Table of ContentsView AllTable of ContentsSymptomsTypesTreatment GoalsPrevention
Table of ContentsView All
View All
Table of Contents
Symptoms
Types
Treatment Goals
Prevention
Although FAS is an incurable lifelong condition that is underdiagnosed, treatment can improve its symptoms. This article will discuss the symptoms, diagnosis, treatment, and prevention of FAS in children and adults.
Fetal Alcohol Syndrome: Facial to Behavioral Effects
Prenatal alcohol exposure is the leading preventable cause of congenital (present at birth) conditions in the United States. When consumed during pregnancy, alcohol crosses the placenta and enters the fetus’s bloodstream.
The result of alcohol on a developing fetus can lead to craniofacial differences, growth impairment,neurodevelopmental disabilities, and behavioral issues. Research shows that alcohol exposure at specific times during pregnancy can affect the brain in various ways, resulting in a spectrum of brain disorders.
Although severe FAS can be recognized at birth, diagnosis is usually made between 8 months and 8 years old when the features of FAS are most prominent, with one study finding an average diagnosis age diagnosis of 4 years old.Here are the common symptoms of fetal alcohol syndrome.
Head and Face Symptoms
Craniofacial symptoms of FAS in children and adults may include:
Growth Impairment and Physical Symptoms
Growth impairment and other physical symptoms of FAS in children and adults can include:
Neurodevelopmental Symptoms
Neurodevelopmental symptoms of FAS in children and adults may include:
Behavioral Symptoms
Behavioral symptoms of FAS in children and adults can include:
How to Tell if a Child Has FASCraniofacial features:Small headLow nasal bridgeWide-set narrow eyesThin upper lipGrowth impairments:Small brain sizeShort statureLow body weightNeurodevelopmental problems:Developmental delaysInability to problem-solvePoor organizational skillsSpeech problemsBehavioral issues:AnxietyDepressionMental health problemsLegal troubles (incarceration)
How to Tell if a Child Has FAS
Craniofacial features:Small headLow nasal bridgeWide-set narrow eyesThin upper lipGrowth impairments:Small brain sizeShort statureLow body weightNeurodevelopmental problems:Developmental delaysInability to problem-solvePoor organizational skillsSpeech problemsBehavioral issues:AnxietyDepressionMental health problemsLegal troubles (incarceration)
Craniofacial features:
Growth impairments:
Neurodevelopmental problems:
Behavioral issues:
FAS in Adults
Children don’t outgrow FAS. It is a lifelong condition affecting people through adulthood. However, most studies have not researched FAS symptoms in people over the age of 30.
Although more research is necessary, some studies show that the craniofacial differences of people with FAS may improve during or after adolescence.The traits most likely to persist are a thin upper lip and a smaller head circumference.
Physical symptoms such as growth impairment remain unchanged during adulthood, with persistent shorter stature.Brain maturation can become prolonged, and aging can accelerate.
Unfortunately, people with FAS are more likely to experience legal troubles, have secondary mental health diagnoses, and have higher rates of suicide. People with FAS have better outcomes if they experience a supportive and loving environment during childhood.
One study found life expectancy is significantly reduced compared to people without FAS (most often due to external causes such as suicide, accidents, or overdose of alcohol or drugs).
Quantity of Alcohol Linked to Fetal Alcohol Syndrome
There is no safe amount of alcohol at any time during pregnancy.Even a small amount of alcohol can have adverse effects on a growing fetus.Alcohol seems most damaging in the first trimester (three months) of pregnancy but can affect the fetus at any time during the pregnancy.
A U.S. study of pregnant adults from 2018–2020 found 13.5% reported current drinking and 5.2% reported binge drinking in the past 30 days.Binge drinking and regular heavy drinking are associated with a higher risk of FAS.
A single episode of binge drinking, especially during the first few weeks of pregnancy, can lead to FAS. Having four or more drinks within two hours is considered a single binge-drinking episode for females.
Because many people do not know they are pregnant during those first few weeks, the risk of FAS increases if you drink alcohol and haveunprotected sex.
Understanding Binge Drinking
Types of Fetal Alcohol Syndrome
Alcohol was not viewed as dangerous for pregnant people until 1973 when the diagnosis of FAS was first implemented. However, the Food and Drug Administration (FDA) did not make a public awareness announcement about the side effects of alcohol use during pregnancy until 1977.
