Fetal Alcohol Syndrome

Fetal alcohol syndrome refers to the group of symptoms or birth defects caused by alcohol exposure during pregnancy.

It causes several physical and mental defects, which are permanent. Children with this syndrome grow at a slower rate compared to healthy babies. This condition is characterized by physical abnormalities and mental retardation.

Fetal alcohol syndrome is one of the leading causes of irreversible mental retardation in children. 

Women who have been drinking alcohol during the course of their pregnancy deliver babies suffering from fetal alcohol spectrum disorders, also known as FASD. This is an umbrella term for a varied range of other disorders. The various types of FASD are mentioned below, some of which can range from mild to severe and lead to mental and physical defects from birth:

• Fetal alcohol syndrome: This is a more severe medical condition in FASD and can cause fetal death as one of the most extreme outcomes of drinking during pregnancy. Such children often have a hard time in school among normal kids and also have trouble interacting with their peers.

• Alcohol-related birth defects: Individuals with alcohol-related birth defects have problems with certain organs, such as the kidneys, heart, or bones. They may also have trouble hearing. In some cases, it could be a mix of all these.

• Alcohol-related neurodevelopment disorder: Individuals with this syndrome can have an intellectual disability that causes trouble with learning and behavior. Such children often face difficulty in school, especially with subjects like math. Children have problems with judgements, memory, attention, and impulse control.

• Prenatal alcohol exposure associated with neurobehavioral disorder: Individuals or children suffering from this condition have problems in three areas: memory and thinking, wherein they face difficulties planning or forget items they planned themselves; behavior, including mood swings wherein they become irritated quickly, find it difficult to shift attention from one task to another, and, at times, throw tantrums; and day-to-day activities, such as bathing, combing hair, and playing around with other kids.

Among all of the above disorders, fetal alcohol syndrome is known to be the most severe condition. Children suffering from this syndrome have a lot of medical problems such as hearing, vision, span of attention, and ability to learn or communicate. The damage in this syndrome is permanent, but the defects can vary from person to person.

The severity of fetal alcohol syndrome's symptoms ranges from mild to severe and vary from child to child. Children with fetal alcohol syndrome have physical, mental, and social or behavioral defects. 

The major physical symptoms of fetal alcohol syndrome include:

• Abnormally-formed limbs and joints
• Reduced growth rate
• Defects in organs like the heart, kidneys, and bones
• Vision and auditory problems
• Facial deformities like wide-set eyes, flat cheek bones, and deformed nose
• Small brain
• Low birth weight
• Lack of coordination
• Difficulty balancing
• Problems with memory
• Issues in judgment
• Hyperactivity
• Mood swings
• Delayed development
• Learning disability
• Cognitive problems and social defects
• Poor socialization
• Hyperactivity
• Difficulty planning
• Lack of imagination
• Learning problems
• Behavioral issue

Many times, the symptoms of fetal alcohol syndrome can be confused with symptoms similar to another medical condition called ADHD. There have been researches which show that children can do better if:

• This medical condition is diagnosed well before the age of six
• Such children are not exposed to any kind of violence in their surroundings
• Children grow up in a loving, stable home during their childhood and schooling years
• Children get special services and special education where their negativities are addressed

Use of alcohol during pregnancy is the main cause of fetal alcohol syndrome.

Alcohol moves from the blood of the mother to the fetus through the placenta. Breakdown of alcohol in the fetus occurs at a slower rate compared to that of the mother. Thus, the level of alcohol in the blood of the fetus remains high. In the womb, the baby’s liver is not fully developed to process alcohol, hence, alcohol can easily get in and damage the various organs of the baby. The severity increases if the drinking is done in the first trimester when the baby’s brain has just started to develop. This does not mean that the second and the third trimester are safe; the brain is still not fully developed at those points, and moderate amounts of alcohol are more than enough to cause interference in this process.

Increased levels of alcohol affect oxygen delivery to the tissues and lead to malnutrition. This exposure results in alcohol syndrome. Pregnant women who drink heavily, to the range of more than four to five drinks per day, have increased chances of delivering a child with fetal alcohol syndrome.

Development of different organs like the brain, heart, and blood vessels begins during the early weeks of pregnancy. Alcohol consumption during this time affects organ development, resulting in characteristic symptoms of fetal alcohol syndrome.

Symptoms may also develop due to drinking during any stage of pregnancy. In most studies, alcohol is known to be harmful during the first three months of pregnancy, but, as a general guideline, consumption of alcohol during the entirety of the pregnancy is said to be harmful, so it is better to restrict one’s intake completely.

