Fetal alcohol spectrum disorder

Fetal alcohol spectrum disorder (FASD) is an umbrella term used to describe abnormalities that can be caused by alcohol consumption 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.
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There is no safe type of alcohol, safe amount of alcohol or 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.

Breastfeeding

It is best not to consume alcohol while breastfeeding.

If a mother drinks alcohol, it passes into the breast milk and the baby will then consume alcohol when drinking the milk.

Alcohol can harm the baby as their brain and nervous system continue to develop after birth.

Assessment for FASD should be done by a multidisciplinary team that includes:

  • a paediatrician or adolescent physician
  • and a psychologist.

Assessment teams should also include a combination of the following professionals if available:

  • speech pathologist
  • occupational therapist
  • social worker
  • physiotherapist.

There are ten brain domains assessed by the multidisciplinary team.

Severe impairment of brain function in at least three of these ten domains needs to be present to reach a diagnosis of FASD.

Different categories of FASD

There are certain facial features that may be associated with FASD. These are known as sentinel facial features.

The Australian Guide to the Diagnosis of FASD recommends that the diagnosis be divided into one of two sub-categories:

  • FASD with three sentinel facial features
  • FASD with less than three sentinel facial features.

Find out more on the FASD Hub website.

Babies

Not all babies who are exposed to alcohol as a fetus are affected identically.

Infants may display any of 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.

Older children

Sometimes children aren't diagnosed until they are older or at school. This is because the effects from alcohol exposure are not always seen at birth.

Most children with FASD will not display the sentinel facial features, but may have learning or behavioural problems that are picked up when they are school-aged.

Signs and symptoms you may see in an older child with FASD include:

  • 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.

FASD is a permanent disability and it is not curable. However, there are interventions that can improve someone with FASD’s quality of life.

Early assessment and interventions are associated with better long term outcomes.

Without the correct intervention, 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.

Support services

It is important that neurodevelopmental support needs are identified in children as early as possible so that support services can be engaged to lessen the impacts on the individual, families, teachers and carers.

Special education, vocational programs and a structured environment can help people with FASD.

Medication can be helpful for hyperactivity and learning problems.

Support programs are available for individuals and families impacted by FASD.

If you have any concerns or would like further information, please contact your GP, midwife or child health nurse.

Find out more about child health services .

Last updated: 06 February 2019

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