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Alcohol and pregnancy—what is foetal alcohol spectrum disorder?

A young pregnant woman on a couch holds up her hand to refuse and offered glass of wine

Foetal alcohol spectrum disorder (FASD) is a lifelong neurodevelopmental condition caused by a child’s exposure to alcohol while in the womb.

The World Health Organisation defines neurodevelopmental conditions as: disabilities in the functioning of the brain that affect a child’s behaviour, memory, or ability to learn.

FASD in Australian is frequently undiagnosed or hidden. Children with FASD can face significant lifelong challenges with physical activities, communication, learning, memory, and behaviour.

This can lead to problems at school, their personal lives and result in antisocial and disruptive behaviour.

How FASD occurs

Alcohol can cross the placenta during pregnancy, leaving the unborn baby exposed to similar blood-alcohol levels as their mother.

There is no safe amount of alcohol that can be consumed when pregnant, as even a small amount of alcohol can harm the baby.

Experts say it’s impossible to predict the amount needed to cause harm as it depends on the type of drinking (e.g., binge drinking), the mother’s genetics and body type, the baby’s genetics, and how the baby metabolises alcohol.

Unfortunately, there’s still outdated and incorrect information that suggests otherwise, and some medical professionals still say it’s okay to drink a glass of wine now and then, or if you’re not in the first trimester (first 3 months).

In many cases, alcohol exposure isn’t deliberate. Up to 50 per cent of pregnancies are unplanned which means women may consume alcohol unaware they are pregnant. For the minority, it’s from significant alcohol dependency.

FASD is not the only possible health risk of drinking alcohol when pregnant.

It can also lead to premature birth or lower birth weight, miscarriage, and a range of other physical, mental, behavioural and learning disabilities.

If you think you may be dependent on alcohol, you should seek support prior to, or during pregnancy, to minimise the risk of harm to your baby. (See getting help below.)

A baby in the womb

Diagnosing, assessing, and managing FASD

Diagnosing FASD is complex. It usually presents as pre-natal alcohol exposure and neurodevelopmental impairment, in three or more developmental areas. Certain facial or other physical features may also be an indicator.

FASD can co-exist with other conditions, so other neurodevelopmental impairments, such as genetic conditions, environmental toxins, and early life trauma, are also considered.

A multidisciplinary team of health professionals, such as paediatricians, psychologists, speech and occupational therapists may be used to assess and diagnose FASD.

As this can be challenging in rural and remote areas, work is underway to improve this and better support community diagnosis.

Support for FASD and other developmental concerns

If you suspect your child has FASD, or are concerned about their development, you can seek support without a diagnosis.

If they’re six or under, connect with an early childhood partner through the National Disability Insurance Scheme (NDIS).

While FASD is a chronic (persistent) neurodevelopmental disorder, interventions and support services are emerging.

It’s important to have a clear understanding of the child’s strengths and challenges to inform an individual learning plan or key developmental goals.

This helps parents, carers, teachers, therapists, and others understand the child and ensure their environment and tasks match their underlying abilities.

This can also help reframe what may be considered challenging behaviours from ‘they won’t’ to ‘they can’t without support.’

Early intervention is important, and an understanding support team can prevent children from suffering long-term implications, such as low self-esteem, mood disorders, school refusal and juvenile justice issues.

Caring for yourself or a loved one who is pregnant

Everyone has a role to play to provide a clear and consistent message around the importance of having an alcohol-free pregnancy.

The Pregnant Pause initiative is a great community of support for mums-to-be and their families and raise awareness of the serious side effects alcohol can have on an unborn baby.

Getting help

If you or someone you care about has an alcohol or other drug concern, contact the confidential Adis 24/7 drug and alcohol support service. Adis is a 24 hour, 7 day a week confidential support service for people in Queensland with alcohol and other drug concerns, their families and health professionals.

Visit the Adis website, or phone 1800 177 833.

Thank you to Dr Francoise Butel of the FASD Clinic at Gold Cost Hospital and Health Service for providing fact-checking and expert input into this blog.

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Last updated: 11 March 2022