Some mistaken ideas about FAS exist. One is that those affected are from certain social classes or ethnic groups. Another is that FAS is a condition of children exposed to massive amounts of alcohol in pregnancy. Certainly, women who drink large amounts of alcohol regularly throughout pregnancy are more likely to have a child with FAS. However, it is equally important to realize that the effects of alcohol can occur in any baby exposed to alcohol before birth. Effects have been found with as little as half a drink of alcohol a day. One per cent of our population suffers from damage due to alcohol use in pregnancy.
It is known that some women may drink heavily in pregnancy (at least one drink a day) and not have an affected child. In fact, only 20 per cent of their infants will be affected. However, a woman with one FAS child has a 77 per cent chance her next child will also have the condition. This has to do with the way women of different ages, body sizes and racial backgrounds break down the alcohol in their systems. The peak levels of alcohol in the bloodstream are an important factor. The effects may be hard to measure, so it is difficult to say any alcohol in pregnancy is safe. The only way to be certain to avoid FAS in any infant is to not drink any alcohol in pregnancy.
and Yukon Territory
Alberta, Northwest Territories and Nunavut
Manitoba and Saskatchewan
Alberta Alcohol and Drug Abuse Commission
AADAC Help Line
(toll free in Alberta): (866) 332-2322
FAS is better understood by recognizing the whole range of effects that alcohol can have on the developing unborn baby. Alcohol has the ability to cause damage at all levels of development. It can interfere with the creation of DNA, which is the genetic code of the cells. It can affect early cell activity, and the forming and development of all the organs. The effects on the brain are called alcohol-related neurological deficits. All other effects are called alcohol-related birth injuries.
Very early in pregnancy, before many women realize they are pregnant, the face and brain are developing. This time period, about 18 days after the egg is fertilized, is when the typical facial features of FAS develop. The upper lip is flat and thin and the bridge of the nose is flattened. There may be folds of skin near the eyes. The eyes are smaller than normal and often develop vision problems. The chin may also be small. These features may not be easy to spot in a newborn. They are most noticeable from eight months to eight years of age.
Affected adults appear normal. Affected babies tend to be smaller than normal at birth. Many of their organ systems can be affected. There may be problems with the forming of bones, the kidneys or the heart. The brain is always involved.
The brain is the first organ to begin to develop and the last to finish, so it is not surprising that alcohol exposure during any time in pregnancy can affect the baby’s brain. The basic structure of the brain may be affected. Or the effects may be at the microscopic level of the microcircuits and chemical transmitters. Most important is how the life of the baby being developed will be affected.
Children with FAS may have all of the features or a few. When there is a history of alcohol exposure in pregnancy and only some features of FAS, it may be called fetal alcohol spectrum disorder (FASD), fetal alcohol effects (FAE) or partial FAS.
The behaviour of these children usually points to a problem. They are seen in school as slow learners and often mistaken as having attention deficit hyperactivity disorder (ADHD). Their learning disabilities are distinct and lifelong. They show poor attention, do not reason well and have difficulty forming memories. They may not remember how to perform tasks even after repeating them again and again. Their understanding of language is very simple. For instance, they often do not recognize figures of speech such as "the fog is as thick as pea soup."
People with FAS do not recognize normal social behaviour and cues. They show poor judgment and fail to consider the outcomes of their actions. They may not finish school, have difficulty getting and keeping jobs and often run into trouble with the law. One quarter of our youth in custody suffer from FASD. They can become homeless and are more likely to develop alcohol and drug habits. Less than 10 per cent of those with FAS manage to live on their own. Their behaviour is impulsive. This may lead to inappropriate sexual activity including teenage pregnancy and street prostitution. Such behaviour makes it very difficult for a family to cope on a day-to-day basis.
Although the effects of alcohol exposure during pregnancy cannot be reversed, treatment is available. Early recognition allows for special learning techniques that may help a child stay in school, graduate and become employed. Family and community support can reduce the risks of the child becoming involved in illegal activities and help provide better living arrangements. Some provinces have special FAS clinics to aid in the diagnosis and treatment of those affected.
One in four women drinks alcohol in pregnancy. Reducing alcohol intake, or better yet, not drinking any alcohol at any stage of pregnancy can benefit the baby. Mothers who want help in stopping alcohol use in pregnancy should ask their caregiver or one of the social agencies such as alcohol and drug abuse centres for assistance. Special methods of stopping may be needed during pregnancy.
All women planning a pregnancy should stop drinking alcohol by their midcycle. Women who may need help to stop drinking should seek this help before becoming pregnant. Many women don’t plan on becoming pregnant but are not using reliable forms of birth control. If there is any possibility of pregnancy occurring, assume it has and live a healthy lifestyle that does not include drinking alcohol.
FAS and drinking alcohol in pregnancy are not just the problems of the family involved, but impact our entire society. Affected children need a greater amount of our education, social assistance, law enforcement and health care resources. We must all recognize the importance of avoiding alcohol in pregnancy.