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.

There are five main types of FASD. Each type includes different physical or developmental characteristics on the spectrum.

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.

FAS is considered the most severe or “involved” type of FASD. A person doesn’t have to have documented exposure to alcohol during pregnancy to have FAS diagnosed, but they must meet three criteria:

  • 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)

Partial fetal alcohol syndrome (pFAS) may be diagnosed if a child has at least two of the typical facial features and a mix, but not all, of the required criteria for FAS.

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 only one of the FASDs to be included in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). As such, it includes specific diagnostic criteria. In this case, the mother must have consumed more than 13 alcoholic beverages during each month (30 days) of pregnancy or more than two alcoholic beverages at a time.

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:

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)

The Centers for Disease Control and Prevention (CDC) explain that roughly half of all pregnancies in the United States are unplanned. Not only that, but women may not know they’re pregnant in the first 4 to 6 weeks.

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.

Language matters

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.

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The risk of FASDs increases with the amount of alcohol consumed. That said, any amount of alcohol may increase the risk of a baby developing an FASD.

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 30 with 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:

Treatment will be unique for each child and will be tailored to any specific needs they may have. In general, treatment involves things like:

Parent training is another crucial piece of the puzzle. This involves understanding the unique challenges of parenting a child with an FASD and adjusting as necessary. Parents may also benefit from joining local support groups or finding a family counselor.

There’s no cure for FASDs, but early treatment can help your child thrive.

You may be eligible for support services through your state:

  • For children under 3 years old, contact your state’s Early Intervention Program and 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.

Diagnosis includes:

  • 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 1 baby in every 1,000 born in the United States may be affected. Other groups, like the National Institutes of Health, have higher estimates — 1 to 5 children per every 100.

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 3 months may cause physical abnormalities, such as those affecting facial features. Alcohol use at any time during pregnancy may lead to issues with growth or the central nervous system.

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.