There is no safe limit on how much one can drink during pregnancy.

Diagnosis of fetal alcohol syndrome is based on the characteristic features of the syndrome. A physical examination of the child reveals the defects associated with it. The earlier this issue is detected, the better its outcome, hence, one should be very clear when this case is brought in front of the doctor so the correct course of treatment can be started.

Information on the amount of alcohol consumed during pregnancy helps assess the risk associated with the development of a disorder.

The growth and development of the child is monitored for a few months to check for changes in the developmental rate. Mental defects are diagnosed by assessing language development, learning abilities, and behavioral issues.

Many of the symptoms of this disease are common to other disorders, thus, differential diagnosis is crucial. The doctor will conduct a physical examination of the baby and, in some cases, it may reveal heart problems or a heart murmur. However, as the baby matures, there can be other signs that help identify or diagnose the condition, including:

• Problems with vision and hearing
• Lack of coordination
• Abnormal growth of bones or facial features
• Slow growth rate compared to other children
• Small head size
• Delay in learning and speaking words or languages

Early treatment of fetal alcohol syndrome may help alleviate some of the symptoms and improve secondary symptoms to a certain extent. There is no complete cure for the disorder. The physical and mental defects due to fetal alcohol syndrome are permanent. 

Treatment includes physical therapy to improve coordination, fine motor skills, and balancing.

Counseling may help improve social skills and behavioral issues. Family counseling may be helpful in coping with the condition at home and provide support to the child.

Medical conditions due to this syndrome, like heart abnormalities, may be treated.

There are no known medications that specifically help treat fetal alcohol syndrome, but there are several medications available which can address the symptoms experienced by the person:

• Stimulants can treat a lack of focus, hyperactivity, and other problems related to behavior.
• Antidepressants can help treat issues such as negativity and depression.
• Neuroleptics can treat anxiety and aggression.
• Antianxiety drugs can help with anxiety.

In some cases, parents may take their children for other treatments, since there is no full-proof medical treatment available for this condition. These treatments include acupuncture, massage, and any other healing practices. Apart from this, one can also try yoga or any movement-related techniques. For individuals suffering from behavioral problems, there are certain institutes which provide behavioral training, such as friendship training, which teaches kids how to interact with their peers and how to socialize like other kids. There are several kinds of functional training, such as reasoning, cause and effect, and self-control. In some cases, kids suffering from this syndrome may need help on an academic level, wherein they would be enrolled in coaching classes to be properly mentored on the subjects they find hard to understand. There are various counseling sessions that can help parents and siblings deal with the challenges that come with this medical condition. They can be taught how to interact with such kids and avoid worsening their current condition on a behavioral level.

Fetal alcohol syndrome is a preventable disorder by avoiding alcohol during pregnancy. If one is planning to have a baby, it is better to stop drinking as soon as possible. There is no safe level of alcohol for a pregnant woman to consume.

It is equally important to abstain from drinking throughout the pregnancy. If one is dependent on alcohol, get help to stop the habit before getting pregnant.

There are no alternative remedies for treating the symptoms of fetal alcohol syndrome.

Loving, supportive, and nurturing care is what is needed for a child affected by this disorder. 

Lifestyle modifications are necessary for children in order to cope with fetal alcohol syndrome.

Children with this disorder are more sensitive to changes in routine, so having a stable family is very important. They are also more prone to drug abuse and violence. Avoid exposure to these at home.

Having a simple routine and rules at home helps them to cope better.

As a parent of a child with fetal alcohol syndrome, every day brings new challenges when it comes to dealing with their behavior. It requires a lot of patience. There are certain suggestions, mentioned below, which can help one cope with the situation:

• Use the reward technique, wherein you point out and use rewards to reinforce good behavior.
• Start implementing daily habits and routines in the child’s life.
• To reinforce learning, use repetition.
• Keep the child safe from others who would take advantage of them, whether at school or at home.
• Identify the child’s strengths and limitations, and show appreciation towards their strengths to encourage them to perform better.
• Create simple rules or limits and enforce them.
• Try to keep things as simple as possible and use specific simple, concrete terms.
• Encourage social interactions and teach the child skills pertaining to daily living.

Fetal alcohol syndrome may lead to complications like:

• Hyperactivity disorder
• Violence
• Aggression
• Substance abuse
• Depression
• Anxiety
• Eating disorders