Fetal Alcohol Syndrome: An Epidemic (Part I)

Fetal alcohol syndrome has been a widely known danger associated with maternal drinking for more than forty years. It is also the most common cause of preventable mental retardation in the United States. The intended purpose of this two-part essay is to examine the silent epidemic that is better known as fetal alcohol syndrome. Nurses Announcements Archive Article

Fetal Alcohol Syndrome: An Epidemic (Part I)

Alcohol exposure damages the central nervous system and peripheral nervous system of the developing fetus in an irreversibly destructive manner. Fetal alcohol syndrome is a notable pattern of birth defects caused by maternal ingestion of alcohol during pregnancy. The telltale facial features, small head, growth impediments, and behavioral problems are all the result of alcohol that has traveled across the placenta during prenatal development.

The three dominant facial features associated with fetal alcohol syndrome are a thin upper lip, short palpebral fissures (decreased eye width), and a smooth or flat philtrum (the vertical groove between the upper lip and the nose). Other signs may include a flat midface, an upturned nose, flat nasal bridge, underdeveloped ears, drooped eyelids, and epicanthic folds. These facial features tend to become less noticeable as the child ages. Other signs of fetal alcohol syndrome include small head size, stunted growth, mental retardation, cardiac and renal abnormalities, vision problems, and poor impulse control.

Children who lack the telltale facial signs might be diagnosed with fetal alcohol effects, which is a range of signs and symptoms seen in children who have had mild exposure to alcohol during prenatal development. Children diagnosed with fetal alcohol effects often have normal IQs and usually do not have any of the facial features seen with full-blown fetal alcohol syndrome. However, these children have issues with impulse control, judgment, social cues, and a whole host of other problems related to brain damage.

Unfortunately, fetal alcohol syndrome has no cure, and the effects are lifelong. There are no reliable global figures on fetal alcohol syndrome, but a 2005 U.S. study estimated a global rate of about 1 per 1000 live births (Hanson, 2011). Moreover, this affliction leads to profound costs to society. An American study, published in the American Medical Journal, did its best to estimate the total U.S. social costs--loss of productivity, lifelong medical care, rehabilitation expenses--and came up with the staggering figure of $4 billion--in 1998 dollars (Hanson, 2011).

Once a nebulous diagnosis, fetal alcohol syndrome is becoming more prevalent, due in part to better detection and more research. In addition, it is a health problem that affects children from all rungs of the economic ladder. People mistakenly believe that only the offspring of the poor and disadvantaged are affected by fetal alcohol syndrome. Invisible are the middle-class mothers who drink during their pregnancies, whose problems with the bottle are shamefully concealed behind closed doors (Philp, 2003).

In fact, the children of higher income women are often misdiagnosed due to preformed notions about maternal backgrounds. Rather than be diagnosed, middle-class children with FAS are far more often labelled as having attention deficit hyperactivity disorder, and shunted into private schools with other learning-disabled kids (Philp, 2003). Children affected by fetal alcohol syndrome must fight an uphill battle from the start. Research shows that people with FAS face daunting odds of dropping out of school, getting fired from jobs, becoming teenage parents, dabbling in drugs, tangling with the police and drifting in and out of homelessness (Philp, 2003). Early diagnosis and intervention is crucial for children with this health problem.

Women can prevent fetal alcohol syndrome by completely abstaining from alcohol during pregnancy. No amount of alcohol is safe during the prenatal period, so experts advise women against consuming any amount of alcohol while pregnant. Although fetal alcohol syndrome is permanent and irreversible, an affected child may receive professional assistance that will enhance his or her maximum function.

References

Report Spells Out Tragedy of Fetal Alcohol Syndrome.

Middle-class FAS: a silent epidemic?

TheCommuter

About TheCommuter, BSN, RN

TheCommuter, BSN, RN, CRRN is a longtime physical rehabilitation nurse who has varied experiences upon which to draw for her articles. She was an LPN/LVN for more than four years prior to becoming a Registered Nurse.

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Specializes in NICU, PICU, PACU.

We are actually seeing less of this where I am, heroin, methadone and oxycodone are what we are seeing more and more of. Very sad. I haven't taken care of a FAS child in many years, but right now, out of 50 kids, we have 10 that are somewhere on the withdrawl spectrum :(

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

I suspect there are a lot of adults in society who have undiagnosed FAS/FAE. After all, the telltale facial traits do fade with time.

In addition, I suspect that many children and teenagers have FAE (fetal alcohol effects). This is harder to diagnose because the infant or child does not have the facial characteristics of full-blown FAS. I get the hunch that many children with FAE are misdiagnosed as having ADD/ADHD, conduct disorder, oppositional defiant disorder, and attachment problems. This issue is probably more prevalent than anyone can imagine.

Studies have shown that pregnant women who consume only two alcoholic drinks give birth to infants with slightly smaller brains.

Commuter, is that two drinks total, or two drinks daily/weekly/monthly? This of interest to me, because my mother drank, if she didn't, and it had that much effect, my brother and i would have been geniuses....

I suspect there are a lot of adults in society who have undiagnosed FAS/FAE. After all, the telltale facial traits do fade with time.

In addition, I suspect that many children and teenagers have FAE (fetal alcohol effects). This is harder to diagnose because the infant or child does not have the facial characteristics of full-blown FAS. I get the hunch that many children with FAE are misdiagnosed as having ADD/ADHD, conduct disorder, oppositional defiant disorder, and attachment problems. This issue is probably more prevalent than anyone can imagine.

Studies have shown that pregnant women who consume only two alcoholic drinks give birth to infants with slightly smaller brains.

I suspect there are a lot of adults in society who have undiagnosed FAS/FAE. After all, the telltale facial traits do fade with time.

In addition, I suspect that many children and teenagers have FAE (fetal alcohol effects). This is harder to diagnose because the infant or child does not have the facial characteristics of full-blown FAS. I get the hunch that many children with FAE are misdiagnosed as having ADD/ADHD, conduct disorder, oppositional defiant disorder, and attachment problems. This issue is probably more prevalent than anyone can imagine.

Studies have shown that pregnant women who consume only two alcoholic drinks give birth to infants with slightly smaller brains.

I write to a prisoner through a writing group. He was thought to have fetal alcohol effect. He doesn't have any of the facial features but was born to an alcoholic mother. Though he has average intelligence he has very poor impulse control and judgement which of course lots of people who break the law do.

He is nearly forty and FAS/FAE wasn't diagnosed when he was born or in early childhood. He was just thought to be a troublemaker as a kid. Of course, being raised by the same alcoholic mother didn't help matters as he was often neglected and ignored. It is a huge problem to those affected and society at large. Thanks for posting and highlighting the subject.