Dual Diagnosis: Fetal Alcohol Syndrome

Dual Diagnosis: Fetal Alcohol Syndrome

Quick links for fetal alcohol syndrome

• What is fetal alcohol syndrome?
• What causes fetal alcohol syndrome?
• What are the risks of fetal alcohol syndrome?
• Fetal alcohol syndrome going unnoticed
• Pregnancy and alcoholism
• Treatment for fetal alcohol syndrome
• Preventing fetal alcohol syndrome
• How to get more information about fetal alcohol syndrome
• References for fetal alcohol syndrome

Pregnancy is a sensitive process, both for the mother and baby.

The unborn child relies on the mother for nutrients, so there is never a time when what the mother ingests is more important.

Drinking while pregnant, therefore, can be very damaging and poses the risk of the child developing fetal alcohol syndrome.

Alcohol is known to have a destructive effect on both the physical and mental health of those who become addicted to it, and this threat is even bigger when an unborn baby is involved.

Fetal alcohol syndrome is often the result of this exposure, though unborn children are also at risk of developing Alcohol-Related Neurodevelopmental Disorder (ARND), [1] Alcohol-Related Birth Defects (ARBD) [2] and Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE). [3]

Exposing a foetus to alcohol not only causes physical and psychological impacts, but these conditions are largely incurable. Preventative measures are the most effective methods of treatment, although some symptoms of fetal alcohol syndrome can be improved if diagnosed early enough.

What is fetal alcohol syndrome?

When a pregnant woman consumes excessive amounts of alcohol it can cause fetal alcohol syndrome (also known as fetal alcohol spectrum disorder) to develop, which involves the unborn baby suffering from both physical and psychological complications. [4]

These might include the development of physical deformities, or the prevalence of learning difficulties in later life.

While some of these traits may be treatable, there is no way of completely curing the disorder itself. [5]

What causes fetal alcohol syndrome?

Fetal alcohol syndrome develops as a result of a pregnant woman consuming alcohol, which is then transported into the unborn child via the placenta.

Not all of the alcohol is transferred, but a significant quantity enters the child’s bloodstream.

Because it is still developing inside the womb, the baby does not yet have a fully functional liver, meaning that the alcohol entering its body cannot be properly filtered.

As a result, a higher concentration of it passes through its system.

This high alcohol concentration then reduces the amount of oxygen and nutrition the baby receives from the mother. This disrupts the development of the baby’s organs and muscles, depriving it of what it needs and causing problems with the functionality of its body and brain.

When is the baby vulnerable to fetal alcohol syndrome?

While exposure to alcohol can be problematic for an unborn baby at any point during pregnancy, the first trimester tends to be the most dangerous period.

Damage as a result of alcohol can occur as early as the first few weeks of pregnancy.

What are the risks of fetal alcohol syndrome?

The effects of fetal alcohol syndrome often manifest as soon as early childhood, being evident in both the child’s behaviour and physical appearance.

The extent and severity of symptoms will depend on the frequency and quantity of alcohol consumption throughout pregnancy. [6]

Some of the physical deformities common with fetal alcohol syndrome include:

• Low weight at birth
• Slow or delayed body growth
• Flat or underdeveloped cheekbones
• Small eye sockets
• Bone, kidney, or heart complications

Behaviour problems are also very common with children who have fetal alcohol syndrome, and these can also be prevalent throughout childhood.

These include:

• Difficulty identifying personal boundaries
• Hyperactivity or restlessness
• Constantly needing physical contact
• Speech and language problems
• Difficulty socialising with other children
• Difficulty staying focused
• Difficulty with reasoning and problem-solving
• Being impulsive
• Ignoring rules or being disruptive

Finally, fetal alcohol syndrome can also impact the brain and nervous system in a significant way.

These conditions include:

• Poor coordination or balance
• Delayed development
• Learning disorders
• Memory issues
• Issues processing information
• Difficulty identifying the consequences of choices
• Poor judgment
• Rapidly changing moods

As the child grows into a teenager and adult, these behaviours may get them into more significant trouble.

