Fetal Alcohol Syndrome

By Dr. Loretta Lanphier, ND, CN, HHP, CH

Despite an aggressive attempt to educate the public to the dangers of drinking while pregnant, there are many babies born every year who are damaged either mentally, physically, or both because their mothers ingested alcohol while they were still in the womb. Perhaps this is simply a consequence of the social acceptance of this drug called alcohol, but it is a costly one that could potentially be totally prevented. Let’s see if we can learn a bit more about the ins and outs of this condition known as Fetal Alcohol Syndrome.

What is Fetal Alcohol Syndrome?

Fetal Alcohol Syndrome (FAS) is actually not one distinct condition, but is rather a single member of a family of related birth defects that are the result of prenatal exposure to alcohol. This group of “congenital” or “birth” defects is collectively known as Fetal Alcohol Spectrum Disorders (FASD). The cluster of mental, physical, and behavioral consequences of fetal exposure to alcohol known as FAS composes the most severe group of effects. The only cause for FAS is the use of alcohol during pregnancy, and unfortunately there is no cure for the illness. The birth defects that occur in a child because of exposure to alcohol are irreversible. FAS can only be prevented by total abstinence of alcoholic beverages during pregnancy, and is in fact one of the few preventable causes of mental retardation.

FAS is a major public health problem in the United States and throughout the Western world. It is the leading cause of mental retardation in developed nations, second only to Down Syndrome. The abuse of alcohol is a world wide epidemic that is clearly responsible for numerous woes in society. Unfortunately, unborn children are one of its largest casualties. It is estimated that approximately 1-2 out of every 1000 babies born in the US will be afflicted with FAS or other forms of alcohol-related damage. This amounts to about 40,000 children every year. The personal price that these kids and their families must pay is enormous. In addition, the cost to society in the form of future teens and adults that will struggle with the implications of FAS is also huge. Yet, this legal drug called alcohol continues to maim and kill, and the profits from the alcohol industry roll on leaving shattered lives in their wake. Obviously, FAS is only one part of a much bigger problem.

What Causes Fetal Alcohol Syndrome?

There is only one cause for FAS, and that is the consumption of alcohol by a woman while she is pregnant. It is impossible to tell how much alcohol is needed to cause damage to a fetus, as every case is unique. However, certain patterns of drinking that involve amounts of alcohol consumed and the timing of such drinking are known to effect unborn children differently. Binge drinking during pregnancy is thought to be particularly likely to produce FAS babies.

Statistics show that some of the worst damage can occur during the first trimester of a pregnancy, and more specifically during the earliest weeks of that period. The most severe birth defects, the specifics of which we will discuss below, occur in children who were exposed to large amounts of alcohol during the first three months of pregnancy. When the exposure occurs near the end of pregnancy, the most common symptoms are premature birth and low birth weights. However, recent studies have indicated that some of the most critical development of the brain happens during the last trimester, so these analyses of FAS effects may have to be revised. While a threshold of “safe” drinking has never been established, it is known that the more a woman drinks during pregnancy, the greater the risk for FAS and related conditions, and the more severe the potential defects will be.

Statisticians tell us that kids who are born to mothers that drank heavily while they were being carried have about a 50% chance of showing signs of FAS. Mothers who drank moderately have approximately a 10% chance of bearing an FAS impaired child. However, these percentages can be very deceptive and are likely artificially low. Many minor or moderate cases of FAS are probably never diagnosed, or if defects are present, they may not be attributed to alcohol exposure. The severity of symptoms varies greatly from child to child. Another problem related to the diagnosis of FAS is that a good number of children who are affected are in foster homes or adopted, and the alcohol use patterns of the birth mother may not be known.

Alcohol that is in the mother’s bloodstream crosses the placenta where it then enters the system of the developing fetus. Researchers believe that the most severe effects of alcohol on an unborn child occur because of nutritional dysfunction caused by the alcohol, and also due to brain damage sustained by the fetus. It has also been discovered that a fetus metabolizes alcohol at a significantly slower rate than that of an adult, Therefore it may receive a much higher dose of alcohol than the mother does, resulting in more severe damage to its developing body.

What Are the Signs and Symptoms of Fetal Alcohol Syndrome?

