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Fetal Alcohol Spectrum Disorder

Why it's important not to drink to your baby's health

Fetal Alcohol Spectrum Disorder
April 2013

Each year about 40,000 babies are born with a fetal alcohol spectrum disorder (FASD). All 40,000 of those cases were 100 percent preventable.

The issue is confusing, and it's not. What's confusing is that women hear two stories when it comes to drinking alcohol during pregnancy. They hear that no amount is okay. Then they hear that well, maybe a little alcohol is okay.

Last year research out of Denmark suggested that light to moderate drinking early in pregnancy had no effect on intelligence, attention span or executive functions like planning, organization and self-control in children age five. Heavy drinking was shown to have negative effects. You could almost hear the sighs of relief and quiet cheers of pregnant women ripple across the country.

What might have fallen on deaf ears is the detail that despite these findings, the authors of the study also noted that "additional large scale studies should be undertaken to further investigate the possible effects." As well, they said the best advice is to choose not to drink.

This is also the advice of Dr. Louis Escobar, pediatric genetics, neuro-developmental pediatrics and newborn follow-up with Peyton Manning Children's Hospital at St. Vincent. He believes women should stop drinking as early as six months before conception. So women who think they may become pregnant should stay away from wine, beer and other forms of alcohol.

Statistics from the Centers for Disease Control and Prevention (CDC) show that 45.6 percent of Hoosier women ages 18 - 44 have had one or more alcoholic drinks in the past 30 days. Slightly more than 12 percent have binged on alcohol, which means they have had four or more drinks on any one occasion during the last 30 days. So Dr. Escobar's advice, which is the advice of many experts in the field, is a tall order for many women. It's also an important one.

While some women may think that having a little wine here or there or drinking in a specific trimester may not hurt, Katelyn Hanson, genetic counselor at Indiana University Medical Center, says the effects of alcohol aren't necessarily related to the amount of exposure or timing of consumption. It varies fetus to fetus and can be related to the age of the mother and how well her liver metabolizes alcohol. What is known for sure, she says, is that the effects of alcohol consumed prenatally are irreversible. They can't be undone.

FASD, according to the national Fetal Alcohol Spectrum Disorders Center for Excellence, is an umbrella term that describes the range of effects that can occur in an individual whose mother drank alcohol during pregnancy. It refers to conditions like fetal alcohol syndrome, alcohol-related neurodevelopmental disorder and alcohol-related birth defects. So, what many people refer to as fetal alcohol syndrome is really the spectrum of disorders related to prenatal alcohol exposure.

Children with FASD can have behavior issues akin to ADHD. They may have trouble with impulse control, concentrating in school and following multi-step directions. They may have short-term memory issues that plague them throughout life. Some infants may also have tremors, seizures, excessive irritability and sleep problems. There are even abnormalities like shorter stature compared to peers. Some have difficulty gaining weight in infancy. Other physical features include small eye openings, smooth philtrum or groove between nose and mouth and thin upper lip. There are many other symptoms and because FASD is a spectrum, individuals can have a range of issues from mild to severe.

To learn more about these symptoms and FASD in general, the CDC website is a great place for women and families to start. Visit www.cdc.gov/fasd.

In the meantime consider the familiar adage that an ounce of prevention is worth a pound of cure. And in this case, make that no ounces.

Tags: Health, In This Issue, Maternity

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