Fetal alcohol spectrum disorders are caused by a baby’s exposure to alcohol during pregnancy. The resulting conditions may cause physical, developmental, or a mix of both physical and developmental disabilities ranging in severity from mild to severe.
You may be familiar with a condition called fetal alcohol syndrome (FAS). This syndrome is part of a broader group of conditions called fetal alcohol spectrum disorders (FASDs), which can be caused by alcohol use during pregnancy.
Keep reading to learn more about FASDs, the characteristics of each, and how you can find help if you suspect a child may have one.
Fetal alcohol spectrum disorders (FASDs) are a group of conditions that may occur when a baby is exposed to alcohol during pregnancy.
The conditions involve certain physical characteristics, issues with learning and behavior, or a mix of both physical and developmental problems.
While FASDs can be caused by heavy drinking, any exposure to alcohol at any time during pregnancy may cause issues with a baby’s growth and development and lead to these conditions.
Fetal alcohol syndrome (FAS)
Fetal alcohol syndrome (FAS) causes issues with the central nervous system, abnormal facial features, and growth issues. Babies born with FAS may have learning disabilities, difficulties with memory and attention span, as well as trouble with speech, hearing, and vision.
- growth delay (whether in the womb or after birth)
- all of the following facial characteristics:
- thin lips
- smooth or flattened ridge between the nose and lip (philtrum)
- short palpebral fissures (narrow space between the inner and outer corners of the eye)
- central nervous system issues
Partial fetal alcohol syndrome (pFAS)
Alcohol-related neurodevelopmental disorder (ARND)
Alcohol-related neurodevelopmental disorder (ARND) affects neurological development. People born with this type of FASD don’t have the typical facial features of growth delays associated with FAS. They may have a low intelligence quotient (IQ), issues with behavior and attention, and learning disabilities. As a result, they may have trouble with math in school and with memory, judgment, and impulsive control throughout life.
Neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE)
People with a neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE) have issues in three different areas:
- Thinking and memory: for example, forgetting things they already learned or difficulty with planning things
- Behavior: for example, temper tantrums, irritability and other shifts in mood, and trouble with the attention needed to perform different tasks
- Daily life: for example, trouble doing everyday tasks like showering, dressing, and playing or spending time with others
ND-PAE is the
Alcohol-related birth defects (ARBDs)
As the title describes, people with alcohol-related birth defects (ARBDs) have some type of structural change associated with the mother’s alcohol use during pregnancy. These birth changes can range from issues with the heart or bones to difficulties with the kidneys or ears (hearing). Some people may have multiple changes.
The symptoms of FASDs vary but may include:
- low body weight
- short stature
- microcephaly (small head)
- heart, kidney, or bone problems
- issues with coordination
- trouble with attention, reasoning, and judgment
- hyperactivity or attention deficit hyperactivity disorder (ADHD)
- difficulty with memory
- learning disabilities, particularly with math
- delays with speech and language
- issues with hearing or vision
- low IQ
- issues with sleep and nursing (babies)
Children with an FASD may also have distinct facial features:
- smooth ridge between the nose and lip (smooth philtrum)
- thin upper lip (thin lip vermillion)
- flat bridge of the nose
- short palpebral fissures (small eye opening)
FASDs are caused by alcohol use at any time during pregnancy, even before a woman knows they’re pregnant. Any alcohol — wine, beer, spirits, etc. — that gets into a mother’s blood can pass directly to the baby through the placenta and affect a baby’s development.
You’ll notice we use the term “woman,” “women,” and “mother” in this article. While we realize this term may not match your gender experience, it’s the term used by the researchers whose data was cited. We try to be as specific as possible when reporting on research participants and clinical findings.
Unfortunately, the studies and surveys referenced in this article didn’t report data for or may not have had participants who are transgender, nonbinary, gender nonconforming, genderqueer, agender, or genderless.
To lower your baby’s risk of an FASD, you should avoid alcohol use:
- when you’re trying to get pregnant
- when you think you may be pregnant
- when you know you’re pregnant
Other risk factors include:
- having another child with an FASD
- being over
age 30with a history of alcohol abuse
- poor nutrition
- having issues with metabolizing alcohol
You’ll likely work with an interdisciplinary team for treatment. This means that doctors and professionals from various areas may be able to help a child with an FASD, including:
- audiologists for hearing and balance problems
- cardiologists for heart issues
- developmental pediatricians and therapists for developmental delays
- nephrologists for kidney issues
- neurologists for issues with the brain and nervous system
- occupational therapists and physical therapists for support with physical development
- ophthalmologists for eye problems
- pediatricians for primary care
- psychologists and psychotherapists for mental health issues
- social workers for social support
- special education teachers for learning support
- speech-language therapists for speech and language assessment
Treatment will be unique for each child and will be tailored to any specific needs they may have. In general, treatment involves things like:
- medication, such as:
- neuroleptics (anti-seizure medications)
- physical therapy
- behavioral therapy
- educational support
You may be eligible for support services through your state:
- For children under 3 years old, contact your state’s
Early Intervention Programand simply state that “you have concerns about your child’s development and would like information about services.”
- For older children, you may receive support through the public school system. You can call your area’s elementary school or the board of education for more information.
While some growth issues may improve, children with FASDs may have short height or developmental delays through adulthood. Other issues, like learning disabilities or ADHD, may improve with appropriate therapies, medications, and other support.
The outlook will be individual for each child, what type of FASD they have, and what treatments/therapies they have access to. Research shows that the sooner a child gets treatment, the better the outcome. Still, identification at any age can help a person get access to support and services to improve their quality of life.
FASD itself isn’t a diagnosis. Instead, it’s an umbrella term for different conditions that arise from alcohol use during pregnancy.
It may be difficult to diagnose FASDs because there’s no single test to make a diagnosis. Instead, you or a doctor may observe a cluster of symptoms in your child that suggests they have an FASD.
- a discussion about the number of times alcohol was used during pregnancy, how much, and at what point during gestation
- observation of central nervous system issues
- observation of growth delays
- observation of characteristic facial features
Experts explain that diagnosis may involve a team of doctors and other professionals and may include a neuropsychological exam.
FASDs are caused by alcohol use at any time throughout pregnancy. The best prevention method is to avoid alcohol use when you’re trying to become pregnant, when you suspect you may be pregnant, or when you know you’re pregnant.
If you’re a heavy drinker, reach out to a doctor for support. Other helpful resources include Alcoholics Anonymous (AA) and the Substance Abuse and Mental Health Services Administration (SAMSHA). It’s important to understand that FASDs can result from occasional drinking as well.
How many people have FASDs?
The CDC explains that it’s difficult to know the true prevalence of FASDs. They estimate that around
What should I do if I think my child may have an FASD?
Make an appointment with your child’s pediatrician to discuss why you think your child may have an FASD. You can share your concerns and ask for a referral to a doctor who specializes in FASDs for further support.
At what point in pregnancy is exposure to alcohol most dangerous?
The CDC explains that there’s no safe time to consume alcohol during pregnancy. Exposure in the first
Speak with a doctor if you’re pregnant and have been consuming alcohol. A doctor can point you to resources that may help you quit. It’s never too late to stop.
If you suspect your child may already have an FASD, a doctor can also help you find the support you need for your child’s development and your own well-being.