Since that time, additional disorders associated with prenatal alcohol exposure have been discovered, leading to the term FASD.Each condition is diagnosed based on a set of specific characteristics, including evidence of PAE, facial dysmorphology, neurodevelopmental problems, and growth impairment. Here are the disorders that make up FASD:
Diagnosis of FAS
The main diagnostic tools for FASD include a thorough physical and neurodevelopmental assessment of the following criteria:
There is no blood test or scan/imaging that can diagnose FASD.
Goal of Fetal Alcohol Treatment
Unfortunately, there is no cure for FAS. Treatment focuses on controlling the symptoms of the condition. Treatment strategies for FAS include nonpharmacologic and pharmacologic interventions.
Lifelong treatment is required and is more effective if collaborative care coordination occurs between all professional agencies. The families of people with FAS should also be included in treatment interventions.
Nonpharmacologic Treatment for FAS
Treatment without medications includes:
Pharmacologic Treatment for FAS
An estimated 50–90% of people with FASD are also diagnosed withattention deficit hyperactivity disorder (ADHD), and many other people have secondary mental health disorders such as depression and anxiety.
The use of stimulants in FAS is mixed. Some studies show it helps reduce hyperactivity but has little effect on improving attention.
First-line treatments for children with ADHD and FAS include methylphenidate- and amphetamine-derived stimulants.
Non-stimulant medications that may be effective in some people with FAS are:
Other medications that treat the side effects of FAS include:
The Impact of Alcohol on Your Body
Abstaining From Alcohol to Prevent Fetal Alcohol Syndrome
The good news about FAS is that it is 100% preventable. About half of the pregnancies in the United States aren’t planned, leaving the opportunity for accidental alcohol use in the first few pivotal months of gestation.
If you are having unprotected sex and not using birth control, you must abstain from alcohol. The U.S. surgeon general also recommends abstaining from alcohol if you’re trying to conceive. If you’re currently pregnant, it’s never too late to stop drinking—reach out to a healthcare provider if you need help quitting alcohol.
Alcohol Use Disorder ResourcesIf you or a loved one is struggling with alcohol, you can find help at the following resources:Alcoholics Anonymous (AA)Moderation ManagementSecular AASMART RecoveryWomen for SobrietyDon’t start an alcohol elimination program without telling your healthcare provider. They may be able to direct you to further options for achieving your goals and provide the medical care that may be necessary to withdraw from alcohol.
Alcohol Use Disorder Resources
If you or a loved one is struggling with alcohol, you can find help at the following resources:Alcoholics Anonymous (AA)Moderation ManagementSecular AASMART RecoveryWomen for SobrietyDon’t start an alcohol elimination program without telling your healthcare provider. They may be able to direct you to further options for achieving your goals and provide the medical care that may be necessary to withdraw from alcohol.
If you or a loved one is struggling with alcohol, you can find help at the following resources:
Don’t start an alcohol elimination program without telling your healthcare provider. They may be able to direct you to further options for achieving your goals and provide the medical care that may be necessary to withdraw from alcohol.
What Is Alcoholism and How to Get Treatment
Summary
FAS is permanent and incurable. Although there is no treatment for FAS, there are strategies that can improve its symptoms. No amount of alcohol at any point during pregnancy is safe. If you are consuming alcohol and trying to become pregnant or you are currently pregnant, reach out to a healthcare provider for help quitting.
