Fetal Alcohol Syndrome (FAS): Meaning, Symptoms, Treatment

Written by Medicover Team and Medically Reviewed by Dr Vempati Satya Surya Prasanthi , Pediatrician

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Fetal Alcohol Syndrome (FAS) is a condition that develops in a baby when the mother consumes alcohol during pregnancy. Alcohol crosses the placenta and affects the developing fetus, which causes permanent physical, behavioural and cognitive problems in babies. It is one of the most severe conditions in the group of disorders known as Fetal Alcohol Spectrum Disorders(FASD).

FAS has lifelong effects and cannot be cured but early diagnosis and supportive care can improve the child's quality of life. The severity of symptoms varies but children with FAS face many challenges in learning, social interaction and in their growth and development.

Types of Fetal Alcohol Syndrome

Fetal Alcohol Syndrome belongs to a group of conditions known as Fetal Alcohol Spectrum Disorders (FASD). These disorders vary in severity depending on how alcohol exposure has affected the baby during pregnancy. The main types include:

• Complete Fetal Alcohol Syndrome (FAS):This is the most severe form, where a child shows the characteristic facial features, poor growth before and after birth and learning or developmental difficulties.
• Partial Fetal Alcohol Syndrome (pFAS):Children with pFAS display some but not all of the classic features of FAS. They may have mild facial differences or growth issues along with behavioural and cognitive challenges.
• Alcohol-Related Neurodevelopmental Disorder (ARND):In this type, physical appearance is usually normal but children face serious problems with brain function. They may struggle with memory, learning, attention, impulse control or judgment.
• Alcohol-Related Birth Defects (ARBD):This includes structural or functional problems in organs such as the heart, kidneys, bones or hearing system that are linked to alcohol exposure during pregnancy.

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Signs and Symptoms of Fetal Alcohol Syndrome

The signs of Fetal Alcohol Syndrome can affect many areas of a child's development. Doctors usually group the symptoms into three major categories like physical features, growth patterns and brain or behavioural problems. The severity can vary from mild to severe and not all children will show the same signs.

Common Symptoms of FAS

• Physical Characteristics:
• Smaller than average head size or microcephaly.
• Smooth ridge between the nose and upper lip that is the absence of philtrum.
• Thin upper lip and flat midface.
• Small or widely spaced eyes.
• Shorter height and lower body weight compared to peers.
• Growth-Related Issues:
• Slow growth before birth.
• Continued poor growth after birth.
• Difficulty gaining weight despite proper nutrition.
• Brain and Behavioural Challenges:
• Poor coordination, clumsiness or balance problems.
• Learning difficulties such as trouble with memory or understanding instructions.
• Hyperactivity, restlessness and short attention span.
• Delayed speech and language development
• Impulsivity, poor judgment and difficulty solving problems
• Struggles with making or maintaining friendships due to social challenges

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Causes of Fetal Alcohol Syndrome

The only known cause of FAS is alcohol consumption during pregnancy. When a pregnant woman drinks, alcohol passes through the placenta and affects the fetus, which cannot process alcohol effectively. This interferes with oxygen supply and normal development of the brain and overall growth of the fetus.

The risk increases with:

• Heavy or binge drinking during pregnancy.
• Drinking during the first trimester, which is the critical stage of brain development.
• Continuous alcohol use throughout pregnancy.

There is no safe level of alcohol consumption during pregnancy. Even small amounts may cause harm.

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Complications of Fetal Alcohol Syndrome

Fetal Alcohol Syndrome does not just affect childhood; it can create lifelong challenges if not managed early. The complications may range from learning and behavioural issues to serious health concerns that impact daily living.

