Alcohol and drug abuse

What is Fetal Alcohol Spectrum Disorder?

Fetal Alcohol Spectrum Disorder is not a disease, but rather permanent brain damage caused by the consumption of alcohol during pregnancy and breastfeeding. Prenatal alcohol use is one of the leading preventable causes of birth defects and developmental disabilities. Fetal Alcohol Syndrome cannot be treated or reversed, and its effects are lifelong and tragic.

Fetal Alcohol Spectrum Disorder is not a condition affecting solely expectant families and the children they bring forth. It affects all levels of society. This impact cannot be ignored. Fetal Alcohol Spectrum Disorder is the leading cause of mental retardation and the neurobehavioral effects of alcohol on the fetus are far more serious than the effects of other drugs such as heroin, cocaine and marijuana.¹

How does a mother's drinking affect her unborn child?

Birth defects associated with prenatal alcohol exposure can occur in the first 3 to 8 weeks of pregnancy, before a woman even knows she is pregnant. If a woman drinks while pregnant, essentially, so does her baby. Blood vessels in the placenta and umbilical cord provide the fetus with nourishment and oxygen. Thus, blood alcohol is also transferred to the fetus and enters its bloodstream.

Alcohol is a tetrogen, a substance toxic to human development. Depending on the timing, amoung and pattern of alcohol consumption, alcohol entering an unborn baby's blood supply can interfere with healthy development.² In other words, by drinking during pregnancy, a woman puts her developing fetus at risk for a wide spectrum of adverse effects including:³

• spontaneous abortion
• small birth weight or size, as compared to their healthy peers
• growth retardation
• physical, mental, and behavioral abnormalities
• poor coordination
• sleep and sucking disturbances in infancy
• hyperactive behavior and learning disabilities
• facial abnormalities such as small eye openings
• impairments of the central nervous system, such as
  • developmental delay
  • speech or language delay
  • mental retardation or lower IQ
  • decreased head circumference
  • poor reasoning and judgment skills

In the worst cases, prenatal exposure to alcohol may result in fetal death. In addition, Fetal Alcohol Spectrum Disorder (FASD) is not a condition affecting solely expectant families and their children: Fetal Alcohol Effects, Alcohol-Related Neurological Disorder and Alcohol-Related Birth Defects affect all levels of society. People with FASD often experience additional problems as they get older such as mental health problems, disrupted school experiences, trouble with the law, unemployment, and inappropriate sexual behavior.⁴

Outcomes of prenatal alcohol consumption

Many people falsely believe that a single drink during pregnancy can cause FASD. Prenatal alcohol exposure does not always result in Fetal Alcohol Spectrum Disorder. Although most babies exposed to alcohol before birth do not have the characteristic facial abnormalities and growth retardation associated with FASD, they do suffer brain and other impairments that are no less significant.⁵

More specifically, Alcohol-Related Neurodevelopmental Disorder (ARND) describes functional or mental impairments linked to prenatal alcohol exposure, such as behavioral or cognitive abnormalities including learning difficulties, poor school performance, poor impulse control, and problems with mathematical skills, memory, attention, and/or judgment. Alcohol-Related Birth Defects describes malformations of the skeletal system and major organ systems, such as defects of the heart, kidneys, bones, and/or auditory system.⁶

Although FASD is 100% preventable when a woman completely abstains from alcohol during pregnancy, in the United States each year, a shocking 12,000 babies are born with Fetal Alcohol Syndrome and nearly 35,000 are borth with Alcohol-Related Neurological Disorder and Alcohol-Related Birth Defects. Fetal Alcohol Spectrum Disorder affects more children each year than Down Syndrome, cystic fibrosis, spina bifida and Sudden Infant Death Syndrome (SIDS) combined.⁷

Can a woman drink safely during pregnancy?

There is no known safe amount of alcohol during pregnancy.

