Fetal Alcohol Spectrum Disorders

1. Fetal Alcohol Spectrum Disorders Carolyn Washburn, MS Family Consumer Science Agent

3. What is Fetal Alcohol Syndrome? Fetal Alcohol Syndrome (FAS) is a pattern of malformations and disabilities resulting from a pregnant woman drinking heavily during her pregnancy. FAS will not occur if the father was drinking heavily or if the pregnant woman was drinking a very small amount of alcohol on rare occasions. Heavy drinking on a consistent basis or binge drinking on an occasional basis can produce FAS.

4. # 1 Cause of Mental Retardation Fetal Alcohol Syndrome is currently the leading cause of mental retardation in the United States.

5. Fetal Alcohol Effects Fetal Alcohol Effects (FAE) is a condition where children are born with less dramatic physical defects, but with many of the same behavioral and psychosocial characteristics as those with FAS. FAE is often thought of as lower on a continuum than FAS, but this is not correct. Many individuals with FAE, while looking quite normal, have significant deficits in their intellectual, behavioral, and social abilities which prevent them from leading normal lives.

6. Alcohol in a pregnant woman's bloodstream circulates to the fetus by crossing the placenta. There, the alcohol interferes with the ability of the fetus to receive sufficient oxygen and nourishment for normal cell development in the brain and other body organs.

7. Costs of FASD On an average, each Fetal Alcohol individual will cost the taxpayer more than $3 million in his or her lifetime. This includes health, special education, psychotherapy, counseling, welfare, crime and the justice system. More than 60% of prisoners are likely affected by alcohol in utero. Add on cost to families (foster, adoptive, natural). Lifetime costs to the individual.

8. Baby with Fetal Alcohol Syndrome Whose baby is this? Baby with Fetal Alcohol Syndrome – IS EVERYBODYS Baby! This is Everybody’s Baby! • Medical costs$ 1,496,000 Special Education $240,000 • Psychiatric care $530,000 Orthodontia $12,000 • Foster care costs $354,000 SSI $360,000 • Respite care $6,000 Residential placement $376,000 • Supported employment $624,000 • Total $ 4,998,000 • Lifetime costs for one child: $5 million* • Who pays for the effects of prenatal exposure to alcohol? Everybody does! • * Figures do not include lost salary of mother and subsequent impact on the local economy.

9. Physical Characteristics

10. Brain Development

11. FAE individuals between 12-51 • 95% will have mental health problems. • 60% will have “disrupted school experience”. • 60% will experience trouble with the law. • 55% will be confined in prison/or treatment center. • 52% will exhibit inappropriate sexual behavior.

12. FAE individuals between 21-51 • More than 50% of males and 70% of females will have drug and alcohol problems. • 82% will not be able to live independently. • 70% will have problems with employment.

13. What YOU Need to Know • When a pregnant woman drinks, so does her baby. • The baby's growth can be altered and slowed. • The baby may suffer lifelong damage.

14. What mom drinks, baby drinks. The alcohol that the pregnant woman drinks goes directly to the developing baby at the same level of concentration. If mom's blood alcohol level is 0.2, so is the baby's. However, mom is much, much larger. Her mature liver acts to detoxify the alcohol. On the other hand, the fetus is incredibly smaller. Its liver is not yet mature. Therefore, while mom might stay drunk for several hours, the developing fetus can stay drunk for three to four days. It is because of this phenomena that binge drinking, consuming two or more drinks per hour, has been found to be more detrimental to the developing infant than low level, chronic drinking. The fetal blood alcohol level becomes very high and stays that way for a long period of time.

15. Remember these things • No amount of alcohol is safe in pregnancy. • If you usually drink, quit if you are trying to get pregnant or if you think you're pregnant. • If you can't quit drinking by yourself, get help quickly.

