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DESCRIPTION
Alcoholic beverages are not healthy for the fetus or the mother-to-be. In adults, the liver breaks down the alcohol. Alcohol can cross the placenta and your baby's liver is not yet able to break down the alcohol. Thus, in the case of heavy drinking, alcohol can cause fetal alcohol syndrome [FAS], a combination of irreversible birth abnormalities. Fetal alcohol syndrome has been reported in babies of women who drank 2 mixed drinks or 2 to 3 bottles of beer or glasses of wine a day. Lesser degrees of alcohol can result in less severe birth defects (fetal alcohol effect [FAE]). No safe level of alcohol consumption has been determined.
The incidence (number of new cases each year) of FAS and FAE are significantly under-reported. Therefore, projections are usually based on estimates of their occurrence per 1,000 live births. Recent studies by researchers Ernest Abel and Robert Sokol suggest that the incidence of FAS can conservatively be estimated at 0.33 cases per 1,000 live births.
FREQUENT SIGNS & SYMPTOMS
Alcohol may affect the baby in many ways. the more you drink, the greater the risk. Fetal Alcohol Syndrome (FAS) is a pattern of mental and physical defects which develops in some unborn babies when the mother drinks too much alcohol during pregnancy. A baby born with FAS may be seriously handicapped and require a lifetime of special care. Some babies with alcohol-related birth defects, including smaller body size, lower birth weight, and other impairments, do not have all of the classic FAS symptoms. These symptoms are sometimes referred to as Fetal Alcohol Effects (FAE). Researchers do not all agree on the precise distinctions between FAS and FAE cases.
Fetal Alcohol Syndrome - infants are shorter and lighter in weight; smaller heads; abnormal features of the face, head, joints and limbs; heart defects and poor control of movement. As they get older, mental retardation is common, as is hyperactivity, extreme nervousness, memory, learning speech, behavior, and poor attention span. The effects are not reversible and may show up later in life.
Possible FAS Symptoms:
- Growth Deficiencies: Small body size and weight, slower than normal development and failure to catch up.
- Skeletal Deformities: Deformed ribs and sternum; curved spine; hip dislocations; bent, fused, webbed, or missing fingers or toes; limited movement of joints; small head.
- Facial Abnormalities: Small eye openings; skin webbing between eyes and base of nose; drooping eyelids; nearsightedness; failure of eyes to move in same direction; short upturned nose; sunken nasal bridge; flat or absent groove between nose and upper lip; thin upper lip; opening in roof of mouth; small jaw; low-set or poorly formed ears.
- Organ Deformities: Heart defects; heart murmurs; genital malformations; kidney and urinary defects.
- Central Nervous System (CNS) Handicaps: Small brain; faulty arrangement of brain cells and connective tissue; mental retardation - usually mild to moderate but occasionally severe; learning disabilities; short attention span; irritability in infancy; hyperactivity in childhood; poor body, hand, and finger coordination.
CAUSES
Chronic (and probably binge-type) alcohol consumption during pregnancy. Alcohol intake can effect the unborn child during the first trimester by interfering with organ development, the second trimester it is associated with mental retardation and the third trimester, retardation of fetal growth.
RISK INCREASES WITH
The greater the alcohol consumption, the greater the risk for birth defects and their severity. Severity also depends upon the gestational age of the fetus at the time of alcohol consumption. The earlier in pregnancy, the greater the risk for more severe deformities occurring in the fetus.
Pregnant women not receiving prenatal health care are at greater risk.
PREVENTIVE MEASURES
Pregnant women (or those likely to become pregnant) should not drink any alcoholic drinks (or use any drugs of abuse). There is not sufficient evidence that indicates and occasional glass of wine or beer is dangerous, but complete abstinence is best and recommended by most midwives and health care providers.
If you are concerned about your alcoholic consumption, seek help from your midwife or health care provider, Alcoholics Anonymous or other support groups.
Get early and continuing prenatal care.
EXPECTED OUTCOME
If maternal alcohol consumption continues, the outcome is unpredictable.
Discontinuance of maternal alcohol consumption assures the best pregnancy outcome.
POSSIBLE COMPLICATIONS
For the child, the defects are generally irreversible. The complications may be mild or severe.
TREATMENT
GENERAL MEASURES
If you drink a few alcoholic beverages (not heavy consumption) before you learned you were pregnant (usually within the first few weeks), it is unlikely that they will affect the unborn child, but do discuss it with your midwife. You may want to get an ultrasound to check our fetal development.
Abstain from drinking alcoholic beverages as soon as you know you are pregnant. The sooner you stop drinking, the less risk there is to the baby.
If you continue to drink alcohol while pregnant, advise your midwife and discuss the problem.
Try to determine how you use alcohol in your life and find substitutes. If the alcohol helps you relax, substitute warm baths, exercise, reading or massage; if the drinking is part of daily ritual such as wine with dinner, drink a non-alcoholic wine-type drink (unless this triggers a desire for alcohol). If you go out to socialize, you may consider drinking a beer such as O'Douls "non-alcoholic" beer ( with 0.4 percent alcohol as compared with regular beer having 4.2 to 10.0 percent alcohol, keeping in mind there is still a very small amount of alcohol in O'Douls, but you would have to drink at least 10 of them to have the same alcohol you would consume with just one regular beer with 4 percent alcohol). If you are an alcoholic, avoid any drink or product that contains alcohol. Fruit juice is always a good choice or a "virgin" drink without the liquor. Try to keep the sodas down to a minimum (high sodium content).
The stresses or difficult situations that caused you to find comfort and solutions in alcohol drinking will need to be faced or avoided.
Join a support group in your community. Additional information is available from: Alcoholics Anonymous
475 Riverside Dr. 11th Floor
NY, NY 10115
(212) 870-3400
If you know a family member or friend who is pregnant and continues to drink alcohol, talk to her about your concern and the risk she is taking with her unborn child.
If you are a parent of a child with fetal alcohol syndrome, get the appropriate help needed for the child's development. Get help for yourself if the alcohol problem is continuing or if you need other psychological or emotional support.
National Organization on Fetal Alcohol Syndrome
MEDICATION
Medicine is usually not necessary for this problem.
ACTIVITY
Usually no restrictions except those that may be concerned with the pregnancy.
DIET
Eat a well balanced diet. Your midwife may give you some Nutritional Guidelines to follow.
NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...
You are pregnant or think you might be pregnant and are continuing to drink alcoholic beverages.
You want to stop the alcohol drinking and need help in coping.
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