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Fetal Alcohol Syndrome

We all like to have a drink every now and then, but drinking alcohol while pregnant is dangerous, and can result in permanent harm to your developing baby. Drinking excessively while pregnant can cause miscarriage or stillbirth, and even a small amount of alcohol while pregnant—especially during the first and second trimester—can cause Fetal Alcohol Syndrome, which is part of a wider spectrum of alcohol-related disorders known by the blanket term Fetal Alcohol Spectrum Disorder (FASD). Alcohol is the most harmful intoxicant a pregnant woman can ingest. It is worse than nicotine or marijuana, and even worse than cocaine or heroin. Fetal Alcohol Syndrome (FAS) causes permanent damage to the central nervous system, which includes the brain. Babies born to mothers who drink too much alcohol while pregnant are at risk for:

  • Lower intelligence
  • Aggressive behavior
  • Stunted growth
  • Facial deformities, including microcephaly
  • Neurological disorders, including epilepsy
  • Attention Deficit Disorder
  • Poor development of social skills
  • Heart problems
  • Kidney problems
  • Poor development of motor skills

Effects of Fetal Alcohol Syndrome on the Brain

Children born to mothers who drink alcohol while they are pregnant often have cognitive disabilities, such as difficulty with learning and remembering. They have difficulty regulating their emotions and are often unable to anticipate the consequences of their actions, and so they tend to have problems with impulse control. They have trouble understanding and following directions, which causes them to fail at performing simple tasks. The frustration caused by this handicap, combined with their limited ability to control their emotional responses, can often get them into serious trouble when they get older.

Physical Deformities Resulting From Fetal Alcohol Syndrome

In addition to the terrible damage it can cause to a developing baby’s brain, FAS causes numerous physical handicaps as well. While children born with this condition tend to have poor muscle tone and coordination, and are prone to serious heart conditions, the effect of FAS on their physical appearance can be heartbreaking. The characteristic appearance of FAS is not unlike that of Down Syndrome (including wide-set eyes with a large epicanthal fold), and many FAS babies have abnormally small heads and upper jaws. Thin, abnormally smooth upper lips are also not uncommon—the philtrum (the little groove in the center of your upper lip) is often entirely absent. Babies suffering from Fetal Alcohol Syndrome also tend to have had their growth stunted while in the womb, and may have a low birth weight. In addition to heart and muscle defects, they are prone to joint and skeletal disorders, and often experience kidney problems. Heart murmurs are especially common in infants, although this symptom sometimes resolves itself as the child grows older.

The Beginning of Fetal Alcohol Syndrome

Alcohol passes from the mother to the baby via the placenta, easily penetrating the placental barrier that protects a developing fetus from other threats. Even small amounts of alcohol can affect the baby, and greater amounts—15 drinks or more per week—have been shown in studies to have a serious effect on birth weight.

Fetal Alcohol Spectrum Disorder

Fetal Alcohol Spectrum Disorder is a broader term than Fetal Alcohol Syndrome, and it encompasses a range of disorders that can arise from drinking while pregnant. These include, in addition to Fetal Alcohol Syndrome, more specific conditions like Alcohol-Related Neurodevelopmental Disorder (ARND) and Partial Fetal Alcohol Syndrome (pFAS). Generally speaking, children born with these conditions may manifest only some of the characteristic symptoms of Fetal Alcohol Syndrome. For example, they may look perfectly normal but have the same emotional and intellectual disabilities that most FAS sufferers face. Or they may have heart conditions or neurological problems without the intellectual disabilities often seen with FAS. Children suffering from FAS-related facial deformities, however, typically also suffer from the stunted brain development associated with the most severe cases of Fetal Alcohol Syndrome.

Drinking Alcohol While Breastfeeding

While drinking alcohol during pregnancy is definitely a bad idea, there is a bit of popular folk wisdom to the effect that drinking moderate amounts of beer can actually be beneficial for breastfeeding. This is partly true. According to the National Institute of Health, beer can stimulate the production of the hormone prolactin, which in turn can increase milk production. The element responsible for this is not alcohol, but a component of the barley from which the beer is made, so this effect can actually be achieved just as well with non-alcoholic beer. This is an important distinction to make, as some studies suggest that infants drink less milk—possibly as much as 20 percent less—if that milk contains alcohol. In light of this, if you must drink beer while breastfeeding, it is advisable to wait at least one hour per beer for the alcohol to leave your system. You may want to use a breast pump to ensure that you have a supply of uncontaminated milk on hand in case your baby gets hungry after you’ve had a few beers.

Questions to Ask Your Doctor About Drinking Alcohol While Pregnant

  • Is it okay for me to have a single beer or glass of wine every once in a while if I’m pregnant?
  • I went to a party and got very drunk about a week before I realized that I was pregnant; is it likely that I have inadvertently harmed my baby?
  • If my baby is born with Fetal Alcohol Syndrome or some other form of FASD, is there anything that can be done to help him or her live a more normal life?
  • Is it okay to drink beer while I am breastfeeding?
  • If I have the flu, is it okay to take medicines that contain alcohol, such as Nyquil?

Medical References:

    Institute of Medicine (IOM), Stratton, K.R., Howe, C.J., & Battaglia, F.C. (1996). Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment. Washington, DC: National Academy Press. West, J.R. (Ed.) (1986). Alcohol and Brain Development. New York: Oxford University Press. Mayo Clinic http://www.mayoclinic.org/diseases-conditions/fetal-alcohol-syndrome/basics/definition/con-20021015 National Organization on Fetal Alcohol Syndrome http://www.nofas.org/ National Institute of Health http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001909/ http://www.ncbi.nlm.nih.gov/pubmed/11065057 Carlo WA. Fetal alcohol syndrome. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 100.2. Cunningham FG, Leveno KJ, Bloom SL, et al. Teratology and medications that affect the fetus. In: Cunningham FG, Leveno KJ, Bloom SL, et al, eds. Williams Obstetrics. 23rd ed. New York, NY: McGraw-Hill; 2010:chap 14.
[Page updated August 2014]