What is Fetal Alcohol Syndrome?

What is Fetal Alcohol Syndrome?

Fetal alcohol syndrome refers to the birth defects that result from exposure to alcohol during pregnancy. Excessive consumption of alcohol during pregnancy may result in the child developing physical deformities, mental conditions, behavioral issues, and learning disorders. The symptoms of fetal alcohol syndrome may differ depending on the child. Many of the defects that the child may face are irreversible. Exposure to any amount of alcohol during pregnancy puts the baby at risk for this syndrome. The amount of alcohol a mother can consume safely without harming the child during pregnancy is still unknown.

Those children or babies who are exposed to alcohol in the womb are at risk of developing fetal alcohol spectrum disorders, or FASDs. FASDs include physical, mental, behavioral, and learning problems. One of the most severe among the FASDs is called Fetal Alcohol Syndrome, which is a result of heavy drinking.

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Fetal alcohol syndrome causes a child to develop deformities, due to alcohol exposure during pregnancy. A child with fetal alcohol syndrome often exhibits facial characteristics that might be difficult for an ordinary individual to recognize as symptoms of the syndrome. However, trained professionals such as doctors are able to identify these traits. These are some of the physical qualities that a child develops due to fetal alcohol syndrome:

  • Narrow eyes
  • Small head
  • Small upper jaw
  • Smooth or indistinct philtrum (the groove in the area between the upper lip and nose)

The severity of the effects of alcohol consumption during pregnancy varies from child to child. Fetal alcohol syndrome can cause mental retardation in children. Some of the most common signs and symptoms of this syndrome are the following:

  • Reduced growth rate of the child before and after birth
  • Poor vision
  • Hearing difficulties
  • Learning disabilities 
  • Delayed mental development
  • Physical deformities
  • Poor coordination
  • Short attention span
  • Lack of impulse control
  • Nervousness and anxiety
  • Heart defects

Children with any one of the other FASDs also suffer similar problems, although with a lesser degree of severity than in fetal alcohol syndrome.

Growth deficiency is defined as a significant reduction in height and/or weight due to prenatal exposure to alcohol. This can be assessed at any point in the child's lifespan. The facial features are believed to be caused majorly during the 10th to 20th week of the pregnancy. The three major facial features that can lead to deformity are:

  • Smooth philtrum – The divot or ridge located between the nose and upper lip flattens due to exposure to prenatal alcohol.
  • Thin vermilion border – This is the thinning in the upper lip due to exposure to alcohol during pregnancy.
  • Small palpebral fissures – This means that the openings of the eyes, or distances between the eyelids, are smaller due to alcohol exposure.

Damage to the central nervous system is the key feature of fetal alcohol syndrome, and is also one of the key features of an FASD diagnosis. Tertagon, that is, exposure to alcohol during the prenatal stage, can lead to brain damage. This can fall anywhere in a continuum of impairments from subtle to major. The damage would depend on the timing and frequency of the alcohol exposure, as well as the genetic tendencies of the mother and the fetus. The damage to the central nervous system are assessed in terms of three different aspects: structural damage, neurological damage, and functional damage.

The structural impairments in the brain of a person with fetal alcohol syndrome are easily observable, with the head being smaller by two or more standard deviations below the average. Other FASDs may be related to other abnormalities in the structure of the brain that may not manifest in a smaller head size.

Neurological abnormalities may be assessed even when structural problems are not observable or tend to not exist. Exposure to alcohol may lead to general damage to the central nervous system, the autonomic nervous system, and the peripheral nervous system. Only a trained doctor can identify whether the problem is related to a neurological abnormality. Neurological problems due to prenatal exposure to alcohol can be hard to determine or they can manifest in disorders such as seizures or epilepsy. A child can have impaired motor skills or clumsy movements, or lack hand and eye coordination, or find it difficult to hear.

Functional problems are those neurodevelopmental abnormalities affecting various functions stemming from brain function. A child can have learning disabilities or difficulties such as being slow to grasp information compared with normal children. There may be communication issues, lack of memory or attention, and poor judgement.

