What does FASD stand for?
It stands for Foetal Alcohol Spectrum Disorders. This is an umbrella term which covers a range of disorders that are caused by being exposed to alcohol in the womb. The most commonly occurring diagnoses are Full Foetal Alcohol Syndrome and Alcohol-Related Neurodevelopmental Disorder.
How common are FASD?
International studies suggest that one in every thousand children has Full Foetal Alcohol Syndrome. The wider spectrum of disorder has been shown in recent studies to be anywhere as high as 85 per 1000 or 8.5% in some groups, with most international studies agreeing on a rough estimate of 1-2% of the population being affected.
What difficulties might someone with FASD have?
It varies from person to person and can depend on how much alcohol they were exposed to in the womb.
Usually, they may have some brain damage and/or developmental difficulties. For example, they are more likely to be diagnosed with Autism or ADHD (Attention Deficiency Hyperactivity Disorder) and may also have difficulties with communication, social functioning, planning and understanding consequence. Many people have simply got problems with how their brains process information and this leads them to struggle in their lives.
Around 10% of those with FASD also develop distinctive facial features. Analysing these features often help us with diagnosis.
How much should I drink when pregnant?
Recent evidence suggests that drinking small amounts of alcohol while pregnant could have more effect on unborn babies than previously thought, but there are mixed messages from the science as it stands now.
It is easier to think of alcohol in terms of the risk from drinking rather than what is safe. If you drink a lot, the risk of causing harm is high. If you drink a little, the risk of causing harm is low. If you do not drink at all, you will not cause harm to your baby from alcohol. This is the only message that fits with the science as it stands today.
The Department of Health therefore recommends that women do not drink any alcohol while pregnant. If they do choose to drink, they should not drink more than one to two units of alcohol once or twice a week, and should not get drunk.
I am pregnant and have had a few drinks. Should I be worried?
Not in the first instance. Whilst we know some things such as your age and nutritional status may affect the health of your baby, it is not always the case that if you drink alcohol, your baby will automatically develop an alcohol-related disorder.
That said, the Department of Health recommends that pregnant women do not drink alcohol when pregnant, because the research into this area is new and on-going.
What should I do if I suspect my child has a FASD?
Your first point of contact should be your GP, midwife or health visitor. They may refer you to a geneticist if your child has the distinctive facial features associated with FASD. However, as this only happens to around 10% of those with a disorder, it may not be until the child starts to experience other difficulties (for example in their behaviour) that they may be refer you onto a developmental paediatrician or psychiatrist.
We accept direct referrals in certain circumstances; usually children aged at least six. By this age, the development delays we would look out for are present but there is still time to help and intervene in managing and treating the disorder. Read Referrals for more information.
Why do you need to have genetic testing? Is FASD a genetic syndrome?
No, FASD is not a genetic syndrome but the presentation of FASD from a behavioral point of view overlaps with other conditions. Good practice would suggest that in order to confidently diagnose FASD, you must first rule out other disorders that are known to have similar behavioral presentations. The most recent research suggests that a CGH array is the best test to conduct in order to look at this. We cannot do that in clinic here, although we can refer on to our regional service at a cost. It is often easier, and in most cases is already commissioned, to have these tests done locally before referral to us.
What help is available once a diagnosis is made?
FASDs can't be cured but they can be managed. The earlier they are diagnosed, the more that can be done to help.
Once someone is diagnosed, we focus on helping that person manage their condition, with the aim of preventing secondary social and psychological conditions developing in the long term, such as social exclusion and mental ill health.
I have more questions
Contact us if you have any more queries.
Dr Raja Mukherjee is recognised as a leading expert in Foetal Alcohol Spectrum disorders (FASD).
Below he answers common questions about FASD. We hope you will find these useful. If you have any further questions in relation to the videos below or any other aspect of the website you can tweet Dr Mukherjee on @rajamukherjee10.