21 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute on Alcohol Abuse and Alcoholism.Fetal alcohol spectrum disorders.Murawski NJ, Moore EM, Thomas JD, Riley EP.Advances in diagnosis and treatment of fetal alcohol spectrum disorders: from animal models to human studies.Alcohol Res. 2015;37(1):97-108.Moberg DP, Bowser J, Burd L, et al.Fetal alcohol syndrome surveillance: age of syndrome manifestation in case ascertainment.Birth Defects Res A Clin Mol Teratol. 2014;100(9):663-9. doi:10.1002/bdra.23245Centers for Disease Control and Prevention.Fetal alcohol spectrum disorders (FASDs).Centre for Addiction and Mental Health.Fetal alcohol syndrome disorders (FASD).Moore EM, Riley EP.What happens when children with fetal alcohol spectrum disorders become adults?Curr Dev Disord Rep. 2015;2(3):219-227. doi:10.1007/s40474-015-0053-7Thanh NX, Jonsson E.Life expectancy of people with fetal alcohol syndrome.J Popul Ther Clin Pharmacol. 2016;23(1):e53-e59.Gosdin LK, Deputy NP, Kim SY, et al.Alcohol consumption and binge drinking during pregnancy among adults aged 18–49 Years — United States, 2018–2020.MMWR Morb Mortal Wkly Rep.2022;71:10–13. doi:10.15585/mmwr.mm7101a2Lees B, Mewton L, Jacobus J, et al.Association of prenatal alcohol exposure with psychological, behavioral, and neurodevelopmental outcomes in children from the adolescent brain cognitive development study.AJP. 2020;177(11):1060-1072. doi:10.1176%2Fappi.ajp.2020.20010086MedlinePlus.Alcohol and pregnancy.Wozniak JR, Riley EP, Charness ME.Diagnosis, epidemiology, assessment, pathophysiology, and management of fetal alcohol spectrum disorders.Lancet Neurol. 2019;18(8):760-770. doi:10.1016/S1474-4422(19)30150-4National Institute on Alcohol Abuse and Alcoholism.Understanding fetal alcohol spectrum disorders.Brown JM, Bland R, Jonsson E, Greenshaw AJ.A brief history of awareness of the link between alcohol and fetal alcohol spectrum disorder.Can J Psychiatry. 2019;64(3):164-168. doi:10.1177/0706743718777403American Academy of Pediatrics.Screening, assessment, and diagnosis.Centers for Disease Control and Prevention.Treatment of FASDs.Centers for Disease Control and Prevention.Fetal alcohol spectrum disorders (FASDs).Nguyen TT, Risbud RD, Chambers CD, Thomas JD.Dietary nutrient intake in school-aged children with heavy prenatal alcohol exposure.Alcohol Clin Exp Res. 2016;40(5):1075-1082. doi:10.1111/acer.13035Varigonda AL, Edgcomb JB, Zima BT.The impact of exercise in improving executive function impairments among children and adolescents with ADHD, autism spectrum disorder, and fetal alcohol spectrum disorder: a systematic review and meta-analysis.Arch Clin Psychiatry (São Paulo). 2021;47:146-156.American Academy of Pediatrics.Behavioral interventions in fetal alcohol spectrum disorders.Centers for Disease Control and Prevention.Types of treatments for FASDs.Centers for Disease Control and Prevention.Unintended pregnancy.
21 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute on Alcohol Abuse and Alcoholism.Fetal alcohol spectrum disorders.Murawski NJ, Moore EM, Thomas JD, Riley EP.Advances in diagnosis and treatment of fetal alcohol spectrum disorders: from animal models to human studies.Alcohol Res. 2015;37(1):97-108.Moberg DP, Bowser J, Burd L, et al.Fetal alcohol syndrome surveillance: age of syndrome manifestation in case ascertainment.Birth Defects Res A Clin Mol Teratol. 2014;100(9):663-9. doi:10.1002/bdra.23245Centers for Disease Control and Prevention.Fetal alcohol spectrum disorders (FASDs).Centre for Addiction and Mental Health.Fetal alcohol syndrome disorders (FASD).Moore EM, Riley EP.What happens when children with fetal alcohol spectrum disorders become adults?Curr Dev Disord Rep. 2015;2(3):219-227. doi:10.1007/s40474-015-0053-7Thanh NX, Jonsson E.Life expectancy of people with fetal alcohol syndrome.J Popul Ther Clin Pharmacol. 2016;23(1):e53-e59.Gosdin LK, Deputy NP, Kim SY, et al.Alcohol consumption and binge drinking during pregnancy among adults aged 18–49 Years — United States, 2018–2020.MMWR Morb Mortal Wkly Rep.2022;71:10–13. doi:10.15585/mmwr.mm7101a2Lees B, Mewton L, Jacobus J, et al.Association of prenatal alcohol exposure with psychological, behavioral, and neurodevelopmental outcomes in children from the adolescent brain cognitive development study.AJP. 2020;177(11):1060-1072. doi:10.1176%2Fappi.ajp.2020.20010086MedlinePlus.Alcohol and pregnancy.Wozniak JR, Riley EP, Charness ME.Diagnosis, epidemiology, assessment, pathophysiology, and management of fetal alcohol spectrum disorders.Lancet Neurol. 