Fetal Alcohol Syndrome

Fetal alcohol syndrome is a group of physical and mental birth defects that can affect the children of mothers who drink alcoholic beverages during pregnancy.

The Leading Known Cause of Mental Retardation

In the United States, the law requires that every bottle or can of beer, wine, or hard liquor that is sold must include the following information on its label: "(1) According to the Surgeon General, women should not drink alcoholic beverages during pregnancy because of the risk of birth defects; (2) Consumption of alcoholic beverages impairs your ability to drive a car or operate machinery and may cause health problems." The first warning refers to the risk of fetal alcohol syndrome (FAS), the leading known cause of mental retardation in the United States. The good news is that this condition is 100 percent preventable as long as a woman does not drink alcohol while she is pregnant.

What Are FAS and FAE?

FAS is a group of physical and mental birth defects that can affect the children of mothers who drink alcohol during pregnancy. Typically, the worst cases are seen in the offspring of mothers who drank heavily. In general, the more the mother drank, the more severe the baby's physical and mental problems are likely to be. The term fetal alcohol effects (FAE) often is used to refer to a less severe form of the syndrome. Since there is no proof that even small amounts of alcohol are safe for unborn children, doctors recommend that women completely avoid alcohol while they are pregnant. Both FAS and FAE have serious long-term consequences for affected children and their families.

According to the American Academy of Pediatrics, there may be as many as 10,000 to 12,000 new cases of FAS each year. In addition, there are probably many more cases of FAE. The exact number is not known, however. Since FAE does not cause the obvious physical defects seen in FAS, it can be difficult to diagnose correctly. To confuse matters further, mothers who drank during pregnancy may hide this fact from their doctors or lie about how much they drank. Experts believe that many children who now are thought to have learning disabilities may actually have undiagnosed FAE.

What Are the Symptoms of FAS and FAE?

Just as alcohol affects the brain of an adult who drinks, it also affects the brain of a developing fetus (FEE-tus), or unborn baby, who is exposed to it before birth. The most serious consequence of a mother's alcohol use during pregnancy is impaired brain development in the fetus, leading to mental retardation. Newborns with FAS often have small brains, indicating poor brain growth while they were inside their mothers, and they typically are small for their age. Other physical defects associated with FAS are narrow eyelids, a flattened midportion of the face, abnormal creases on the palms of the hands, heart defects, hearing and vision problems, and joint abnormalities. These problems are permanent.

Children with FAE may not have these physical defects. However, children with either FAS or FAE are likely to have behavioral and emotional problems. FAS and FAE can cause learning difficulties and slow down a child's development of speech, motor skills, and coordination. Children with these conditions often are impulsive, inattentive, and

disorganized. They may have little understanding of the consequences of their behavior. They also may have trouble with following directions, solving problems, listening to people in authority, and socializing with peers. Sometimes these symptoms do not become evident until a child is 3 or 4 years old.

Living With FAS and FAE

Life for children and young people FAS or FAE is often very difficult. Parents, caregivers, teachers, and other adults in authority need to be consistent and firm, setting predictable routines for the young person to follow. Adults may find that they have to repeat instructions again and again, making sure the child knows what is expected. Clear consequences for inappropriate behavior and rewards for appropriate behavior can be used to help the child make better choices. These children also tend to learn best when tasks are broken down into small pieces and new concepts are taught through concrete examples. In addition, medication may be part of the treatment plan.

Many children with FAS or FAE attend special education classes, just like other students who have learning disabilities or mental retardation. This gives them a chance to work with a specially trained teacher that would not be possible in the regular classroom.