Fetal Alcohol Spectrum Disorders May Affect More American Children than Previously Estimated, Study Found
A study published in late 2014 in the journal Pediatrics found that between 2.4 and 4.8 percent of children in the United States may have some type of fetal alcohol spectrum disorder (FASD).
The study examined the range of FASDs, which includes four clinical diagnoses: fetal alcohol syndrome, partial fetal alcohol syndrome, alcohol-related neurodevelopmental disorder, and alcohol-related birth defects.
The percentage of children found to be affected by FASD in this study is much higher than most previous estimates. The Centers for Disease Control and Prevention, for instance, estimate that between 0.2 and 1.5 per 1,000 children have some type of FASD.
The study’s lead author offered that the higher numbers in the new study may have resulted from more rigorous, first-hand observations and tests that specially-trained researchers conducted with the children who participated in the study.
Past studies estimating FASD rates in children in the general population had relied mostly on passive methods, such as surveillance or clinic-based studies. Health experts now believe that these more hands-off methods may have underestimated the extent of the problem.
Lead researcher Philip May, PhD, professor of public health at the University of North Carolina at Chapel Hill, commented that while mothers are generally aware that alcohol is harmful to an unborn baby, abstaining from drinking alcohol while pregnant may be a challenge — especially before a woman knows she is expecting. Dr. May believes that the high number of children affected by drinking during pregnancy may be the result of social pressures or women’s difficulty in changing their drinking habits.
For the study, researchers selected a nationally representative town in the Midwest. The town’s average alcohol consumption was about 14 percent higher than the national average, or a liter of alcohol more per person a year. The middle-class town had 32 schools with more than 2,000 first-graders. Around 70 percent of the children’s parents allowed the youths to take part in the study.
The researchers identified children who had developmental problems, or who were below the 25th percentile for height, weight or head circumference — smaller size and a smaller head are two common effects of fetal alcohol syndrome. The children then received memory, cognitive (thinking) and behavioral tests. A comparison group of normally developing first-graders was also given the tests.
Additionally, the children were examined for other physical characteristics of fetal alcohol syndrome, which include small eye openings, a smooth philtrum (the skin between the upper lip and the nose, where most people have an indentation), and a thin red border on the upper lip.
The researchers determined that 6 to 9 of every 1,000 children had fetal alcohol syndrome, and between 11 and 17 had partial fetal alcohol syndrome. The study also identified predictors that a child would have FASDs: the longer it took a mother to know she was pregnant, how often she drank three months before pregnancy, and the more the child’s father drank, the greater the likelihood that the youth would have FASDs.
What Are Fetal Alcohol Spectrum Disorders?
“Fetal Alcohol Spectrum Disorders” is the umbrella term covering a wide range of permanent, lifelong conditions that can be mild to severe. They include many types of physical defects, as well as cognitive, behavioral, emotional and adaptive functioning deficits.
Regular heavy alcohol use during pregnancy puts the unborn child at highest risk for severe problems; but health experts underscore that there is no such thing as a “safe” amount of alcohol to consume during pregnancy, and all alcohol should be avoided.
Alcohol abuse can not only damage the brain itself, but also the neural pathways that the brain uses to communicate with other parts of the body, such as the muscles. That, in turn, can lead to permanent malformations in the muscles and bones. These defects may or may not be apparent at birth.
Of the four sub-categories in FASD, fetal alcohol syndrome (FAS) is the most severe; children with FAS have abnormal facial features, structural brain anomalies, growth problems (including slower or stunted growth, as well as skeletal defects), and behavioral problems. Children at the less severe end of the spectrum may have intellectual deficiencies or behavioral issues, including inability to concentrate and complete tasks.
Babies born to women who abused alcohol may be small or underweight; they may have difficulty nursing or eating, and their growth will continue to lag because of it. These infants may also experience tremors, seizures, excessive fussiness and problems sleeping. Because alcohol affects the way the fetal brain communicates with different developing organs, babies exposed to high amounts of alcohol can be born with a hole in the wall of the heart that separates the four chambers. Skeletal defects include fused bones in the arms, fingers, hands and toes. People with FASD may also have vision and hearing problems, as well as kidney and liver defects.
Another risk for women who use or abuse alcohol in pregnancy is that they could have malnutrition and lack of prenatal care; these two factors could affect organ and skeletal development, as well.
Health experts point to the fact that women receive mixed messages about alcohol use during pregnancy from friends, family or even health care providers. The general consensus among health authorities is that no amount of alcohol is safe to drink during pregnancy.
Alcohol is such a strong teratogen (an agent that causes defects in an unborn baby) that it is best for women who are planning a pregnancy, or those who may become pregnant without planning it, to drink only lightly, if at all. And according to the findings of the above study, it is also important for the father not to abuse alcohol.
Health authorities caution that alcohol can harm an unborn child from the earliest stages of development — even before the woman knows she’s pregnant — to the latest stages. There is no safe time to drink alcohol during a pregnancy.
Governments in different countries are trying to get these messages out, as the rates of alcohol use, binge drinking and drinking during pregnancy seem to be rising among young women.
Alcohol is the leading cause of preventable birth defects, and intellectual and neurodevelopmental disabilities. If a woman does not know she is pregnant, she should stop drinking alcohol immediately after she learns that she is pregnant.
Much better ways to relax or to reduce anxiety during pregnancy than resorting to drinking poisonous alcohol include:
- Talk therapy
- Call a crisis hotline for support
- Joining a support group for expectant moms
- Joining an exercise class for expectant moms
- If you’re a person of faith, now is a great time to pray!
- Reaching out to your partner, family or friends for support
- Light exercise such as daily walks, if your pregnancy is healthy
- Taking unhurried baths using aromatherapy salts and body gels
- Enjoying a glass of sparkling apple juice, or a less-sweet glass of half regular apple juice and half sparkling water
- Listening to your favorite soft music
- Meditation
- Adopting an attitude of gratitude for the miracle that’s happening within you
- Planning your baby’s nursery, and even making some of the things you’ll need by hand
- Crocheting or knitting booties, hats and blankets for your baby
- Having some non-caffeinated green or chamomile tea
Are Non-Alcoholic or Alcohol-Free Beer or Wine Safe During Pregnancy?
It’s best not to take a chance even with these beverages; the reason for that is that “non-alcoholic” beverages such as beer can contain about half a percent of alcohol (as compared to 5 percent alcohol in regular beer). Alcohol-free beer, on the other hand, is supposed to contain no alcohol at all; however, studies have found that even beverages labeled “alcohol-free” can actually contain more alcohol than those labeled “non-alcoholic.”
The best thing, to be safe, then, is to stick to sparkling waters, sparkling water mixed with fruit juices, smoothies, regular purified water (try adding some fresh lemon juice, to add a nice flavor), milk (LOTS of milk!) and other drinks that you know for sure will do you and your baby good, and no harm.
By Cynthia Sanchez. A graduate of the University of Washington, Cynthia has extensive experience writing about health and wellness topics for different media.