Frequently Asked Questions

FAS and Other Prenatal Alcohol-Related Conditions

Q. What is FAS?

• FAS stands for fetal alcohol syndrome. It is one of the leading known preventable causes of mental retardation and birth defects. FAS is the severe end of a spectrum of effects that can occur when a woman drinks alcohol during pregnancy. Fetal death is the most extreme outcome. FAS is characterized by abnormal facial features and growth and central nervous system (CNS) problems. People with FAS may have problems with learning, memory, attention span, communication, vision, and/or hearing. These problems often lead to difficulties in school and problems getting along with others. FAS is a permanent condition. It affects every aspect of an individual’s life and the lives of his or her family. However, FAS is 100% preventable—if a woman does not drink alcohol while she is pregnant.

Q. What are FAE, ARND, and ARBD?

• Prenatal exposure to alcohol can cause a spectrum of disorders. Many terms have been used to describe children who have some, but not all, of the clinical signs of FAS. Three terms are fetal alcohol effects (FAE), alcohol-related neurodevelopmental disorder (ARND), and alcohol-related birth defects (ARBD). One way that FAE has been used is to describe children who have all of the diagnostic features of FAS, but at mild or less severe levels. In 1996, the Institute of Medicine (IOM) replaced FAE with the terms ARND and ARBD. Those with ARND may have functional or mental problems linked to prenatal alcohol exposure. These include behavioral and/or cognitive deficits. Examples are learning difficulties, poor school performance and poor impulse control. They may have difficulties with mathematical skills, memory, attention, and/or judgment. Those with ARBD may have problems with the heart, kidneys, bones, and/or hearing.

Q. How common are FAS and other prenatal alcohol-related conditions?

• The reported rates of FAS vary widely. These different rates depend on the population studied and the surveillance methods used. CDC studies show FAS rates ranging from 0.2 to 1.5 cases per 1,000 live births in different areas of the United States. Other prenatal alcohol-related conditions, such as ARND and ARBD, are believed to occur about three times as often as FAS.

Q. How do I know if my child has been affected by maternal alcohol use?

• If you think a child may have FAS or another prenatal alcohol-related disorder, contact a health specialist in your area. Please see the next question for information on how to locate a health specialist near you. Children with FAS or ARND may be small for gestational age or short in relation to peers and may have facial abnormalities such as small eye openings. They may have poor coordination or hyperactive behavior. They may have developmental disabilities such as speech and language delays, learning disabilities, mental retardation, or low IQ. They may have problems with self-care such as tying shoes or organizing one’s day. Persons with FAS or ARND can have poor reasoning and judgment skills and sleep and sucking disturbances (in infancy). Persons with FAS often have problems as they get older. These might include mental health problems, disrupted school experiences, trouble with the law, unemployment, and/or inappropriate sexual behavior.

Q. I suspect my child may have FAS. What should I do?

• You may want to contact the National Organization on Fetal Alcohol Syndrome (NOFAS). NOFAS has a directory of national and state services such as diagnostic and treatment services and family support groups. Go to http://www.nofas.org/. At their home page, click on “Resources and Information.” From there, click on “National & State Directory.” From the map, click on your state for a list of services.

Q. Can FAS be treated?

• FAS is a permanent condition. It lasts a lifetime. It affects every aspect of a child's life and the lives of his or her family members. There is no cure for FAS. However, FAS is the only birth defect that can be completely prevented – if a woman does not drink alcohol while she is pregnant. With early identification and diagnosis, a child with FAS can get services that can help him or her lead more productive lives.

Q. If a woman has FAS, but does not drink during pregnancy, can her child have FAS? Is FAS hereditary?

• FAS is not genetic or hereditary. If a woman drinks alcohol during her pregnancy, her baby can be born with FAS or another prenatal alcohol-related condition. If a mother was born with FAS or another prenatal alcohol-related condition, her own child cannot have FAS or a related condition, unless she drinks alcohol during pregnancy.

Q. What are the economic consequences of FAS?

• The 10th Special Report to the U.S. Congress on Alcohol and Health estimated the annual cost of FAS in 1998 to be $2.8 billion.
   

Pregnancy and Alcohol Use

Q. Is there any safe amount of alcohol to drink during pregnancy? Is there a safe time during pregnancy to drink alcohol?