2019;18(8):760-770. doi:10.1016/S1474-4422(19)30150-4National Institute on Alcohol Abuse and Alcoholism.Understanding fetal alcohol spectrum disorders.Brown JM, Bland R, Jonsson E, Greenshaw AJ.A brief history of awareness of the link between alcohol and fetal alcohol spectrum disorder.Can J Psychiatry. 2019;64(3):164-168. doi:10.1177/0706743718777403American Academy of Pediatrics.Screening, assessment, and diagnosis.Centers for Disease Control and Prevention.Treatment of FASDs.Centers for Disease Control and Prevention.Fetal alcohol spectrum disorders (FASDs).Nguyen TT, Risbud RD, Chambers CD, Thomas JD.Dietary nutrient intake in school-aged children with heavy prenatal alcohol exposure.Alcohol Clin Exp Res. 2016;40(5):1075-1082. doi:10.1111/acer.13035Varigonda AL, Edgcomb JB, Zima BT.The impact of exercise in improving executive function impairments among children and adolescents with ADHD, autism spectrum disorder, and fetal alcohol spectrum disorder: a systematic review and meta-analysis.Arch Clin Psychiatry (São Paulo). 2021;47:146-156.American Academy of Pediatrics.Behavioral interventions in fetal alcohol spectrum disorders.Centers for Disease Control and Prevention.Types of treatments for FASDs.Centers for Disease Control and Prevention.Unintended pregnancy.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institute on Alcohol Abuse and Alcoholism.Fetal alcohol spectrum disorders.Murawski NJ, Moore EM, Thomas JD, Riley EP.Advances in diagnosis and treatment of fetal alcohol spectrum disorders: from animal models to human studies.Alcohol Res. 2015;37(1):97-108.Moberg DP, Bowser J, Burd L, et al.Fetal alcohol syndrome surveillance: age of syndrome manifestation in case ascertainment.Birth Defects Res A Clin Mol Teratol. 2014;100(9):663-9. doi:10.1002/bdra.23245Centers for Disease Control and Prevention.Fetal alcohol spectrum disorders (FASDs).Centre for Addiction and Mental Health.Fetal alcohol syndrome disorders (FASD).Moore EM, Riley EP.What happens when children with fetal alcohol spectrum disorders become adults?Curr Dev Disord Rep. 2015;2(3):219-227. doi:10.1007/s40474-015-0053-7Thanh NX, Jonsson E.Life expectancy of people with fetal alcohol syndrome.J Popul Ther Clin Pharmacol. 2016;23(1):e53-e59.Gosdin LK, Deputy NP, Kim SY, et al.Alcohol consumption and binge drinking during pregnancy among adults aged 18–49 Years — United States, 2018–2020.MMWR Morb Mortal Wkly Rep.2022;71:10–13. doi:10.15585/mmwr.mm7101a2Lees B, Mewton L, Jacobus J, et al.Association of prenatal alcohol exposure with psychological, behavioral, and neurodevelopmental outcomes in children from the adolescent brain cognitive development study.AJP. 2020;177(11):1060-1072. doi:10.1176%2Fappi.ajp.2020.20010086MedlinePlus.Alcohol and pregnancy.Wozniak JR, Riley EP, Charness ME.Diagnosis, epidemiology, assessment, pathophysiology, and management of fetal alcohol spectrum disorders.Lancet Neurol. 2019;18(8):760-770. doi:10.1016/S1474-4422(19)30150-4National Institute on Alcohol Abuse and Alcoholism.Understanding fetal alcohol spectrum disorders.Brown JM, Bland R, Jonsson E, Greenshaw AJ.A brief history of awareness of the link between alcohol and fetal alcohol spectrum disorder.Can J Psychiatry. 2019;64(3):164-168. doi:10.1177/0706743718777403American Academy of Pediatrics.Screening, assessment, and diagnosis.Centers for Disease Control and Prevention.Treatment of FASDs.Centers for Disease Control and Prevention.Fetal alcohol spectrum disorders (FASDs).Nguyen TT, Risbud RD, Chambers CD, Thomas JD.Dietary nutrient intake in school-aged children with heavy prenatal alcohol exposure.Alcohol Clin Exp Res. 2016;40(5):1075-1082. doi:10.1111/acer.13035Varigonda AL, Edgcomb JB, Zima BT.The impact of exercise in improving executive function impairments among children and adolescents with ADHD, autism spectrum disorder, and fetal alcohol spectrum disorder: a systematic review and meta-analysis.Arch Clin Psychiatry (São Paulo). 2021;47:146-156.American Academy of Pediatrics.Behavioral interventions in fetal alcohol spectrum disorders.Centers for Disease Control and Prevention.Types of treatments for FASDs.Centers for Disease Control and Prevention.Unintended pregnancy.