• Learning and intellectual difficulties like children may struggle with academic performance, memory and problem-solving.
• Social and behavioural challenges like difficulty in making friends, poor impulse control and difficulty adjusting to social situations are common.
• Sensory problems such as vision or hearing impairments can affect communication and learning.
• Organ-related defects like some children develop abnormalities of the heart, kidneys or bones.
• Neurological issues such as Seizures, poor coordination or developmental delays may occur.
• Long-term dependence like many people may find it difficult to live independently as adults.
• Mental health risks like Anxiety, depression and other psychiatric concerns may develop over time.

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When to See a Doctor

Parents should not delay seeking medical help if they notice signs that suggest developmental or behavioural concerns in their baby after birth. Early treatment can help the child improve and control the impact of the syndrome.

Consult a doctor if your child:

• Has developmental delays in learning, speech or movement.
• Shows distinct facial features or poor growth compared to peers
• Struggles with attention and memory or controlling behaviour.
• Experiences coordination problems or frequent hyperactivity.
• Was known to have been exposed to alcohol before birth.

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Diagnosis of Fetal Alcohol Syndrome

Diagnosing FAS can be challenging because its symptoms resemble other developmental conditions like ADHD or autism. Doctors use a combination of medical history, physical features and behavioural assessments to diagnose FAS.

Steps in Diagnosis:

• Medical history: This is to evaluate whether the mother consumed alcohol during pregnancy.
• Physical examination: This is done to identify distinctive facial features, head size or growth restrictions.
• Neurological evaluation: The doctor performs this test to assess coordination, reflexes and brain function.
• Developmental and behavioral testing: This test is done to measure learning skills, memory, language and social interaction of the baby.
• Imaging tests: Some imaging tests like MRI/CT scans, are performed to scan the brain for detecting structural differences.

An accurate diagnosis is important because it helps families access specialised therapies, educational support and medical care tailored to the child's needs.

Treatment & Management of Fetal Alcohol Syndrome

There is currently no cure for Fetal Alcohol Syndrome (FAS) but early treatment and continuous support can improve the child's development and quality of life. A combination of therapies, treatment and family support can help children achieve successful results.

1. Lifestyle and Home Support

• Establish a structured daily routine to give the child stability and reduce confusion.
• Provide extra attention in school through personalised learning support.
• Encourage regular physical activity to strengthen coordination and motor skills.
• Involve parents and caregivers to share experiences and coping strategies.

2. Developmental Therapies

• Speech therapy: Focuses on enhancing communication skills and addressing language delays.
• Occupational therapy: Promotes independence by improving fine motor skills and daily living activities
• Behavioral therapy: Helps manage hyperactivity, impulsive behavior and social interaction issues.
• Special education programs: Provide personalised teaching methods to improve academic performance.

3. Fetal Alcohol Syndrome Treatment

• Doctors may prescribe medications to manage associated problems such as ADHD, anxiety or depression.
• Routine health check-ups for vision, hearing and heart function are important, as FAS may affect multiple organs in your baby.

4. Family and Parental Guidance

Children with FAS can make steady progress in learning, behaviour and social skills if the symptoms are managed and treated with care and support.

• Parenting training programs teach them how to handle or control the behavioural and emotional challenges of their babies.
• Counselling services help families cope with stress and maintain a supportive environment at home.

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Prevention of Fetal Alcohol Syndrome

Fetal Alcohol Syndrome is 100% preventable. The most effective way to prevent it is for women to completely avoid alcohol during pregnancy.

• Women who are planning for a pregnancy should stop drinking before conceiving.
• Because many pregnancies are unplanned, so avoid alcohol if you are trying to conceive.
• If a woman consumed alcohol before realising she was pregnant, she should stop immediately and see a doctor to control the impact on the baby.

FAS and other alcohol-related birth disorders can be fully prevented by raising awareness and making safe choices.

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Conclusion

Fetal Alcohol Syndrome is a lifelong condition caused by alcohol exposure during pregnancy. Although it is difficult to cure this syndrome completely, early diagnosis, therapies and supportive care can improve a child's development and quality of life. The best prevention is complete avoidance of alcohol during pregnancy.

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