They may find themselves disregarding laws, struggling with sexual impulses, or not being able to remember important things.

Fetal alcohol syndrome going unnoticed

It can sometimes be difficult to identify fetal alcohol syndrome as some symptoms can be misclassified as stubbornness or ignorance.

Children may wrongly be perceived as troublesome or naughty, choosing to act in a disruptive way.

In some situations, the condition can also be clouded by a child having a high IQ, which may encourage teachers to think nothing is wrong but the child’s attitude.

Many who are born with the condition can also show no physical signs of it, further increasing the chance of it going unnoticed.

Pregnancy and alcoholism

Many women are aware of the dangers of consuming alcohol while pregnant, and those who continue to use it frequently are often sufferers of alcoholism, which does not allow them to stop.

Pregnancy can be very difficult, putting a woman through intense physical and psychological discomfort.

Those who have used alcohol as a way to relax before becoming pregnant (or those susceptible to substance use) may therefore turn to alcohol as a way of soothing their pregnancy pains or distress.

While this can be very damaging for the unborn child, the woman may not be able to stop as a result of the alcohol’s effect on their body.

As an individual consumes more alcohol, the body gradually begins to depend on it to function.

Women who used it before becoming pregnant, therefore, may not be able to suddenly stop their drinking and may experience uncomfortable or dangerous withdrawal symptoms when they try to.

Treatment for fetal alcohol syndrome

When it comes to treating fetal alcohol syndrome, there is, unfortunately, no viable method of reversing its effects.

The condition occurs during the baby’s development within the womb, and so the symptoms are permanent.

However, if it is spotted early enough, there are ways of helping reduce their impact.

If treatment begins before the age of 6, services can help a child’s educational development and reduce the impact of their behavioural tendencies.

Children can also benefit from the implementation of several protective factors, including a stable and nurturing home life and participation in special education services. [7]

Fetal alcohol syndrome can also be difficult for parents to deal with, sparking emotional and psychological distress.

A struggling mother or father can benefit from receiving counselling services to help them cope with their child’s condition better, as well as learn more about the syndrome itself.

As mentioned above, alcoholism can play a significant role in the development of fetal alcohol syndrome.

Therefore, it may be of use to help a mother struggling with alcohol abuse to overcome her addiction.

This might include a medically assisted detox – designed to wean the body from its dependency – along with therapies that try to work through their underlying motivations to drink.

Preventing fetal alcohol syndrome

Unfortunately, the best way to limit the impact of fetal alcohol syndrome is to prevent it from developing in the first place.

While refraining from alcohol during pregnancy may seem too simple, it is essential that women take care when consuming it even before they are pregnant.

Often, they will become pregnant before realising, and so the foetus can be exposed to alcohol without mothers even knowing.

The same principle applies to those who are close to giving birth.

A mother may believe that they cannot influence the baby’s development when they are due to give birth, but this is not the case. The baby is always developing and can be impacted by alcohol even up to the day of birth.

As a result of these things, it is important for women to abstain from alcohol consumption both when they are pregnant and when they are trying to become pregnant.

How to get more information about fetal alcohol syndrome

Fetal alcohol syndrome can be a scary prospect, so it is important to speak to a doctor or GP if you suspect that you may have consumed alcohol while pregnant.

If you are concerned about your alcohol consumption and are unable to stop, get in touch with your GP or an alcohol support charity to discuss possible treatment methods.

References for fetal alcohol syndrome

1. https://www.niaaa.nih.gov/sites/default/files/ARNDConferenceConsensusStatementBooklet_Complete.pdf
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6707172/
3. https://www.cdc.gov/ncbddd/fasd/features/neurobehavioral-disorder-alcohol.html
4. https://www.nhs.uk/conditions/foetal-alcohol-spectrum-disorder/
5. https://kidshealth.org/en/parents/fas.html
6. https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-fetal-alcohol-spectrum-disorders
7. https://www.cdc.gov/ncbddd/fasd/facts.html