FREE ESSAY ON FETAL ALCOHOL SYNDROME

FETAL ALCOHOL SYNDROME

Fetal Alcohol Syndrome: A Preventable Birth Defect
"If women didn't drink anymore during pregnancy, there would never be another baby born
with Fetal Alcohol Syndrome or Fetal Alcohol Effect" (McCuen 33). This is a very powerful
statement. It is also a very simple cure for an alarmingly high birth defect that all
women have the power to stop. "Every year more than 40,000 American children are born
with defects because their mother drank alcohol while pregnant " (McCuen 34). That is 1
to 3 per 1,000 live births (McCuen 31). Many of these cases go undiagnosed "It is also
the number one cause of mental retardation in the United States, and one of the three
leading causes of birth defects." (McCuen 33-34). "Alcohol produces more significant
neurobehavioral effects in the fetus than other drug including cocaine, heroin and
marijuana" (Fetal). With such horrible repercussions associated with drinking alcohol why
would any woman think of drinking alcohol during pregnancy, but thousands of women do
everyday. 
First let's begin by defining what Fetal Alcohol Syndrome and Fetal Alcohol Effect are.
FAS and FAE for short. FAS "is a cluster of congenital defects including nervous system
dysfunction" (McCuen 31). "FAE shares some of the same characteristics as FAS, but it is
not as evident. However babies with FAE have equal amount of brain damage as babies with
FAS" (Fetal). FAS and FFAE are caused by the ingestion of teratogens. "Tetragon's are any
substance capable of producing fetal abnormalities, such as alcohol or tobacco"
(Dworetzky 81). In the case of FAS and FAE, alcohol is the tertagion. "FAS and FAE are a
group of birth defects that have no cure. People with FAS or FAE have a range of problems
as severe as being mentally retarded too less visible problems like difficulty paying
attention" (McCuen 33). Some other problems associated with the syndrome may be learning
problems, with low IQ's, developmental delays both physical and mental, difference in
facial features, being hyperactive, small for their age or a variety of health problems,
with 
We have known the effects of alcohol on the fetus since 1968. A French scientist by the
name of Lemoine "recognized the multiple effects that alcohol can have on a developing
fetus (Broadwell and Saunders 555). "The findings of Lemoine were dismissed, but not
until 1973 when Jones published a report on the effects of alcohol on children of
alcoholic mothers. In Jones' report he categorized traits of FAS in five categories.
Growth, performance, cranio-facial, skeletal and cardiac" (Broadwell and Saunders 555).
The first category is growth, which includes pre and postnatal onset growth deficiencies.
The second category is performance, which includes low IQ's; the average IQ is 63 in a
child with FAS of FAE. Another factor affected in performance is fine motor dysfunction,
which is manifested by weak grasp, poor hand-eye coordination, and/or tremulousness,
irritability in infancy, and hyperactivity in child hood. The third category is
cranio-facial abnormalities, which include mild to moderate microcephaly (Small head
size), short palpebral fissures (eye slits), maxillary hypoplasia, and short nose, smooth
philtrum (zone between the nose and the mouth) with thin and smooth upper lip. The fourth
category is skeletal abnormalities which include joint abnormalities including abnormal
position and/or function, altered palmer crease patterns, small distal phalanges, small
fifth fingernail. The final category is Cardiac abnormalities that include heart murmurs,
frequently disappearing by 1 year of age. Ventricular septal defect most common followed
by auricular septal defect (Browdwell and Saunders 555). 
In some cases of FAS renal problems have been also diagnosed. "A spectrum of anomalies of
the kidney and urinary tract has been observed among children with moderate or extensive
signs of FAS" (Rossett and Weiner 69). "Hepatic (liver) disease has been observer as well
in several FAS cases" (Rossett and Weiner 70). "Children with FAS may also be more
susceptible to life threatening bacterial infections as well a minor infectious
diseases...Small bones in the base of the skull may cause morphologic problems of the
nasal sinuses which predispose them to obstruction and infection" (Rosett and Weiner
71-71). 
"Alcohol, like other teratogenic agents, is associated with a spectrum of malformations
related to dose and timing. The multiplicity of effects suggests that alcohol can alter
development throughout gestation" (Rosett and Weiner 65). Therefore because it is not
known when in fetal development when alcohol causes neurological and physical defects no
amount of alcohol is safe. The best way to prevent FAS is by abstaining from the use of
alcohol products. This sounds so simple, but for many women it is not. Usually infants
born to mothers who are alcoholics have little to no prenatal care. With no prenatal care
a mother who consumes alcohol is not warned or told of the dangers of drinking. A lot of
these children end up in foster care being shuttled back and forth between families, due
to the behavioral and physical problems 
FAS and FAE does not discriminate against race, creed or color. Studies have shown, "In
the United states one in 500 children is diagnosed with FAS and one in 300 children is
diagnosed with FAE. On the Indian reservation the numbers are much more staggering. They
are one in 99 FAS children born" (McCuen 59) "FAS is 30 times more commonly reported in
Native Americans than it is in whites, and six times more common in blacks" (McCuen 55).
