Fetal alcohol spectrum disorder

What is fetal alcohol spectrum disorder?

Fetal alcohol spectrum disorder (FASD) is the term used for a wide range (spectrum) of behavioural, developmental and physical problems in babies. FASD can happen when alcohol in the mother or birthing parent blood passes to the baby through the placenta.

 The damage caused by alcohol cannot be reversed or cured. But health professionals can support people to live well with FASD. 

Around 3 in 100 children in the UK live with FASD.

FASD can be avoided by not drinking alcohol during pregnancy.

What causes fetal alcohol spectrum disorder?

If you drink during pregnancy, alcohol passes from your blood to your baby through the placenta. Your baby’s tiny body cannot process it as well as your body can. They are also exposed to it for longer. This is because alcohol also passes into the amniotic fluid that surrounds them. Your baby swallows this, wees back into the fluid and then swallows it again. So, they can swallow alcohol over and over again.

There is no proven safe amount of alcohol that you can drink during pregnancy. The more you drink, the greater the risk of harm to your baby.  

Whether FASD symptoms are mild or severe depends on how much, and how often, a person drinks throughout their pregnancy. The larger the amount of alcohol consumed, the more severe symptoms often are.

What is the difference between fetal alcohol spectrum disorder and fetal alcohol syndrome?

Drinking alcohol heavily or regularly in pregnancy can also cause Fetal alcohol syndrome (FAS).  

FAS is more severe than FASD. Children with FAS usually have severe physical and mental disability.

What are the physical and mental signs of fetal alcohol spectrum disorder?

A baby with FASD does not always show symptoms when they’re born, but physical signs may include:

• distinctive facial features, such as small eyes, a thin upper lip, and a smooth area between the nose and upper lip  
• a head that is smaller than average (microcephaly)
• a cleft palate or lip
• abnormally developed fingers or toes.

Problems with mental (cognitive) and physical development may become clearer later. These include:

• issues with sleep and feeding
• problems with hearing and vision
• problems with kidneys, heart or other organs
• learning difficulties, such as problems with thinking, speech or memory
• problems with balance and coordination
• issues with managing emotions and developing social skills
• mood, attention or behavioural problems
• problems with the joints, muscles or bones
• poor growth – they may grow slowly as they get older and be shorter than average as an adult.

Drinking alcohol during pregnancy can also increase the risk of a baby being born with cerebral palsy, a lifelong condition that affects movement and coordination. NHS has more information about cerebral palsy.

How is fetal alcohol spectrum disorder diagnosed and how early?

It is extremely unlikely that any ultrasound scans you have during pregnancy will be able to find signs of FASD in your baby. This means that your healthcare professional will not be able to diagnose the condition before your baby is born. 

Can I drink any alcohol during pregnancy?

No amount of alcohol has been found to be safe to drink during pregnancy. Even low levels can affect your baby, so the safest approach is that you do not drink any alcohol at all during pregnancy.

Try not to worry if you drank alcohol before you knew you were pregnant. The risk of harm to your baby is likely to be low. The main thing is to stop drinking as soon as you can. Stopping drinking alcohol in pregnancy as soon as possible will cut the risk of harm to your baby.

Talk to your doctor or midwife if you are worried about alcohol use during pregnancy. You can be honest with them if you’re concerned that you cannot stop. They’re there to support you, not to judge you, so try to be open about drinking alcohol. They can get extra support for you.

You might find our tips for an alcohol-free pregnancy helpful.

Find out more about alcohol in pregnancy.

Can I drink alcohol if I’m trying to get pregnant?

Doctors recommend not drinking any alcohol at all if you are trying for a baby.

This is because drinking alcohol is linked to fertility problems in both men and women. If you drink a lot, and often, you may find it harder to get pregnant. There is also a risk that you may be pregnant for a few weeks before you realise. Find out more about alcohol and planning a pregnancy.  

What treatment is there for fetal alcohol spectrum disorder?

Unfortunately, the damage caused by alcohol cannot be reversed. But early treatment and specialist can make a big difference to your child's life. That's why it's best to get support as soon as possible.

Speak to your GP or health visitor if you have concerns about your child's development or think they could have FASD. Getting your child the help they need is the best thing you can do for them. Your GP or health visitor are there to support you. They can refer your baby for an assessment, which involves a physical examination and blood tests, to rule out other conditions that have similar symptoms to FASD.

Sometimes, it’s hard to spot some of the signs and symptoms of FASD in very young children, so your child might not be diagnosed until they’re older.  

If FASD is diagnosed you will be given educational and behavioural strategies to meet your child’s needs and help them cope better.

Are there any other risks of drinking alcohol in pregnancy?

Yes. Drinking during pregnancy can increase your risk of:

• miscarriage  
• stillbirth
• premature labour
• having an underweight baby.

The more you drink, the more your baby will be affected, and the less healthy they will be. Stopping drinking will increase your chance of having a healthy pregnancy and baby. Doing this as soon as you are pregnant or better still, when you are trying to get pregnant, can help you avoid damage that cannot be reversed. 

Where can I find more support and information?

National Organisation for FASD is a UK support group for people with fetal alcohol spectrum disorder and their families.

Drinkline is a national alcohol helpline. If you're worried about your own drinking or someone else's, call this free helpline on 0300 123 1110 (weekdays 9am to 8pm, weekends 11am to 4pm).

With You is a UK-wide charity that provides free support to people who have issues with drugs, alcohol or mental health.

Alcoholics Anonymous (AA) is a free self-help group. Its "12-step" programme involves getting sober with the help of support groups.