Foetal alcohol syndrome has been reported in the news this morning, as one of the UK’s leading experts in child health calls for stronger warnings on alcohol to alert women to the dangers of drinking while pregnant.
We’ve asked our resident Dr Anastasia Alcock to give us the low-down on Foetal Alcohol Syndrome, a condition affecting children whose mothers drink during pregnancy.
The number of diagnosed cases of babies born with foetal alcohol syndrome has tripled since records were first kept 16 years ago.
What is foetal alcohol syndrome?
- Foetal Alcohol Spectrum Disorder (FASD) – this is the umbrella term covering a range of neurological, physical and behavioural impairments caused by exposure to alcohol in the womb. Many can be hard to diagnose.
- Foetal Alcohol Syndrome (FAS) – a serious form of FASD that is associated with distinctive facial features making it easier to recognise.
There are three main components of FAS:
- Facial abnormalities – children with FAS have distinct facial features including: small and narrow eyes, a small head, a smooth area between the nose and the lips and a thin upper lip.
- Intrauterine growth restriction (i.e. a small baby) and failure to catch up
- Neuro-developmental abnormalities causing learning disability, cognitive impairment and behavioural problems
There is a spectrum within this disorder; FAS is at the severe end of the spectrum.
In the UK, NICE guidelines, the British Medical Association (BMA) guidance and the Royal College of Obstetricians and Gynaecologists (RCOG) agree that pregnant women should not drink alcohol especially within the first three months, due to the increased risk of miscarriage. If women choose to drink alcohol, they are advised to have no more than 1-2 units of alcohol no more than 1-2 times a week. There is no evidence of harm at this level. Binge drinking (more than 7.5 units a day) may harm the baby.
What is a unit of alcohol?
In the UK 1 unit is 10ml (or 8 grams) of pure alcohol. This correlates to;
Half a pint of beer
A single measure of a spirit
Half a 175ml glass of wine at 11.5%- just for interest, a bottle of wine is about 8 units.
The NHS has a free NHS Drinks Tracker app- it allows you to keep a drink diary and get feed back on your drinking.
How does alcohol affect the developing baby?
We don’t know exactly how much alcohol is safe to drink in pregnancy. It depends on a number of factors such as how fast a mum-to-be absorbs alcohol, her physical health, diet and what medication she is on.
Not all women who drink heavily during pregnancy have babies with FAS. It is clear that there are other factors that affect the vulnerable foetus and more research is needed to identify these.
There are a number of reasons why women might drink alcohol while pregnant; in the early stages they might not know they are pregnant so are unaware of the risk. When a mum-to-be drinks, the alcohol in her blood passes freely through the placenta into the developing baby’s blood. Because the foetus does not have a fully developed liver, it cannot filter out the toxins from the alcohol as an adult can. The alcohol circulates in the baby’s blood system. It can destroy brain cells and damage the nervous system of the foetus at any point during the nine months of pregnancy.
Knowing this puts more pressure on pregnant women. I do not think that science has all the answers but the best course is to try not to drink during the first trimester (the first 12 weeks) and then to limit your alcohol intake to as little as possible throughout the rest of your pregnancy.
The FASD Trust operates a helpline for parents and carers of children with FASD. Call 01608 811 599.
National Organisation on Foetal Alcohol Syndrome UK. Or call their helpline on 08700 333 700.
DR ANASTASIA ALCOCK
MRCPCH MBBS BSc(Hons) DTM&H DPID DRCOG