Tomorrow, September 9th, is International Fetal Alcohol Spectrum Disorder (FASD) Day. With that in mind, let’s explore what fetal alcohol spectrum disorder is and if it is different from fetal alcohol syndrome. We will also discuss some of the most common questions people have about this spectrum and syndrome.
What is FASD? And is FAS The Same Thing?
Physical Traits of FASD and FAS
Fetal alcohol spectrum disorders (FASD) is a collection of physical, cognitive, and behavioral problems that can show up in children who were exposed to alcohol while in utero. FASD may present physically as a smooth philtrum—the are between the nose and upper lip which ascends from the cupid’s bow, a smaller than average head size, low body weight, shorter stature, small eyes, a thin upper lip, small palpebral fissures, the presence of epicanthal folds, some ear anomalies, a small and upturned nose, and/or a low nasal bridge.
With Fetal Alcohol Spectrum Disorder, not all physical features will be seen. In fact, some physical features might not be seen at all in someone with FASD. For Fetal Alcohol Syndrome (FAS), however, three distinct physical features will be seen: small palpebral fissures (the width of the eyes is reduced), a thin upper lip, and a smooth philtrum as assessed against the Lip-Philtrum Guide specific to ethnicity. All FAS cases are FASD cases, but not all FASD cases are FAS. FAS is on the more severe side of the spectrum that is FASD.
Some physical traits may not be easily seen, such as heart defects, vision problems, hearing deficits, kidney issues, and bone concerns. The brain size may be small as to accommodate the smaller head circumference. Seizures can also be a concern amongst these children.
Cognitive, Behavioral, or Learning Disabilities in FASD or FAS
Particularly in children, both FASD and FAS can impact their outward capabilities. It can range from hyperactive behavior, learning disabilities, delays in their speech, intellectual disability, poor judgement and reasoning skills, attention deficits, poor memory, and difficulty with sleep as an infant.
As FASD is a spectrum, the cognitive concerns can be incredibly mild or severe to the point of needing intervention and intensive supports for the parent or caregiver(s). While there are a number of signs and symptoms that cross-over in this realm between FASD/FAS and Autism, the two are not interchangeable and in fact, autism rarely linked with FASD/FAS. FASD is more than twice as common than autism. Attention Deficit Hyperactivity Disorder, however, is a diagnosis that is seen frequently with FASD/FAS children and adults.
Physical development may be difficult for infants and children with FASD or FAS as it can interfere with coordination or balance. Processing information may be difficult for them and thus their ability to learn new things, including physical movement, can be inhibited. Infants may appear more limp than their like-aged counterparts.
More severe forms of Fetal Alcohol Spectrum Disorder can be diagnosed at birth, such as Fetal Alcohol Syndrome, however, some may not be diagnosed until early or later childhood as the behavioral and cognitive factors become more apparent.
How is Fetal Alcohol Syndrome or Spectrum Disorder Diagnosed?
As we discussed in the beginning, the disorder is a spectrum and can hold a wide range of signs and symptoms, some of which can be seen visually when a baby is born. Others are observed through an infant’s behavior or during a child’s development. An infant born with small eyes, a thin upper lip, and a smooth philtrum may be monitored for other signs of a suspected Fetal Alcohol Syndrome. These other signs can be a poor APGAR score, poor muscle tone, difficulty sleeping, and/or difficulty nursing secondary to a poor sucking reflex.
For kids who fly under the radar due to limited or absent physical features, behavioral assessments performed by professionals may help to diagnose the spectrum disorder.
Can a father’s alcohol consumption cause FASD or FAS?
No. A father’s alcohol consumption prior to or during conception will not contribute to these Fetal Alcohol Spectrum Disorders. From what we currently know, this spectrum develops while the fetus is developing inside the womb. The father only provides a single chromosome that holds no nutrients to enrichen the infant in its development, so it cannot negatively impact the fetus’ development.
Can one drink cause it or can one drink of wine hurt a developing baby during pregnancy?
We simply do not know. What we do know is that there are different times during embryonic development that can increase the risk of damage to the baby. We cannot recommend any alcohol at all to be safe during pregnancy.
Sometimes, women will find themselves pregnant unintentionally and during the first few weeks of the pregnancy, the woman may have had multiple episodes of drinking. This is of course incredibly distressing for women as they fear for the health of their baby. It isn’t until around the third week post-fertilization (4-6 weeks pregnant, depending on last menstrual period) that maternal alcohol consumption can more clearly affect the developing embryo to the point of birth defects. Prior to that point, alcohol consumption may contribute to failure to implant/initiate pregnancy, or induce an early miscarriage.
Of course, there is no steadfast rule and no guarantee that your baby will be healthy, but it is worth it to try and turn things around now. If you find yourself pregnant after a weekend of partying or if you find yourself pregnant in the middle of an alcoholic lifestyle, it is not too late to reach out to your doctor or midwife and get the support you need to have a health pregnancy.
Selected Books For Caregivers, Kids, and Loved Ones
I did a quick search through Amazon to see what books were available on the market, addressing fetal alcohol spectrum disorders and fetal alcohol syndrome. I was really surprised and happy to see a number of books available. In particular, I found a series following Strawberry and Cracker, who are twins living with the syndrome. The series is aimed at a younger audience of 5-12 years of age, making it a really kind way to introduce kids to the idea of the differences and challenges some people may experience. The book series is written by Barbara Studham, who has experience with raising children with the spectrum and disorder. This book in particular addresses the twins learning about their disorder.
Specific to caregivers, Understanding Fetal Alcohol Spectrum Disorder: A Guide to FASD For Parents, Carers, and Professionals is written by Maria Catterick and Liam Curran and has received a number of positive reviews.
The links above do have an affiliate code in it, but the contents of this post is written through the lens of professionalism with the intent of helping to educate others and spread awareness for FASD/FAS.