16. Even Small Amounts -----of alcohol can be harmful. Because no amount of alcohol can be considered safe, pregnant women should avoid all alcohol during the entire pregnancy. (Drinks with alcohol in them include beer, wine, hard liquor and wine coolers.)

17. Binge Drinking Having 5 or more drinks at a time is particularly dangerous for your baby, because it makes the level of alcohol in your blood very high very quickly. So, even if you don't drink every day, you may put your baby at risk for fetal alcohol syndrome.

18. Results of Consumption • Forty-four percent of women who drink heavily during pregnancy will have a child with Fetal Alcohol Syndrome. • Of the other 56%, some will have Fetal Alcohol Effects, be Fetal Alcohol exposed, to minor learning and behavioral difficulties. A few will be apparently normal.

19. Are young people drinking? •In 2003, 44.9% of 9th through 12th graders reported drinking alcohol on one or more of the past 30 days; prevalence of current drinking was higher for females (45.8%) than among males (43.8%) •In 2003, 28.3% of 9th through 12th graders reported binge drinking (having five or more drinks of alcohol in a row or within a couple of hours) at least once during the past 30 days. The prevalence of binge drinking was higher for males (29%) than among females (27.5%) **Center for Disease Control, YRBS, 2003

20. 36.5% of girls 13-17 report some alcohol drinking in The United States. • Binge drinking has become an accepted “norm” for young people.

21. Despite warnings, frequent drinking among pregnant women appears to be increasing. Frequent drinking is defined as 7 or more drinks per week or 5 or more drinks on at least one occasion.

22. What are our youth drinking? Spykes, made by Anheuser-Busch, is a malt beverage with 12 percent alcohol content — about the same as wine. It comes in mango, lime, melon and chocolate flavors and is infused with caffeine as well as the herbs ginseng and guarana. Sold in 2-ounce bottles that go for 75 cents to a dollar apiece, Spykes “gives kick to your beer, flavor to your drink, and is a perfect shot,” according to the promotional Web site. This was taken off the market May 2007.

23. Statistics • How common is fetal alcohol syndrome? • In the United States, about 1,200 children are born each year with fetal alcohol syndrome. It is the leading cause of mental retardation in this country.

24. Study • The incidence of Fetal Alcohol Syndrome (FAS) has been estimated at 1 to 3 per 1000 live births. Fetal Alcohol Spectrum Disorders (FASD) (which include FAS) are estimated to occur in about 1 in 100 births. Cessation of drinking during pregnancy can improve the outcome even if the unborn child is already affected. For individuals born with FASD, an early diagnosis appears to be a protective factor against secondary disabilities. A quick screening tool to identify newborn children at risk has been elusive. Alcoholism: Clinical & Experimental Research. 25(2):283-287, February 2001.Barr, Helen M.; Streissguth, Ann P.

25. Fetal Alcohol Syndrome and Fetal Alcohol Effects do not go away. Once the brain is damaged, it is permanent. Most of the damage that occurs in the brain is a result of the brain tissue not moving and growing where it should, resulting in areas of the brain which are not developed at all or are underdeveloped. Neuronal connections that should have been made are simply are not there. Since brain tissue does not regenerate, this damage to the brain is permanent, especially if the tissue did not form initially. It doesn't ever get better.

26. Physical, cognitive, and social deficits associated with FAS: • Low birth weight • Failure to thrive (eat and grow well) • An exaggerated startle response • Poor wake and sleep patterns • Hyperactivity, distractibility and attention deficits • Lying and stealing are common behaviors • Impulsiveness • Temper tantrums • Poor social skills • Poor abstracting abilities

27. Children with alcohol-related birth defects typically have: • attention deficits • language difficulties • learning disabilities • impulsive behavior • poor judgment

28. Alcohol can cause permanent damage to a baby before most women realize they are pregnant.

29. Where Are These Children? • Foster and Adoptive Care -80% of these children do not stay in their birth homes. • Your Schools and Neighborhoods • Today’s Adults

30. The Good News…….

31. The good news is that FAS is 100% preventable. • Education and awareness by everyone at all levels is necessary. Individuals in their child-bearing years, both men and women, need to know the grave harm that can be caused to an unborn child by drinking during pregnancy. Our children world-wide need to know so they will not make these irreversible decisions.