The Royal College of Obstetricians and Gynaecologists recently conducted a large study including 400,000 American women, all of whom had consumed alcohol during pregnancy. Not a single case of fetal alcohol syndrome occurred and no adverse effects on children were found when consumption was under 8.5 drinks per week. The guidelines of the Royal College of Obstetricians and Gynaecologists further recommend that "women should be careful about alcohol consumption in pregnancy and limit this to no more than one standard drink per day." Negative effects appear to be related to relatively higher levels of consumption per occasion, and hence, to higher blood alcohol content levels. Alcohol in the mother's blood crosses the placenta freely and enters the embryo or fetus through the umbilical cord.⁸

The American College of Obstreticians and Gynecologists concludes that "There is no evidence that an occasional drink is harmful." and points out that "It's hard to determine the amount and timing of alcohol consumption that puts the fetus at risk."⁹

Of course, alcohol consumption during pregnancy may have very subtle or undetectable effects. Thus, until more is known for certain, pregnant women may be well advised to exercise their safest option, that of completely abstaining during pregnancy and breastfeeding.¹⁰

Who's at risk?

It's been suggested that those who give birth to FASD children characteristically smoke, use illegal drugs, are frequently malnourished, and rarely receive adequate medical care during pregnancy. It's also been suggested that because of their addiction, these women are virtually immune to our current educational approach, perhaps because so many of them are poorly educated and often lead marginal lives.¹¹ This is a blanket generalization. FASD affects children of all socioeconomic levels. This is not just a poor person's problem nor is it restricted to any particular culture. The incidence is high and it affects everyone.

What if I'm pregnant?

If you consumed alcohol before realizing you are pregnant, it's important to stop drinking now. The sooner you stop drinking, the better your chance of having a healthy baby. You could be pregnant and not know it—if you are sexually active and engaging in high-risk sexual activity, you should consider either using contraception or abstaining from alcohol. Similarly, it's also important to avoid drinking if you are trying to become pregnant and if you are breastfeeding.

As we've seen, the effects of FASD are irreversible and tragic. FASD, however, is completely preventable. It's important, therefore, to increase public awareness and education and to increase access to prenatal care. Other strategies include the screening of all women of childbearing age for alcohol problems and the use of appropriate strategies, such as treatment for alcohol problems. The key is to eliminate drinking before conception.¹²

How can I make a difference?

Many parenting organizations throughout North America are applauding an Alberta (Canada) program known as Born Free, a project initiated November 1, 1999. Through the Born Free project, some Alberta restaurants and lounges have become partners in helping to reduce the number of babies being born with FASD by offering free non-alcoholic drinks to pregnant women. The rogram encourages women to make healthy choices.¹³

Take action¹⁴

Write to or lobby your politicians on a local, provincial/state, and national level. Insist that the same amount of emphasis must be placed on FASD as has been placed on drinking and driving campaigns. Insist that a portion of liquor tax revenues must be placed into education and prevention programs.

Although beer and liquor companies fund responsible drinking campaigns, they should also be allocating significant dollars to educating women about the dangers of drinking during pregnancy. You can write to or lobby major liquor companies to encourage them to fund education, research, and prevention programs.

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1. Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention and Treatment. Institute of Medicine. (1996)
2. What is Fetal Alcohol Syndrome? No FAS.
3. Fetal Alcohol Syndrome. Wellness Partners LLC. (2004)
4. Fetal Alcohol Syndrome. Wellness Partners LLC. (2004)
5. What is Fetal Alcohol Syndrome? No FAS.
6. What is Fetal Alcohol Syndrome? No FAS.
7. What is Fetal Alcohol Syndrome? No FAS.
8. What is Fetal Alcohol Syndrome? D. J. Hanson. (2002)
9. What is Fetal Alcohol Syndrome? D. J. Hanson. (2002)
10. What is Fetal Alcohol Syndrome? D. J. Hanson. (2002)
11. What is Fetal Alcohol Syndrome? D. J. Hanson. (2002)
12. What is Fetal Alcohol Syndrome? No FAS.
13. You CAN Help Prevent Fetal Alcohol Syndrome and Fetal Alcohol Effects. Spruce Grove Born Free Project.
14. You CAN Help Prevent Fetal Alcohol Syndrome and Fetal Alcohol Effects. Spruce Grove Born Free Project.