• When a pregnant woman drinks alcohol, so does her unborn baby. There is no safe amount of alcohol that a woman can drink during pregnancy. There is also no safe time during pregnancy to drink alcohol. The negative effects of alcohol on an unborn fetus can occur in every trimester of pregnancy. Therefore, women should not drink if they are pregnant, planning on becoming pregnant, or could become pregnant (that is, sexually active and not using an effective form of birth control).

Q. How does alcohol cause these problems?

• If a woman drinks alcohol while pregnant, her developing fetus is at risk for a spectrum of harmful effects. These include: miscarriage, abnormal facial features, and growth and CNS problems. Alcohol in the mother's blood crosses the placenta freely and enters the embryo or fetus through the umbilical cord. Alcohol exposure in the first three months of pregnancy can cause structural defects (e.g., facial changes). Growth and CNS problems can occur from drinking alcohol any time during pregnancy. The brain is developing throughout pregnancy. It can be damaged at any time. It is unlikely that one mechanism can explain the harmful effects of alcohol on the developing fetus. For example, brain images of some persons with FAS show that certain areas have not developed normally. The images show that certain cells are not in their proper place and tissues have died in some areas. Click here for more information on the underlying mechanisms of prenatal alcohol exposure [PDF].

Q. What is a "drink"? What if I only drink beer or wine coolers?

• All drinks containing alcohol can hurt an unborn baby. A standard 12-ounce can of beer has the same amount of alcohol as a 4 ounce glass of wine or a 1-ounce shot of straight liquor. Some alcoholic drinks such as malt beverages, wine coolers, and mixed drinks often contain more alcohol than a 12-ounce can of beer.

Q. Is there anything I can do now to decrease the chances of having a child with FAS?

• If a woman is drinking during pregnancy, it is never too late for her to stop. The sooner a woman stops drinking, the better it will be for both her baby and herself. A woman should use an effective form of birth control until her drinking is under control. If a woman is not able to stop drinking, she should contact her physician, local Alcoholics Anonymous or local alcohol treatment center, if needed. The Substance Abuse and Mental Health Services Administration (SAMHSA) has a Substance Abuse Treatment Facility locator. This locator helps people find drug and alcohol treatment programs in their area.

• If a woman is sexually active and not using an effective form of birth control, she should not drink alcohol. She could be pregnant and not know it for several weeks or more.

• Mothers are not the only ones who can prevent FAS. Significant others, family members, schools, health and social service organizations and communities can help prevent FAS through education and support.

Q. I just found out I am pregnant. I have stopped drinking now, but I was drinking in the first few weeks of my pregnancy, before I knew I was pregnant. Could my baby have FAS? What should I do now?

• The most important thing is that you have completely stopped drinking after learning of your pregnancy. It is never too late to stop drinking. The sooner you stop, the better the chances for yourself and your baby. It is not possible to know what harm may have been done already. Some women may drink heavily during pregnancy and their babies are fine. Others drink less and their babies show various signs of alcohol exposure. Many body parts and organs are developing in the embryonic stage (weeks three to eight of the pregnancy). This is the time when most women do not know they are pregnant. There is no known safe amount of alcohol or safe time to drink alcohol during pregnancy. It is recommended not to drink at all if one is pregnant or planning to become pregnant. If a woman is sexually active and not using an effective form of birth control, she should not drink at all. The best advice is to talk to your doctor about this and be sure to receive routine prenatal care throughout your pregnancy.

Q. Can a father’s drinking cause FAS?

• How alcohol affects the male sperm is currently being studied. Whatever the effects are found to be, they are not FAS. FAS is specifically caused by the mother’s alcohol use during pregnancy. However, the father’s role is important. He can help the woman abstain from drinking alcohol during pregnancy. He can encourage her abstinence from alcohol by avoiding social situations that involve drinking. He can also abstain from alcohol himself.

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This page was last updated Thursday, August 05, 2004

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National Center on Birth Defects and Developmental Disabilities

The National Center on Birth Defects and Developmental Disabilities (NCBDDD) promotes the health of babies, children, and adults, and enhances the potential for full, productive living.  Our work includes identifying the causes of birth defects and developmental disabilities, helping children to develop and reach their full potential, and promoting health and well-being among people of all ages with disabilities.