SWISS MEDICAL EXPERTISE: ZURICH, MALLORCA, LONDON, NEW YORK

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Our anniversary is approaching. Would it be ok if I have a glass of wine?”

“Can I have a bottle of beer with dinner now and then?”

“I just found out that I am pregnant but I consumed alcohol just yesterday. Is my baby going to be fine?”

It’s common for women to ask questions like these during pregnancy. Unfortunately, the advice they get can be particularly confusing. Almost every American health organization recommends completely abstaining from alcohol during pregnancy, but some experts consider it safe to have a drink occasionally.

Despite the varying nature of advice, it is impossible to ignore the potential side effects of fetal alcohol syndrome (FAS) on the developing baby: developmental delays, low birth weight, and lifelong behavioral issues. Up to 5 percent of children born in Texas alone suffer from FAS, and statistics suggest that the incidence of this disorder is still underreported.

pregnant woman refusing a glass of wine

Also known as Fetal Alcohol Spectrum Disorder (FASD), fetal alcohol syndrome happens when a woman continues to drink alcohol during pregnancy, including beer, wine, hard liquor, and hard ciders. Without using alcohol, it is impossible for FAS to occur. But why is alcohol so dangerous during pregnancy? One reason is that it can pass through the mother’s bloodstream to the fetus via the umbilical cord, i.e., a tube-like structure that internally connects the baby with the mother’s body. Another reason is that the baby’s body cannot break down alcohol the same way as an adult body does. As a result, it may persist in the baby’s bloodstream for longer.

Alcohol is capable of interfering with the normal development of the fetus, especially its brain, because of the following reasons:

  • Alcohol kills body cells in different parts of the fetus, leading to delayed or abnormal physical development.
  • Alcohol causes constriction of the blood vessels, reducing the blood flow to the fetus. This causes a shortage of nutrients and oxygen in the developing baby’s body.
  • Alcohol alters the way nerve cells develop and how they travel and function within the brain.
  • When the fetus’s body process alcohol, it releases toxic byproducts that accumulate in the brain and cause damage.

Damage from alcohol may occur at any point during pregnancy. However, the first three months are when the baby is most vulnerable, as this is when most body organs are developing. Experts believe that it is impossible to pinpoint all of the development that takes place during pregnancy, making it dangerous for mothers to consume alcohol at any point before childbirth.

The symptoms of FASD may include deformities in the face, skeleton, and multiple organs of the body. Children and adults may also face behavioral problems and central nervous system handicaps in later life.

Mentioned below are some FASD symptoms adults and children are likely to encounter due to prenatal alcohol exposure:

Facial characteristics of fetal alcohol syndrome

  • Small head and eye openings
  • Drooping eyelids
  • Webbing between the base of the nose and eyes
  • Short, upturned nose with flat cheekbones
  • Inability to move eyes in the same direction
  • Sunken nasal bridge
  • Thin and smooth upper lip
  • Small upper jaw
  • Opening in the roof of the mouth
  • Malformation of ears

Growth Deficiencies

  • Failure to grow properly compared to others in the same age group
  • Slower physical development
  • Smaller body weight and size

Skeletal Deformities

  • Deformed sternum and ribs
  • Abnormal palmar creases
  • Curved spine
  • Extra fingers
  • A caved-in chest wall
  • Limited joint movement
  • Hip dislocations
  • Excessive hair
  • Underdeveloped toenails or fingernails

Organ Deformities

  • Defects in the structure of the heart
  • Heart murmurs
  • Umbilical or diaphragmatic hernia
  • Underdeveloped brain
  • Kidney or urinary defects
  • Genital malformations

Central Nervous System Handicaps

  • Small brain size
  • Mild to severe mental retardation
  • Poor memory skills
  • Learning disabilities
  • Poor language skills and shorter attention spans
  • Irritability in infancy
  • Poor coordination
  • Poor reasoning
  • Little to no judgment skills
  • Hyperactivity in childhood
  • Poor problem-solving skills

Behavioral Problems

  • Poor concentration
  • Anxiety
  • Stubbornness
  • Social withdrawal
  • Poor parenting skills
  • Impulsiveness
  • Psychiatric problems
  • Problems with daily living
  • Long-term unemployment
  • Criminal behavior
  • Inappropriate sexual behavior
  • Addiction problems

In the long run, FAS can lead to multiple secondary problems and conditions in adults that make life more challenging and difficult for them. Some of these long-term effects of fetal alcohol syndrome in adults include:

