. Thus, it is recommended to take supplements of vitamin E, C, and omega 3 fatty acids, which reduces the risk of FASD in newborns.

Postnatal nutritional interventions:

Nutritional status has a strong association with the development of cognitive abilities in your baby throughout their childhood. Hence, studies found that children suffering from FASD do not consume an adequate amount of calories, omega 3 fatty acids, choline, and vitamin D. However, these nutrients can attenuate the harmful effects of alcohol on both behavioral and brain development. In one study, the supplementation of choline in the diet of FASD children showed positive outcomes in brain development. It is thus recommended that FASD children should consume an adequate amount of these nutrients, which improves their mental development and functioning.

Exercise interventions:

Physical activity has several health benefits on behavior and brain outcomes. Research found that exercise can improve learning abilities and memory by elevating circulating proteins, which encourages brain performance such as brain-derived neurotrophic factor (BDNF). Moreover, research also found that running can enhance intellectual and learning abilities in rodents who were exposed to alcohol at prenatal state.

Counseling:

You can also improve the symptoms of fetal alcohol syndrome in children by using behavioral training. For example, friendship training can teach your child how to learn social skills, talk, and interact with their fellows. On the other hand, executive function training can also play a promising role in improving skills including self-control, understanding effect and cause, and reasoning. Some important educational and behavioral therapies are:

• Good buddies is an effective children friendship training program which improves social skills in FASD child. Through this training, your child learns how to deal with teasing, slipping into a group, and appropriate sharing. This strategy involves sessions for the child and parents for 12 weeks.
• Families Moving Forward (FMF) program provides support to the families who deal with challenging FASD behaviors. Moreover, it is the most effective strategy for a child suffering from severe behavioral problems. The duration of the program is between 6 to 11 months and involves almost 16 sessions. Services are offered by specialized trainers and mental health providers.

Moreover, a child with FASD also needs academic help. For example, a math teacher can help your child in improving their learning abilities.

Parent training:

Parental training is also important; you can learn about the disabilities of your child and how to interact with and care for your baby. Hence, siblings and parents can help FASD children in solving the social issue through support groups and talk therapy. Here are some simple parenting tips which can be useful:

• Pay attention to your child’s talents and strength
• Accept the limitations of your kid
• Use simple examples and language
• Give a reward for every positive behavior
• Use music, hands-on activities, and visual aids to help your child learn
• Remember, most of your child’s challenging behavior is due to brain problems instead of willful misbehavior

Alternative approaches:

In every medical condition, disability, and injury, there are several untested strategies which are endorsed by using informal networks. Thus, these strategies are known as alternative techniques. Before applying these interventions, first consult your health professional and check it out sensibly. Thus, your child’s doctor can offer guidance about the benefits and risks of these treatments. Some of these effective alternative approaches are:

• Therapy of creative art
• Yoga
• Acupressure and acupuncture
• Energy healing, massage, and Reiki (palm healing technique, which promotes physical or emotional healing)
• Biofeedback (body-mind technique used to gain control over involuntary functions of the body, including blood flow, heart rate, blood pressure, and skin temperature)
• Homeopathy, herbal, and vitamin supplements
• Visual imagery and relaxation therapies
• Auditory training

Positive factors:

Studies reveal that there are positive factors which help in reducing the secondary effects of fetal alcohol syndrome in children. Some of these positive factors are:

• Early diagnosis. Children who are detected at an early stage can be given appropriate social services and educational classes, which helps in solving their social and behavioral issues.
• FASD children must get a stable, nurturing, and loving home environment, which helps in preventing secondary behavioral issues such as unemployment, incomplete education, and criminal acts.
• FASD children should never be exposed to violence.
• Involve your child in social services and educational classes.

In the bottom line:

Hence, to prevent fetal alcohol syndrome disorder it is recommended to avoid alcohol intake during pregnancy. Moreover, this disorder is incurable, but you can manage its symptoms through multiple interventions.  

References:

1. May, P. A. et al. Dietary intake, nutrition, and fetal alcohol spectrum disorders in the Western Cape Province of South Africa. 46, 31-39 (2014).
2. Nyaradi, A., Li, J., Hickling, S., Foster, J. & Oddy, W. H. J. F. i. h. n. The role of nutrition in children’s neurocognitive development, from pregnancy through childhood. 7, 97 (2013).
3. Chambers, C. et al. 2MATERNAL ALCOHOL CONSUMPTION DURING PREGNANCY, NUTRITIONAL STATUS, AND IMPACT ON INFANT OUTCOMES. 48 (2013).
4. Warren, K. R., Hewitt, B. G., Thomas, J. D. J. A. R. & Health. Fetal alcohol spectrum disorders: research challenges and opportunities. 34, 4 (2011).
5. Voss, M. W., Vivar, C., Kramer, A. F. & van Praag, H. J. T. i. c. s. Bridging animal and human models of exercise-induced brain plasticity. 17, 525-544 (2013).
6. Fetal Alcohol Syndrome, <https://www.mayoclinic.org/diseases-conditions/fetal-alcohol-syndrome/diagnosis-treatment/drc-20352907>
7. Fetal Alcohol Syndrome, <https://www.healthline.com/health/fetal-alcohol-syndrome>
8. Center for Disease Control and Prevention, Fetal Alcohol Spectrum Disorders FASD,