32. From: Fantastic Antone Succeeds • FETAL ALCOHOL SYNDROME/EFFECTS • "The alcohol-affected child is like a garden. Some seeds need to be planted year after year, like the carrots and the radishes. The seeds the birds carry away have to be replaced almost immediately. But there are bulbs that grow in the garden and every year they come up almost without tending. It can be too easy to see what failed to come up this year and step on the crocuses close to the ground. The important thing is to be thankful that there is a garden. It is not a wasteland."

33. "The births of all things are weak and tender, and therefore, our eyes should be intent on beginnings.“ -Michel Eyquem Montaigne

34. Everyone Suffers the Effects Children born with Fetal Alcohol Syndrome (FAS) or Fetal Alcohol Effects (FAE) have an impact on all members of society. Not only does the individual effected face a lifetime of pain, frustration and disappointment, the impact on all levels society cannot be ignored.

35. Remember-It is Preventable!

36. How much is too much???

37. Is there a safer alcohol drink? • NO! They all contain approximate amounts of alcohol. Hard Liquor Beer Wine

38. From the Office of the Surgeon General • Based on the current, best science available we now know the following: • Alcohol consumed during pregnancy increases the risk of alcohol related birth defects, including growth deficiencies, facial abnormalities, central nervous system impairment, behavioral disorders, and impaired intellectual development. • No amount of alcohol consumption can be considered safe during pregnancy. • Alcohol can damage a fetus at any stage of pregnancy. Damage can occur in the earliest weeks of pregnancy, even before a woman knows that she is pregnant. • The cognitive deficits and behavioral problems resulting from prenatal alcohol exposure are lifelong. • Alcohol-related birth defects are completely preventable.

39. For these reasons: • A pregnant woman should not drink alcohol during pregnancy. • A pregnant woman who has already consumed alcohol during her pregnancy should stop in order to minimize further risk. • A woman who is considering becoming pregnant should abstain from alcohol. • Recognizing that nearly half of all births in the United States are unplanned, women of child-bearing age should consult their physician and take steps to reduce the possibility of prenatal alcohol exposure. • Health professionals should inquire routinely about alcohol consumption by women of childbearing age, inform them of the risks of alcohol consumption during pregnancy, and advise them not to drink alcoholic beverages during pregnancy.

40. The problems that school face? The primary challenge schools face is that FAS/FAE students are disruptive, unpredictable and have uninterruptible behavior. They need to be taught what other students may just assimilate. They require repetitive instruction, less distractions, specialized techniques, and additional encouragement. They require understanding and support.

41. Special Needs FAS children will have special needs and behavioral challenges: Hyperactivity Problem processing

42. What Can You Do? • Education Information, Posters, Signs Start talking before they start drinking • Understanding Patience, Reinforcements

43. Early diagnosis can help prevent secondary disabilities such as mental health problems, dropping out of school, trouble with the law and substance abuse. • After diagnosis, parents and teachers often find that their ability to cope with the child's behavior changes dramatically when they understand that the problems are most likely based on organic brain damage, rather than the child's choice to be inattentive or uncooperative.

44. What helps the FAS child? • Early diagnosis. • Loving, stable structured family with knowledge of diagnosis. • Tools to develop to the best of their abilities and the support needed. • Understanding school and community.

45. What Youth Can Do Teen Councils Light a Little Star (March of Dimes) Booths, face painting, free information Posters – Put where alcohol is sold and in public restrooms Poster Contests State Legislation They can make a difference!

46. A Child’s Story John Kellerman

47. Media

48. Cultural Differences

49. Would you?

50. Mothering begins before birth!