National Institute on Alcohol Abuse and Alcoholism.Fetal alcohol spectrum disorders.
Murawski NJ, Moore EM, Thomas JD, Riley EP.Advances in diagnosis and treatment of fetal alcohol spectrum disorders: from animal models to human studies.Alcohol Res. 2015;37(1):97-108.
Moberg DP, Bowser J, Burd L, et al.Fetal alcohol syndrome surveillance: age of syndrome manifestation in case ascertainment.Birth Defects Res A Clin Mol Teratol. 2014;100(9):663-9. doi:10.1002/bdra.23245
Centers for Disease Control and Prevention.Fetal alcohol spectrum disorders (FASDs).
Centre for Addiction and Mental Health.Fetal alcohol syndrome disorders (FASD).
Moore EM, Riley EP.What happens when children with fetal alcohol spectrum disorders become adults?Curr Dev Disord Rep. 2015;2(3):219-227. doi:10.1007/s40474-015-0053-7
Thanh NX, Jonsson E.Life expectancy of people with fetal alcohol syndrome.J Popul Ther Clin Pharmacol. 2016;23(1):e53-e59.
Gosdin LK, Deputy NP, Kim SY, et al.Alcohol consumption and binge drinking during pregnancy among adults aged 18–49 Years — United States, 2018–2020.MMWR Morb Mortal Wkly Rep.2022;71:10–13. doi:10.15585/mmwr.mm7101a2
Lees B, Mewton L, Jacobus J, et al.Association of prenatal alcohol exposure with psychological, behavioral, and neurodevelopmental outcomes in children from the adolescent brain cognitive development study.AJP. 2020;177(11):1060-1072. doi:10.1176%2Fappi.ajp.2020.20010086
MedlinePlus.Alcohol and pregnancy.
Wozniak JR, Riley EP, Charness ME.Diagnosis, epidemiology, assessment, pathophysiology, and management of fetal alcohol spectrum disorders.Lancet Neurol. 2019;18(8):760-770. doi:10.1016/S1474-4422(19)30150-4
National Institute on Alcohol Abuse and Alcoholism.Understanding fetal alcohol spectrum disorders.
Brown JM, Bland R, Jonsson E, Greenshaw AJ.A brief history of awareness of the link between alcohol and fetal alcohol spectrum disorder.Can J Psychiatry. 2019;64(3):164-168. doi:10.1177/0706743718777403
American Academy of Pediatrics.Screening, assessment, and diagnosis.
Centers for Disease Control and Prevention.Treatment of FASDs.
Nguyen TT, Risbud RD, Chambers CD, Thomas JD.Dietary nutrient intake in school-aged children with heavy prenatal alcohol exposure.Alcohol Clin Exp Res. 2016;40(5):1075-1082. doi:10.1111/acer.13035
Varigonda AL, Edgcomb JB, Zima BT.The impact of exercise in improving executive function impairments among children and adolescents with ADHD, autism spectrum disorder, and fetal alcohol spectrum disorder: a systematic review and meta-analysis.Arch Clin Psychiatry (São Paulo). 2021;47:146-156.
American Academy of Pediatrics.Behavioral interventions in fetal alcohol spectrum disorders.
Centers for Disease Control and Prevention.Types of treatments for FASDs.
Centers for Disease Control and Prevention.Unintended pregnancy.
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