  • Mental health issues, such as depression, attention deficit disorder, and psychotic disorders
  • Legal issues due to problems with understanding social cures and anger management
  • Alcoholism and drug addictions
  • Academic challenges
  • Inability to perform well in careers

The effects of FAS become particularly hard to navigate in adulthood, especially when the patient has to take care of themselves all alone. Such individuals often require help, especially with finding housing, transportation, employment, and daily life responsibilities. Unfortunately, many such individuals never receive the support and resources they need to have a good-quality life. Surveys suggest that 80% of people with fetal alcohol disorder have employment issues, 35% fall victim to addictions, and 60% face legal troubles.

Apart from the problems mentioned above, most individuals with FAS may develop the following secondary effects:

  • Homelessness
  • Victimization
  • Inability to live independently
  • Difficulty raising their own children

Diagnosing fetal alcohol syndrome requires a thorough assessment and expertise, particularly in adults. Early diagnosis can significantly improve the affected individual’s ability to function later in life.

To diagnose fetal alcohol syndrome, a doctor may:

Discuss drinking during pregnancy

If you are a parent concerned about your child, a doctor may enquire about your consumption of alcohol during pregnancy. In the case of an adult, they may ask if their mother was a drinker.

Monitor the symptoms

A doctor may watch out for the signs and symptoms of FAS, especially during the child’s initial weeks, months, or years of life. Some experts may also monitor their child’s brain growth and physical development. Adults may also undergo in-depth assessments, evaluations, and brain scans to confirm the diagnosis.

A doctor may also assess a patient for the following:

  • Health issues
  • Cognitive ability
  • Learning difficulties
  • Behavioral and social problems

Many features of FAS are similar to other disorders that commonly hit adults and children. To rule out these orders, a healthcare provider may refer the patient to a neurologist, a developmental pediatrician, or other expert training in FAS.

Fetal alcohol syndrome is not curable, and its symptoms are likely to impact a child throughout life, even when they enter adulthood or grow older. However, seeking treatment early on can help reduce the severity of certain symptoms and improve the overall development of children.

The most common treatment options for FAS include:

  • Using medications to treat certain symptoms, such as behavior issues and attention deficits
  • Training parents to help the affected child in the best way possible
  • Providing education and behavior therapy to address the concerns with learning and emotional regulation

Parental training is particularly helpful in helping families cope with the social, behavioral, and educational challenges that may arise due to FAS. As a part of this training, parents may learn different rules and routines that can potentially help their child cope with different situations. Having a supportive and stable home can greatly benefit such children and can even support better management of fetal alcohol syndrome in adults personality.

Apart from conventional treatment, some protective factors potentially decrease the negative impacts of FAS on a child. These include:

  • Getting a diagnosis before the age of six years
  • Using special education and appropriate social services to tackle common challenges
  • Ensuring a supportive family environment without the use of violence

In the case of adults, some additional alternative approaches can be particularly beneficial to manage symptoms. These may include:

  • Biofeedback therapy
  • Relaxation therapy
  • Auditory training
  • Visual imagery
  • Creative art therapy
  • Meditation
  • Yoga and exercise
  • Massage therapy
  • Reiki
  • Animal-assisted therapy
  • Acupuncture and acupressure

It is common for many women to continue to drink alcohol throughout pregnancy. Alcohol is often a part of parties, sports events, and other social activities and many people rely on it to relax at the end of a busy day. Considering these facts, giving up on alcohol during pregnancy may be difficult.

However, considering the permanent nature of this disease and the long-term effects of fetal alcohol syndrome in adults, it is imperative to make an effort and cut back on alcohol as much as possible. Consider following the tips mentioned below to facilitate the process:

  • Think about the times when you are most likely to drink alcohol. Try swapping your usual alcoholic drink with something safer, like water or a fruity drink. You may consider adding a straw, a lemon, or an umbrella to the glass to make it more fun.
  • Avoid situations or places where you are most likely to drink, such as bars and parties.
  • Let your partner and loved ones know you are not drinking during pregnancy, and ask for their support.
  • Get rid of all alcohol from your home.

If you feel that you have an alcohol addiction and require extra help, you can:

  • Talk to your doctor about joining an alcohol treatment program
  • Join the local Alcoholics Anonymous support group
  • Contact an alcohol rehabilitation center specializing in pregnant women

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