Foetal (Fetal) Alcohol Syndrome (FAS)

What is Foetal Alcohol Syndrome?

Foetal alcohol syndrome (FAS) refers to growth, mental, and physical problems that may occur in a baby when a mother drinks alcohol during pregnancy. The defects that are part of foetal alcohol syndrome are irreversible and can include serious physical, mental and behavioral problems, though they vary from one child to another. Foetal alcohol syndrome is a growing problem in South Africa along with other birth defects caused by drug usage (‘crack babies’). While foetal alcohol syndrome is often thought to be a result of alcohol abuse, even moderate alcohol usage during pregnancy can result in FAS.

How does Foetal Alcohol Syndrome occur?

Alcohol itself may not be directly responsible for all, or any, of the features of FAS. It is the byproducts generated when the body metabolizes (“burns”) alcohol that has an effect on the unborn foetus. The end result is a decrease in the number of brain cells (neurons), abnormal location of neurons (due to disturbance of their normal migration during fetal development), and gross malformation of the brain.

Features of Foetal Alcohol Syndrome

The most common and consistent features of FAS involve the growth, performance , intelligence, head and face, skeleton, and heart of the child.

• Growth is in the womb is diminished and the birth weight is therefore lessened.
• The FAS infant is very irritable and performance may be impaired. The older FAS child is hyperactive. Fine motor skills are impaired with weak grasp, poor eye-hand coordination, and tremors.
• Intelligence is also diminished.
• The head is small (microcephalic). This decrease may not even be apparent to family and friends. It is evident upon comparison of the child’s head circumference to that of a normal child on a growth chart. The usual degree of microcephaly in FAS is classified as mild to moderate. It is primarily due to failure of brain growth. The consequences are neither mild nor moderate.
• The face is characteristic with short eye openings (palpebral fissures), sunken nasal bridge, short nose, flattening of the cheekbones and midface, smoothing and elongation of the ridged area (the philtrum) between the nose and lips, and smooth, thin upper lip.
• The skeleton shows characteristic changes; abnormal position and function of joints, shortening of the metacarpal bones leading to the fourth and fifth fingers, and shortening of the last bone (the distal phalanx) in the fingers. There is also a small fifth fingernail and a single transverse (simian) crease across the palm.
• A heart murmur is often heard and then may go away. The basis is usually a hole between the right and left sides of the heart between the ventricles (the lower chambers) or less commonly, the atria (the upper chambers).
• A number of other birth defects can occur in children with FAS. These include such major birth deformities such as hydrocephalus (increased fluid pressure on the brain that may require shunting to relieve the pressure), cleft lip (sometimes with a cleft palate), coarctation (narrowing) of the aorta, and meningomyelocele (spina bifida) (3)

FAS lasts for a lifetime and there is no cure. Special school services can help with learning problems. Routines and consistency at home may help with behavior problems. Women can prevent FAS and other problems related to alcohol use by not drinking when they are pregnant.