Apart from these, there can be heart murmurs, which do usually disappear after the child turns one year old. There can also be abnormalities in the joints, including an altered palmar crease pattern or small fifth fingernails.

Factors that influence the risk of fetal alcohol syndrome are the following:

  • Maternal health
  • Drinking patterns
  • Age of the mother
  • Stress levels
  • Maternal nutritional status
  • Use of other substances like tobacco

Many of the symptoms of this syndrome are similar to attention deficit hyperactivity syndrome (ADHD), which may make diagnosis of this syndrome difficult. The unusual facial features, difficulty in coordination, smaller head size, short attention span, and hyperactivity are the warning signs in most cases.

The question of limited alcohol intake

There is no amount of alcohol intake during pregnancy that is pronounced as completely safe. Alcohol should be considered largely unsafe during pregnancy period, as it carries with it a huge risk for both the mother and the unborn. Even a small amount of alcohol can harm the fetus and increase the chances of a miscarriage.

Alcohol can easily pass through the placenta, the organ that provides nourishment to the baby throughout the pregnancy period. Exposure to alcohol in the first trimester, when many a mother is not aware that she is pregnant, can lead to birth deformities in the child.

The brain of the child develops throughout the pregnancy period. Hence, alcohol consumed during the second and third trimesters can still lead to behavioral and learning problems in the child.

All of these problems can be prevented if a woman avoids alcohol intake when she is or may be pregnant, or planning to be.     

Treatment of fetal alcohol syndrome

Although there is no complete cure for this syndrome, an early diagnosis can improve the developmental outlook for the child. The earlier the appropriate treatment, the better the mental development chances of the child. Children with this syndrome respond positively when they are in a loving, nurturing environment. Children with fetal alcohol syndrome should not be exposed to violence, and it is recommended that the child receive special education at school.

There are a number of things that can be done to help the child reach his or her potential. The best chances of this are available when the condition is diagnosed at an early age. There are various therapies or services that can benefit the child:

  • These children can join classes that help them learn social skills including how to interact with their peers.
  • Physical therapy, speech language classes, and occupational therapy.
  • Counseling sessions for both the parents and the child with a mental health professional.
  • Counseling sessions for the parents and the child's siblings so that they can be taught how to be sensitive in dealing with the child, and have patience when it comes to behavioral problems.

There are no known medications that would treat fetal alcohol syndrome specifically, although medications can help address the symptoms experienced by the person:

  • Stimulants, which can be used to treat the problem of lack of focus, hyperactivity, and other behavioral problems 
  • Antidepressants, which can help treat issues such as depression or sadness and negativity
  • Neuroleptics, which can help treat anxiety and aggression 
  • Antianxiety drugs, for anxiety

Complications of fetal alcohol syndrome

Fetal alcohol syndrome can lead to various complications if the diagnosis is not done in a timely manner:

  • Hyperactivity disorder
  • Violent behavior
  • Getting very aggressive even for smallest of the matter,
  • Drug abuse
  • Depression
  • Anxiety attacks
  • Eating disorders
  • Suicidal tendencies

Coping with behavioral problems

For a parent of a child with fetal alcohol syndrome, every day is a new challenge. The behavior of such children may require a lot of patience. Here are useful techniques to facilitate behavioral improvements:

  • Identify their strengths as well as their limitations, and show appreciation for their strengths to encourage them to perform better.
  • Create simple rules or limits and enforce them.
  • One should try to keep things as simple as possible. Try to use specific, simple, and concrete terms with the child.
  • Use the reward technique. Point out and give rewards, which can help reinforce acceptable behaviors. 
  • Keep the child guarded from others, since others may take advantage of their incapacities, whether at school, other places, or even at home.
  • Encourage social interactions and teach them skills pertaining to daily living.
  • Implement daily habits and routines in their life.
  • Reinforce learning with the help of repetition.