Fetal alcohol spectrum disorder

Fetal alcohol spectrum disorder (FASD) is an umbrella term given to a range of conditions caused by alcohol exposure during pregnancy. 

If a pregnant woman drinks alcohol, it passes from the woman’s bloodstream into the baby’s bloodstream and the baby will have the same blood alcohol concentration as the mother. 

Alcohol can cause multiple effects on unborn infants including:

  • miscarriage
  • stillbirth
  • damage to cell growth
  • a spectrum of lifelong disabilities from brain damage known as FASD.

Signs and symptoms

There are three diagnoses under FASD that are used in Australia: fetal alcohol syndrome, partial fetal alcohol syndrome and neurodevelopmental disorders - alcohol exposed.

Fetal alcohol syndrome (FAS) 

Fetal alcohol syndrom is the most severely affected end of the FASD spectrum. 

Children with FAS will have distinctive facial features of small eye openings, thin upper lip and an absent/ lengthened groove between the upper lip and nose. 

Babies will have low birth weight, failure to thrive, small heads and brain abnormalities. 

People with FAS may have behavioural problems, language problems, vision and hearing impairments and problems with reasoning, thinking and judgement.

Partial fetal alcohol syndrome (PFAS)

People with PFAS will have only some of the symptoms of FAS.

Neurodevelopmental disorders - alcohol exposed (ND-AE) 

Children diagnosed with ND-AE will not usually display facial abnormalities or growth deficits, but will have central nervous system dysfunction. Children with neurodevelopmental disorders do not learn from mistakes and do not understand consequences.

Not all babies who are exposed to alcohol as a fetus are affected identically. Infants may display the following signs and symptoms:

  • low birth weight
  • small head circumference
  • failure to thrive
  • feeding problems
  • sensitivity to noise, touch and/or light
  • developmental delay.

Sometimes diagnoses are not given until a child is older or at school as the effects from alcohol exposure are not seen at birth. Most children with FASD will look normal, but will have learning or behavioural problems that may be picked up when they are school-aged. 

Listed below are some of the signs and symptoms you may see in an older child with FASD:

  • learning difficulties
  • developmental delays
  • attention deficit/hyperactivity/ADHD
  • memory problems
  • difficulties with social relationships
  • impulsiveness
  • inappropriate behaviour
  • poor understanding of consequences
  • major organ damage such as brain, heart and liver damage.

Prevention

There is no safe amount of alcohol and no safe time to drink alcohol while pregnant. To prevent FASD, the safest option is to avoid alcohol if you are pregnant or trying to get pregnant.

It is never too late in pregnancy to stop or cut down drinking alcohol as this will increase your chance of having a healthy baby.

It is best not to consume alcohol while breastfeeding also. If a mother drinks alcohol, it passes into the breast milk and the baby will then consume alcohol when drinking the milk. As the baby’s brain and nervous system continues to develop after birth the alcohol can cause harm.

Treatment

FASD is a permanent disability and therefore it is not curable. However, there are interventions that can improve someone with FASD’s quality of life. Early diagnosis and intervention are important to allow the person to achieve the best outcomes in life.

Special education, vocational programs and a structured environment can help people with FASD throughout their lives. Medication can be helpful for hyperactivity and learning problems.

Secondary problems for adolescents and adults with FASD

It is important for someone with FASD to be given the diagnosis of FASD so their behaviour can be managed appropriately and they can be given the support they need in life.

Without the correct diagnosis, it is more likely for secondary issues to arise such as:

  • mental health problems
  • incomplete schooling
  • unemployment
  • physical/sexual/social abuse
  • alcohol and drug problems
  • criminal activity.

Contact

For more information contact the Centre for Disease Control.

Last updated: 27 June 2017