International Foetal Alcohol Syndrome Day, 9 September 2012

Many mothers are not aware that drinking excessive amounts of alcohol during pregnancy can be harmful to their unborn baby. Alcohol may be toxic to the foetus and can cause a number of health problems for both the mother and the unborn child including spontaneous abortion, premature labour, stillbirth and foetal alcohol syndrome, which is a variety of different birth defects.

As part of the Government Employees Medical Scheme's (GEMS) on-going effort to educate our members and future members on a range of healthcare topics, this article explores the subject of foetal alcohol syndrome this International Foetal Alcohol Syndrome Day, 9 September 2012. International Foetal Alcohol Syndrome Day is commemorated annually to improve awareness of the dangers of consuming alcohol while pregnant.

What is foetal alcohol syndrome?
Alcohol that is consumed easily crosses the placenta from mother to child. Excessive drinking may cause foetal alcohol syndrome (FAS), which is a range of conditions that affect the baby. Children who are born to mothers who drink heavily may suffer brain damage, mental handicaps, emotional and behavioural problems and birth defects, including defects of the face, heart and other organs. It should be noted that such damage caused to an unborn child by drinking is permanent and not reversible.

An individual who has been affected by FAS may experience a range of mental difficulties including:

• Low IQ
• Developmental delays
• Learning problems
• Behavioural problems
• Mental health problems such as depression
• Disorders such as attention deficit hyperactivity disorder
• Increased risk of substance abuse

It is estimated that between one and two thirds of children with special educational needs are affected by their mothers' alcohol drinking, according to the SA National Council on Alcoholism and Drug Dependence (SANCA). South Africa has one of the highest incidences of FAS in the world.

Additional risk factors
The damage that may be caused to a baby by drinking alcohol varies greatly and depends upon a number of factors and not just on the amount of alcohol that is consumed during pregnancy. It has been shown, for example, that women who smoke and take other drugs with alcohol tend to have children who are more severely affected by FAS.

The nutrition of the mother during pregnancy also plays an important role. The children of women who have had the benefit of better nutrition during their pregnancy tend to be less severely affected than those who are not well nourished. FAS therefore tends to be a more severe problem among the poorer sections of the population. However, it has been shown that even the children of wealthier women who have been well nourished often suffer from developmental, behavioural and learning problems if their mother has consumed a lot of alcohol during her pregnancy.

Among the risk factors for FAS are:

• Age - an older mother who is over the age of 30 is more likely to develop problems than a younger woman
• Poor nutrition and poverty
• Genes - some babies seem to have more of a predisposition to developing a problem than others
• The consumption of other drugs such as tobacco, prescription drugs, illegal drugs and caffeine
• A lack of knowledge about the dangers of alcohol.

Diagnosis
FAS is not always easily diagnosed as it causes other conditions, such as attention deficit hyperactivity disorder (ADHD), which may not necessarily be traced back to drinking. Indeed, doctors and parents may not even be aware that certain problems in a child are caused by FAS.

Treatment
As has already been noted, there is no cure for children who have been affected by FAS although special educational programmes and behaviour modification therapy are available to support children affected by the condition. There are also medications available to treat problems such as ADHD, and surgery for some congenital defects such as a heart defect. These treatments may be expensive, however, and it is preferable to prevent the condition rather than treat its symptoms.

How much is harmful?
Just how much alcohol can you drink during pregnancy? Small amounts of drinking have not yet been shown to have any negative effects on a foetus, but experts warn that alcohol is a very powerful drug for an unborn baby. Interestingly enough alcohol is considered to be more harmful to a foetus than illegal drugs such as marijuana, cocaine and even heroine, and none of those should be taken during pregnancy as they too can have an impact on the development of a growing baby.

Some experts say that pregnant women should not drink regularly or heavily, and certainly never get drunk. The World Health Organization (WHO) recommends that pregnant women and women who are trying to get pregnant should give up drinking completely. The KwaZulu-Natal Department of Health agrees saying that FAS is thought to be the third highest cause of intellectual disability in babies, and women should completely "refrain from drinking alcohol during pregnancy".

Avoid drinking during pregnancy
Drinking during pregnancy is dangerous for the baby and is not recommended. Any woman who is pregnant or who plans to get pregnant is well advised to give it up immediately. Those mothers who have a drinking problem should contact one of the many support groups that are available.

For any GEMS member queries please phone the GEMS call centre on 0860 00 4367 or send an SMS to 083 450 4367. GEMS will assist you in every way possible to ensure your family's health and wellbeing.

Sources:
1. KwaZulu-Natal Department of Health, www.kznhealth.gov.za/fas.htm.

2. Better Health Channel,
www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Fetal_alcohol_spectrum_disorder.

3. SANCA, www.sancawc.co.za/master/article.php?id=14.