What is Fetal Alcohol Spectrum Disorder?
Fetal Alcohol Spectrum Disorder (FASD) is a condition that arises when a mother consumes alcohol during her pregnancy. Alcohol use during pregnancy is a leading cause worldwide of preventable birth defects and developmental disabilities in children.
In South Africa, these are the facts:
- FASD is thought to affect at least 3 million of the South African population
- FASD is 100% preventable
How does Fetal Alcohol Spectrum Disorder occur?
Alcohol easily passes through the placenta which is the organ of the body that sustains a baby during pregnancy. The developing cells of the fetus (unborn baby) can be damaged due to the harmful effects of alcohol, leading to severe defects which are not curable. The fetus is at risk during the entire pregnancy period. Since the brain starts developing soon after conception, the brain is especially vulnerable, leading to permanent brain damage. As most pregnancies in South Africa are unplanned, women often continue to use alcohol without realising that they are pregnant.
How can Fetal Alcohol Spectrum Disorder be avoided?
Women should not drink alcohol during pregnancy or if they are trying to get pregnant to avoid the risk of Fetal Alcohol Spectrum Disorder. There is no known safe quantity of alcohol that can be consumed during pregnancy or whilst trying to conceive, to avoid the risks. Any amount of alcohol can harm a developing fetus.
- If you suspect that your child might have Fetal Alcohol Spectrum Disorder, take him/her to a doctor or clinic as soon as possible. If the health practitioner cannot assist you, ask to be referred to a paediatrician or to a Human Genetic clinic at a district or provincial hospital.
- If you suspect that you might have an alcohol addiction or if you find it difficult to cut down on your drinking, seek help at your clinic, doctor, a social worker, church/religious leader.
- If you are a light or social drinker and are planning a pregnancy, avoid alcohol.
- It is of the utmost importance to understand that pregnant women do not drink intentionally to harm their unborn babies. Pregnant women who consume alcohol often report that they do so in an effort to manage stress (self-medication) or that they are experiencing pressure from their partners (fathers of the fetus), family members and friends to drink alcohol. Some also indicate that they have received incorrect information from health practitioners. It is therefore the responsibility of partners, family members and friends to share the message of ‘no alcohol during pregnancy’ and to support pregnant women within their circles to abstain from alcohol use.
How does Fetal Alcohol Spectrum Disorder affect children and/or adults?
- It is a life-long condition.
- There are a number of physical signs, which includes growth stunting and a smaller than normal head circumference, as well as organ damage. In some individuals there might also be facial features, but the majority of people with FASD have no or very little physical signs. Since these physical signs have to be measured and examined by a trained medical specialist, it is very risky to focus on it. It often also leads to wrong diagnoses.
- It is therefore more important to rather note the developmental and behavioural problems resulting from the brain damage which might include some of the following:
- Delayed development
- Attention problems
- Difficulty in understanding cause and effect of behaviour
- Impulse control challenges which might lead to e.g. impulsive behaviour
- Interpersonal relationship problems
How is Fetal Alcohol Spectrum Disorder diagnosed?
It is a very complex diagnosis to make. Internationally the following criteria should be followed to make a confirmed diagnosis and to exclude the possibility of incorrect diagnosis (or labelling):
- Medical examination and dysmorphology assessment by a trained medical doctor;
- In-depth maternal interview to identify causative factors, but also to exclude possible other causes of e.g. brain damage in the fetus or baby after birth;
- Neurodevelopmental Assessment (Psychological testing) to determine the specific areas of developmental delay or challenges as to exclude other possible conditions.
By combining the findings of the above examinations, a diagnosis can be made.
As the diagnostic services for FASD is not readily available in South Africa, the best option for those who are concerned will be to visit the nearest clinic or doctor and to share the reasons for the concern.
The Foundation for Alcohol Related Research (FARR) is the leading NGO source of research and information on Fetal Alcohol Spectrum Disorders (FASD), and the most severe form of this disorder, namely Fetal Alcohol Syndrome (FAS) in South Africa. Since 1997, FARR has been dedicated to building positive futures in South African communities by significantly reducing birth defects and mental disabilities caused by alcohol consumption during pregnancy.
FARR can also be contacted on firstname.lastname@example.org or 021 686 2646 for guidance on where to seek help.
On-going management and care of an individual with Fetal Alcohol Spectrum Disorder
The damaged caused by prenatal alcohol use is irreversible and permanent. In an ideal situation it is of value to get a diagnosis as early as possible. This will enable the parents/caregivers to seek information and guidance from specialist in the field to support and guide them on the identification of the strengths of the individual with FASD (children or adults), and to guide them on how to manage the challenges. With the proper guidance, support, and security individuals with FASD can be helped to reach their full potential given their limitations.