Fetal Alcohol Spectrum Disorder (FASD)

What is fetal alcohol spectrum disorder (FASD)?

A baby born to a person who drinks alcohol during pregnancy can have many problems. This is called fetal alcohol spectrum disorder (FASD). FASD includes:

• Fetal alcohol syndrome (FAS).  This is the most severe effect of drinking during pregnancy. It may include fetal death. Babies born with FAS have abnormalities of the face. They also have growth and central nervous system (CNS) problems. This includes learning and mental disabilities.

• Partial fetal alcohol syndrome. This refers to children who have only two of the physical aspects of fetal alcohol syndrome. They have slow growth and CNS problems. 

• Alcohol-related neurodevelopmental disorder (ARND).  Children with ARND may have learning and behavior problems. These may include problems with math, memory or attention, and impulse control or judgment. They may also do poorly in school. 

• Alcohol-related birth defects.  This can include defects in the heart, kidneys, bones, or hearing.

What causes FASD?

FASD happens when a person drinks alcohol during pregnancy. Like other drugs, alcohol can pass from the parent's blood through the placenta to the baby. Alcohol is broken down more slowly in the baby than in an adult. Alcohol levels can stay high in the baby's body. This affects development. No amount of alcohol during pregnancy is safe. There is no safe time to drink in pregnancy. Even light or moderate drinking can affect the growing baby. 

What are the symptoms of FASD?

Babies or children with FASD may have:

• Slow fetal growth and low birth weight

• Alcohol withdrawal symptoms in newborns, such as high-pitched cry, jitteriness, and seizures

• Sleep and sucking problems in infancy

• Abnormalities of the face, such as small eyes and thin mouth

• Shorter height than other children of the same age

• Poor physical coordination

• Hyperactivity

• Learning or thinking problems or low IQ

• Speech or language delays

• Problems with daily living, reasoning, and judgment

The symptoms of FASD may look like other health conditions or problems. Make sure your child sees their healthcare provider for a diagnosis.

How is FASD diagnosed?

Most often, a healthcare provider can diagnose FASD based on the person's history and how the baby looks. The provider will examine the baby to look for changes in the face, eyes, and upper lip. A newborn may show signs of alcohol withdrawal. These include shaking and high-pitched crying. Older children may have learning tests. The provider will check for development problems. There is no single test to diagnose FASD. 

How is FASD treated?

Newborns may need special care in the newborn intensive care unit. A newborn may get medicine to help with alcohol withdrawal. 

The physical problems seen in FASD last throughout life. But programs can help improve a child's development. Such programs may focus on improving a child's behavior with early education and tutoring. Programs also help parents with parenting skills. Medicine may help a child's attention problems or hyperactive behaviors. Over time, your child may get help from special education programs and social services.

What are possible complications of FASD?

Complications of FASD can range from mild learning disabilities to more severe behavior and mental problems. Physical disabilities or birth defects in children with FASD don't get better. Long-term problems may include:

• Mental health problems

• Poor social skills

• Unemployment

• Not finishing school

What can I do to prevent FASD in my child?

FASD is 100% preventable. But this means a person must stop using alcohol before getting pregnant. No amount of alcohol is safe. A person should stop drinking at once if they think they could be pregnant.

How can I help my child live with FASD?

FASD is a life-long condition. Most states have early intervention programs. Public school systems can also offer support to children with FASD. State and local social services can help families with special education and social services. Studies have shown that getting help early is best. Children with FASD also are helped by being in a loving, nurturing, and stable home. Parents may also need respite care. This means that someone else takes over the care of the child for a short time. This gives the parents a break so they can take care of other family needs. Ask your child's healthcare provider about services in your area.

Key points about FASD

• FASD is a group of physical, mental, and social problems in a child that are caused when a person drinks alcohol during pregnancy.

• The problems include abnormalities of the face and central nervous system and poor growth. FASD can also cause mental health, behavior, and development problems. 

• There is no cure for FASD. But getting help early can help improve a child's behavior.

• Medicine may help a child's attention difficulties or hyperactive behaviors.

• Families may also get help by learning parenting skills and having access to respite care.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s healthcare provider after office hours, and on weekends and holidays. This is important if your child becomes ill and you have questions or need advice.