What is Fetal Alcohol Spectrum Disorder?
Fetal alcohol spectrum disorder (FASD) refers to the range of problems caused by a mother exposing an unborn baby to alcohol during pregnancy.
If a woman drinks alcohol while she is pregnant, the alcohol crosses the placenta from her blood into the baby’s bloodstream and the baby is exposed to similar concentrations of alcohol as the mother.
The effects of alcohol on a fetus include:
- harm to the development of the fetal nervous system, including the brain
- under-nourishment of the growing baby
- triggering of changes in the development of the baby’s face, resulting in the typical FASD facial features.
Babies severely affected by FASD are at risk of dying before they are born.
Not all babies exposed to alcohol develop FASD. The risk of harm to the fetus is highest when the mother drinks a large amount of alcohol very often – for example if she is a heavy drinker or frequently binge drinks.
To avoid FASD, avoid alcohol when pregnant
The National Health and Medical Research Council (NHMRC), Australia’s main health research organisation, recommends that for women who are pregnant or planning a pregnancy, not drinking alcohol is the safest option.
The World Health Organization recommends that pregnant women be advised not to drink alcohol.
Diagnosis of FASD
An accurate diagnosis of FASD is important. It can help provide appropriate care for the child and prevent FASD happening again in any later pregnancy.
The three main features used to make a diagnosis of FASD are:
- significant problems with learning and behaviour
- certain facial features that are known to be associated with FASD
- a history of prenatal alcohol exposure.
Facial features associated with FASD include:
- short horizontal length of the eye opening, from the inner corner to the outer corner of the eye
- a smooth philtrum (the usually ridged area of skin between the upper lip and the nose)
- a thin upper lip.
Learning and behavioural problems may include:
- learning difficulties
- memory problems
- limited attention span / ease of distraction / hyperactivity
- difficulty relating actions to consequences
- difficulty following instructions (but able to repeat them verbally)
- difficulty with abstract thinking – such as about mathematics, money or time
- slow cognitive processing (thinking)
- difficulty with social relationships
Other findings that are seen more commonly in children with FASD are birth defects, slow growth before and after birth and delayed development. Detailed information about the characteristics of FASD can be found in the NOFASD fact sheet ‘FASD – Characteristics across the lifespan’.
The Australian Guide to the diagnosis of FASD sets out the diagnostic criteria to help doctors make a diagnosis of FASD. These guidelines were updated in 2016.
In severe cases, FASD may be diagnosed at birth, but in many cases, the diagnosis occurs later, when the child is having problems with learning or behaviour. Sometimes, the condition is never diagnosed.
Children grow and develop at different speeds. If you’re worried about your child’s development it’s a good idea to speak with your GP or maternal and child health nurse.
Treatment of FASD
FASD causes lifelong disability and cannot be cured, but a person with FASD can be assisted by programs to help them with their learning and behaviour. Such assistance can enable a person with FASD to maximise their independence and achievements.
Treatment programs are individualised and are usually coordinated by a developmental paediatrician. A wide range of educational and behavioural strategies have been shown to be effective in children with FASD, and stimulant medication may be helpful for the management of attention-deficit/hyperactivity disorder.
Occurrence of FASD is unknown
Researchers estimate that FASD occurs in one in 100 children, but the incidence of FASD varies from study to study for a number of reasons, including:
- While FASD is considered internationally to be the leading preventable cause of intellectual and developmental problems, there is evidence that FASD is under-diagnosed. Parents and doctors may not realise that FASD is the cause of a child’s developmental problems.
- Maternal intake of alcohol varies during a pregnancy and can be difficult to accurately record.
- Alcohol may not be the only drug consumed during pregnancy.
- There are many environmental and individual factors that can contribute to learning and behavioural problems. Many children diagnosed with alcohol-related problems are exposed to social difficulties that may also impact on their development.
Where to get help
This page has been produced in consultation with and approved by:
Victorian Clinical Genetics Services (VCGS)
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