Pregnancy and Alcohol: Foetal Alcohol Spectrum Disorder (FASD)

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I attended a really insightful training day recently in the Alex Hotel, which by the way is amazing and so chic. I literally wanted their entire interior décor.

In 2012 I attended a training event about this topic and while it left an impression on me then, it didn’t to the extend it does now that I work in Maternity Hospital. I want to share the information I learnt because I know I was shocked at some of the findings. Knowledge is power and the more aware we are the more change that can be made.

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What is FASD Foetal Alcohol Spectrum Disorder? 

Affected children have a wide range of learning, emotional and social challenges, as well as much higher incidences of physical health conditions. Each year in Ireland at least 600 babies are born with FASD.

  • It causes lifelong brain damage to a baby.
  • Affects the brain’s ability to process information up to ten seconds longer than a person without FASD.
  • Language skills are impacted.
  • FASD delays processing speed.
  • It negatively affects memory.
  • Children’s receptive skills are impacted.
  • These children have to try much harder in school and in life in general.
  • If a mother consumes alcohol during 6-8 weeks gestation, it is likely that their child’s facial features will be affected including a very thin upper lip, smooth philtrum and short fissure.3
  • Three or more of the brain domains are affected.
  • Children with FASD are more likely to have physical health problems such as immune issues, heart problems, bone and muscles, vision, hearing and endocrine issues, thyroid, seizures and sleep disorders. (Himmelereich, Lutke & Travis (2016).

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This table breaks down what FASD looks like at the different developmental stages.

Age range Symptoms
0-36 months ·         Failure to thrive

·         Feeding issues

·         Sleeping

·         Irritability

·         Cause and effect

·         Overwhelmed

·         Temper tantrums

·         Physically aggressive

·         Unable to learn from experience

·         Accident prone

·         Fearless

6-10 ·   Visual memory better than auditory

·   Information comes and goes

·   Difficulty in distinguishing facts

 

 

8-10 ·         Severe mood swings

·         Struggle with self regulation

·         Executive functioning

·         Need constant reminders

·         Confabulate stories

10-14 ·         Speech

·         Very literal

·         Easily get lost in conversation

·         Following norms isn’t appealing

·         Risk of alcohol and drug misuse

14-18 ·         Struggle with having boundaries

·         No understanding of risk

·         Sexually inappropriate

·         Overly affectionate

·         Cognitive disorder

Adulthood ·         Lack social skills

·         Blame others for their mistakes

·         Struggle with employment

·         Engage in criminal activity

·         Can be drawn to abusive relationships

·         Mental health difficulties

Andrew, G (2011)

Along with all of this, the roots of attachment grow out of a typical brain. From the start, a baby born with FASD is going to struggle with the basic primary function to attach to a secure person.

Staggering Facts:

The statistics show that 600 babies are born with FASD in Ireland a year. There are five countries with the highest amount of babies born with FASD and Ireland is top of this table. Not a league we want to be winning.

Despite this epidemic, we don’t screen for alcohol in pregnancy routinely. This prevents detection, early intervention and most importantly the opportunity to provide education to mothers to be.

If a child has FASD they are more likely to become addicted to alcohol or illicit substances themselves. As a result of children with FASD’s inability to regulate their emotions, or understand the consequences of their actions, many are incarcerated as adults and spend their time in the criminal justice system.

Two in five pregnancies resulting in a newborn with FASD are as result of an unplanned pregnancy; yet in Ireland contraception is costly and some of our most vulnerable groups don’t have access to this resource for financial reasons.

Alcohol directly passes through the placenta in pregnancy and produces the most serious neurobehavioral effects on the foetus compared to heroin, cocaine and cannabis use in pregnancy.

Important Questions to ask if you Work in this Area:

  • How many weeks pregnant were you when you discovered you were pregnant?
  • Were you socialising a lot during this time?
  • What’s your relationship and frequency of use with alcohol?

These questions need to be asked throughout pregnancy. A lot of women feel unwell in the first twelve weeks of pregnancy and may not be drinking at this stage. Therefore no information is given if she denies alcohol use however an uninformed mother may start drinking when they begin to feel well in pregnancy.

Education campaigns in schools also need to occur so that this can be addressed from a young age. The provision of information to young adults is crucial so that they can make safe and informed decisions and be aware of the potential devastating impact of an unplanned pregnancy.

Drymester:

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Drymester was a ten week digital campaign rolled out in Manchester. It was the first awareness campaign of its kind. It had three criteria’s and was a huge success in raising awareness.

  1. Take the pledge not to drink in pregnancy!
  2. Do it together partner supportive also. (Women do not get pregnant alone and need to be in it together with their partners or support person)!
  3. Spread the word!

Myths Debunked:

  • One or two drinks are fine in pregnancy – no amount of alcohol is safe for a baby at any stage of pregnancy.
  • The harm is done no point in stopping now – it is beneficial to stop drinking at any stage of pregnancy.
  • It is the mother’s fault – alcohol is the problem not our women.

Final Thoughts:

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Pregnant women receive conflicting information about drinking during pregnancy and are often assured by family and friends and unfortunately even some professionals that occasional alcohol use in pregnancy won’t do any harm. The facts are that there is no proven level of safe drinking during pregnancy.

Alcohol is the problem not the women. It is not a blame game it could happen anyone who experiences an unplanned pregnancy. Our whole perception of alcohol use in Ireland needs a transformation. Our glasses are getting bigger; you can nearly fit your head into current gin glasses. We need to step back and consider what message this is sending out about our drinking habits in general. The damage alcohol does to hundreds of babies each year is a very real health issue that needs to be addressed.

The first three months of pregnancy can be a very isolating time for pregnant women .If they use alcohol as a coping mechanism in general life it is highly likely that they will struggle to stop in pregnancy particularly at this gestation if there are other psychosocial issues. This is the most crucial stages of baby development.

This training really brought home the enormity of the issue at hand and that it is one that needs urgent addressing. While this can seem overwhelming, I am reminded of the phrase ‘How do you eat an elephant? One bite at a time’. There is hope, if these children and young people are given a safe, protected and supported environment into their 20’s they can do well but prevention is key and is possible.

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I will leave you with this thought courtesy of Dr. Chris Loocke:

‘The egg that made you was developing in your mother when she was a six week old embryo in your grandmother. Not only does prenatal experience count but pre pre natal experience counts’.

Thank you for taking the time to read this. I hope you learnt something. More than ever, please share this with your friends and family it is such an important message that needs to be communicated.

ENDpae is a support group for parents with children with FASD.

Andrew G (2011) ‘Diagnosis of FASD: An Overview in Fetal Alcohol Spectrum Disorder: Management and Policy Perspectives of FASD Chapter 5 Riley, Claren and Weinburg and Jonsson, Eds Weinheim Wiley – VCH.

 

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