There are numerous symptoms that can occur when a fetus is exposed to alcohol. These are generally categorized into two different groups. Physical problems are put under an umbrella labeled Alcohol-Related Birth Defects (ARBDs),  and those that affect children mentally and behaviorally are calledAlcohol-Related Neurodevelopment Disorders (ARNDs). Some of the most common symptoms include:


  1. Facial Features:  Many cases of FAS are distinguished by certain facial features that typically occur in affected children. These features are not found exclusively in FAS children, and they are not found in all cases of FAS, so they cannot be used as the only means of diagnosis. However, some of the most common ones include:
    1. Unusually small eyes
    2. Shortened eye “openings” (leading to a droopy or squinty appearance)
    3. Thin, underdeveloped upper lip
    4. Flattened area between the upper lip and the nose (this is where the characteristic ridge of skin called the “philtrum” normally develops)
    5. Upturned nose
    6. Deformed joints, fingers, and / or limbs
  1. Heart defects:  These can include heart murmur, which often dissipates when the infant reaches the age of one, or other structural abnormalities that can lead to cardiac difficulties throughout the patient’s lifetime.
  2. Growth and development issues:  Many FAS babies are born prematurely, at abnormally low birth weight and / or size, and they may not mature at normal rates both before and after birth.


  1. Mental retardation
  2. Abnormally low IQ (averaging 63)
  3. Microcephaly (abnormally small head and brain size)
  4. Hearing and vision dysfunctions
  5. Motor retardation (difficulties with movement and speech)
  6. Hyperactivity
  7. Impulsive behaviors
  8. Shortened attention span
  9. Nervousness and anxiety
  10. Irritable, fussy behavior in infants (including excessive crying)

Not all FAS children will exhibit these symptoms, and those that are found vary greatly in intensity. Often minor cases of FAS are not diagnosed until later in life when the child experiences difficulties with academics or social adjustment. Sometimes the factor of prenatal alcohol exposure is not taken into consideration until an investigation is undertaken due to physical or behavioral problems.

What Complications Can Occur From FAS Later in Life?

Due to the effects of prenatal alcohol exposure, many older children, teens, and adults have numerous difficulties at adjusting to a normal life. Problems such as learning disabilities, difficulties adjusting to a classroom setting, and conflicts with peers plague school aged FAS children. Studies have shown that adults with a history of FAS also have a higher than normal incidence of criminal behaviors, spousal abuse, substance abuse, employment difficulties, and financial problems. Many find it difficult to settle down and be productive members of society. The total cost to society due to the general effects of alcohol abuse and specifically those of FAS is undoubtedly weighty.

What Can Be Done to Treat or Prevent Fetal Alcohol Syndrome?

The good news is that FAS is preventable by total abstinence of alcohol during pregnancy. The bad news is that the effects of this condition are irreversible in the victims of the disease. However, when dealing with a child or adult that is struggling with the effects of FAS, there are some tips that can be useful at managing the behavioral aspects of the condition. Some of these include:

  1. Due to difficulties with concentration and consistent, calm behavior, it is helpful for many children who suffer from FAS to have well-defined routines to which they can be accustomed to. Work with them by providing structure and limits to help them stay on track. Many FAS children have a hard time with traditional classroom settings. While special education classes may be helpful, the quality of such services varies greatly between different school districts. One excellent option that many parents are turning to is home schooling. FAS children need the attention and love of a concerned parent, and they will often flourish under such circumstances. If you are the parent of an FAS child, you many want to seriously consider home schooling.
  2. Often victims of FAS are not fully developed mentally  or socially, and they may have difficulties knowing limits and what is or is not appropriate in social settings. Teach them the skills they need for daily living, and they may need to be protected in their innocence from people that might take advantage of them, especially in their younger years. Many of these children have been through the mill of abuse, rejection, and multiple foster homes before they come into your care. Raising a child with FAS takes a lot of love, time, and dedication.
  3. Beware of doctors that will try to put them on medications such as Ritalin and other stimulants or antidepressants. These drugs will only damage and confuse their minds even further, but unfortunately many children who exhibit any form of behavioral problems are all too easily subject to the whims of a health care provider that recommends medication. Be an advocate for these kids, and don’t let the system get them started on these dangerous drugs!

It is sad indeed that FAS children are innocent victims of a society that condones and even encourages alcohol abuse. It only makes the situation tragically worse when these kids are introduced to mind-altering medications with their associated dangerous side effects. If you are the natural parent or adopted parent of an FAS child, look on your calling as a ministry to these children. They need the tender guidance of adults that will patiently help them to overcome and manage the unfortunate consequences of their condition.

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