Fetal alcohol spectrum disorder

Q: I’m pretty sure my sister didn’t drink during her pregnancy but my six-monthold niece looks like she may have fetal alcohol syndrome. Is it possible that something else is the case? – Emma W., Los Angeles

A: Yes, it’s possible; although we don’t know what symptoms have made you suspect fetal alcohol syndrome. FAS happens because alcohol is what’s called a teratogen – a substance that can cross the placenta and damage a developing embryo and fetus. Other teratogens include antibiotics such as tetracycline, some acne meds, some anti-seizure meds, lithium, anti-rheumatics and chemotherapy – as well as recreational drugs. Experts believe that teratogens can begin affecting an embryo growing in the womb about 10 to 14 days after conception. Perhaps your niece was exposed to one of them in utero.

But whatever the cause of your concern, your niece needs to be evaluated by a pediatrician who’s a specialist in developmental problems ASAP. The sooner she’s treated for any developmental problems she may have, the better her chances of overcoming any deficits.

Fetal alcohol syndrome or fetal alcohol spectrum disorder happens when a woman consumes alcohol while pregnant. Often a woman doesn’t know she’s pregnant when she’s drinking – only 50 per cent of pregnancies are planned. (That’s why we suggest women of childbearing age and those trying to get pregnant skip alcohol.)

A meta-analysis of 328 studies found that worldwide, 9.8 per cent of women used alcohol during their pregnancy. Of that group, one in every 67 delivered a child with FAS.

FAS has distinct symptoms, although the degree to which they’re present is arrayed along a spectrum. A child is born with some cognitive impairments as well as physical impairments, such as low birth weight, low post-natal growth rate and what’s referred to as “dysmorphic facial features.”

Make sure your sister and niece get evaluated so the little one can get the care she needs right now.