It is estimated that nearly 40% of all Native American women meet the criteria for
alcohol dependency (McCuen 46). That would explain why they are 30 times more likely to
have a child with FAS or FAE. If something is not done immediately there will be an
explosion of FAS or FAE children in the Native American community. "The reported rates of
FAS are higher among Native Americans and African Americans. These differences may be due
to actual differences in the occurrence, or may in part reflect under-diagnosis among
some racial/ethnic groups, and over-diagnosis among others. Nonetheless, we must help all
women to realize the dangers associated with fetal exposure to alcohol" (CDC).
"Publicly funded treatment program's in the United States are only able to serve 11% of
more than an estimated 280,000 pregnant alcohol and drug-dependent woman who seek
treatment" (McCuen 63). I find this appalling, in " New York a survey of treatment
programs found that pregnant addicted woman were refused treatment by more than half of
the available treatment programs" (McCuen 63). 
"FAS and other alcohol-related birth defects can be prevented if women do not drink
alcohol during pregnancy. They must use reliable birth control methods when they engage
in patterns of binge drinking (5 or more drinks on one occasion) or regular drinking at a
level of more than 7 drinks per week. The CDC is working to develop innovative approaches
for identifying women at high risk of having a child with FAS, for helping them
understand the risks that drinking poses for their unborn babies, and for helping them
change their behavior. CDC currently funds projects that are testing a variety of
methods" (CDC). Some of the methods include "Screening in prenatal clinics, Detecting
cases of FAS in order to identify women at high risk of giving birth to another child
with FAS, Counseling and support to achieve abstinence, Case management and
follow-up"(CDC). 
The Center for Disease Control (CDC) is implementing many prevention methods in combating
FAS and FAE some of them include "Collaborative partnerships with states, universities,
and other organizations to develop state and locally based systems for surveillance of
FAS and other alcohol-related birth defects. For instance, the CDC has worked with state
and local health departments in Washington to develop a population-based model for FAS
surveillance among first grade students in two counties in the state. They identified
previously unknown cases of FAS and referred the children for therapeutic and special
education services. Their mothers were referred to local health care providers." (CDC).
Another prevention method the CDC has implemented is "Disseminate information, in
collaboration with other agencies, from the ongoing systematic collection, analysis, and
interpretation of FAS data. State and local programs can use this information to modify
their activities so that they are using the most cost-effective strategies to combat FAS
and other alcohol-related birth defects" (CDC). The CDC can only implement these
programs, but it is up to the states to utilize these programs to help inform woman of
the dangers of alcohol. There are several agencies, organizations, states and
universities affiliated in implementing the CDC's programs some of them include "The
Indian Health Service," who" have signed an inter-agency agreement with CDC for a joint
program to prevent FAS. Three universities and five state health departments have
cooperative agreements with the CDC to develop surveillance methods for identifying
high-risk women, to design prevention strategies, and to evaluate the effectiveness of
these strategies. Another project exists with the Association of Schools of Public
Health, Emory School of Public Health, and Georgia Mental Health Institute to develop an
accurate method for conducting active, hospital-based FAS surveillance and a case-control
study of risk factors for FAS. Monroe County Health Department (NY) has a cooperative
agreement with the CDC to use a follow-up program for high-risk infants to develop
methods for identifying children with FAS after the newborn period. 
While there is no cure for FAS or FAE there have been some treatments developed.
"Treatment programs need to include special education and vocational training components
that emphasize skills leading to the patient functioning in society in the least
restrictive, but safest possible environment" (McCuen 50). Prevention of FAS is the most
effective treatment. The cost is astonishing for the long term care of children who have
FAS or FAE. In Alaska Senator John Binkly estimated the cost at over 1.4 million dollars
over the life span of the individual. Multiple this estimated cost by about 40,000
children a year born with FAS or FAE and the cost is astronomical (McCuen 50). The only
possible option for prevention of FAS and FAE is to abstain from alcohol. "If only woman
didn't drink anymore during pregnancy, there would never be another baby born with Fetal
Alcohol Syndrome or Effect" (McCuen 33).
Bibliography
Work Cited
Broadwell, Debra and Saunders, Rebecca B. Child Health nursing comprehensive approach to
the care of children and their families. Philadelphia: J.B. Lippincott, 1993.
Dworetzky, John P. Introduction to Child Development. St. Paul, MN: Web, 1996.
Fetal Alcohol Syndrome. Oklahoma University. 20 Jan.2001 .
McCuen, Gary E. Born Hooked. Hudson, WI: Gary E. McCuen Publications, 1994.
Rosett, Henry L. And Weiner, Lyn. Alcohol and the Fetus a Clinical Perspective. New York:
Oxford University Press, 1984.
Stratton, Kathleen, Howe, Cynthia, Battaglia, Fredrick. Fetal Alcohol Syndrome:
Diagnosis, Epidimiology, Prevention, and Treatment. Washington, D.C.: National Academy
Press, 1996. 
Prevent Fetal Alcohol Syndrome and other Alcohol-Related Developmental Disabilities
20 Dec 1996. The Center for Disease Control. 20 Jan 2001 
.