Home / Treating an Alcoholic With Comorbid Medical Issues / Fetal Alcohol Syndrome (Dysmorphic)

It is well-known that drinking can harm fetal development during pregnancy. This can include the earliest stages of pregnancy, so drinking at all while attempting to become pregnant can be harmful to the child.

When a baby is born with developmental damage from maternal alcohol use, there are several related conditions called fetal alcohol spectrum disorders (FASDs) that could lead to difficulty learning, remembering, or thinking; the condition could stunt the child’s growth, or both. Although FASD is preventable, the Centers for Disease Control and Prevention (CDC) reports about 0.2 to 1.5 infants are born with FASD out of every 1,000 births in the United States. However, as the conditions associated with FASDs change, it is hard to estimate how many people may have this developmental disorder.

Fetal alcohol syndrome (FAS) is one of the most serious FASDs and one of the first identified. In 1973, the cluster of physical, mental, and behavioral symptoms associated with FAS was described in medical literature. The most extreme form of FAS involves fetal death during pregnancy because development is so harmed by maternal alcohol consumption. People who survive childhood with FAS may have unusual facial features, growth problems, and development delays or damage in their central nervous system (CNS). These mental changes may include cognitive or thinking problems, struggles with memory, reduced attention span, communication problems, poor vision, and poor hearing. It is likely that a child diagnosed with FAS will have a combination of these issues.

What Causes Fetal Alcohol Syndrome? Alcohol is a teratogen, meaning it is a substance that can cause harm to a fetus in development. The cause of any FASD, including fetal alcohol syndrome, is when alcohol enters the bloodstream and, like other food and drink consumed by the mother, the toxin passes through the placenta and affects the child.
Fetuses consume a lot of what the mother does, and since the baby is still developing, blood alcohol content (BAC) in the infant will rise much faster than in the mother. The fetus does not metabolize alcohol from shared blood as fast as an adult body does, so the infant remains intoxicated for much longer. The more a woman drinks while pregnant, the more likely she is to harm her unborn baby.

Signs of Fetal Alcohol Syndrome

According to the American Academy of Pediatrics (AAP), alcohol abuse appears to be most harmful in the first trimester, or during the first three months of pregnancy.

Physical signs that a child or adult may have FAS include:

  • Small head
  • Facial features that are different, including small and wideset eyes, thin upper lips, short and upturned noses, or smooth skin between the nose and upper lip
  • Deformities of the fingers, extremities, or other joints
  • Slow physical growth, low birth weight, or small stature or low weight during childhood
  • Hearing and vision problems
  • Heart defects
  • Kidney problems
  • Bone development issues or bone conditions like osteoporosis

Brain-related effects of FAS include:

  • Poor coordination or balance
  • Learning disorders
  • Delayed mental development compared to peers
  • Poor memory
  • Trouble processing information
  • Difficulty paying attention
  • Trouble identifying consequences of actions
  • Impulse control problems
  • Poor judgment
  • Hyperactivity
  • Rapid mood swings

Depending on FAS’s severity, developmental issues may be noticed during infancy, but in many cases, developmental and behavioral problems may not become apparent until the child enters preschool or elementary school. Behavioral issues can include:

  • Trouble with academics and socializing with peers
  • Difficulty understanding social cues and making friends
  • Problems adapting to change
  • Aggression or breaking rules
  • Trouble switching between tasks, such as in class or on the playground
  • Poor concept of time
  • Impulse control struggles
  • Difficulty staying on task in class or in a group
  • Trouble understanding goals and working toward them

Adults with FAS may struggle to maintain employment, experience mood or behavioral disorders, and suffer from isolation or social problems. Getting treatment early in life to manage these issues through education and therapy is important. People with FAS, or their parents, may qualify for Social Security Disability Benefits (SSDI), which can help to remove some worry about the individual’s future security.

Treating Fetal Alcohol Syndrome

FAS is a lifetime condition, meaning that a child born with FAS will always have it. There are no medications that specifically treat this disorder, although some medicines like antidepressants or stimulants may be used to treat specific symptoms, like anxiety or hyperactivity. Behavioral therapy is a more common approach and more helpful in the long-term. Training in schools or special classes can help children with FAS understand how to navigate the world, depending on their skill level and needs. Parents and siblings may also benefit from classes geared toward understanding and raising children with FAS.

Many women who are or may become pregnant may not be able to afford treatment for alcohol use disorder, or they may not be able to access treatment for other reasons. Fortunately, more treatment programs have options specifically for women who need help overcoming alcohol use disorder so they can maintain custody of their children, get help for their unborn child, and learn skills to stay away from alcohol.