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Preventing Fetal Alcohol Syndrome: A Historical Report Compiled By The Oromocto

When a woman drinks during pregnancy, it could have serious consequences for the baby she is carrying. The result, could be a child born with Fetal Alcohol Syndrome or Fetal Alcohol Effects (FAS/FAE). Those Born with FAS/FAE often experience a lifetime of medical problems. Those problems have been identified over the past fifteen years, and research has shown that FAS/FAE can be greatly reduced, or eliminated, when a woman abstains from using alcohol during pregnancy.

The incidence of FAS/FAE is high in the Yukon and Northern British Columbia and is found to be even higher among Indian people. The following article is reprinted from Your Child! Our Future! A report compiled by Oromocto Indian Nation, New Brunswick, and provides factual and educational information about FAS/FAE.

In a community somewhere in Canada, the doctor told her what she already suspected – she was pregnant. This was the best news she had heard in a long time and she couldn't wait to tell her husband family and friends. To celebrate the good news, she and her husband went to a friend's house for a party. All evening, people gave her special treatment and there were many toasts to the good news. She had lots to drink at the party, everyone was drinking and happy for the parents-to-be. This party was the start of many more parties and showers that she would go to during her pregnancy.

Several months later, she walked into the house with the baby. Her friends and family were gathered around to see the new arrival. The baby started crying; someone said that the baby must be hungry. She agreed with this and went to get something. She opened the fridge, took out a bottle of beer, removed the cap, put a nipple over the mouth of the bottle and began to feed beer to her baby. At first everyone thought it was just a joke but when her husband realized that it wasn't, he grabbed the baby away and asked if she had “gone crazy” her friends and family began to think that the baby should be taken away and raised by someone who would take better care of the helpless infant.

What is the point to this story?

It's not likely that anyone would ever feed beer to a newborn baby, but looking at the two parts of this story, is there really any difference? In the first part of the story, is there really any difference? In the first part of the story, is there really any difference? In the first part of the story everyone was happy for the woman and didn't think it was wrong for her to have “a few drinks to celebrate”. In fact, her husband and friends may have encouraged her to have “a few drinks to relax”. In the second part of the story, everyone was able to see the newborn baby and were against feeding beer to a helpless infant. Unfortunately, the baby had been drinking alcohol all through the story the baby drank every time the mother drank during the pregnancy and yet most people did not notice. When the mother drank, the alcohol entered her blood and crossed over into the baby's blood and the liquid (fluid) in the womb. The unborn baby couldn't do anything to stop it. Once the alcohol reached the unborn baby, it may have damaged the baby's brain and central nervous system, growth and development, and it may have caused many other birth defects. We know that a woman is not likely to feed alcohol to their unborn babies (i.e. fetus) and risk that their baby could be born with Fetal Alcohol Syndrome or Fetal Alcohol Effects; FAS/FAE for short. What is FAS/FAE? These are the names given to a group of birth defects that can happen to a baby whose mother drank alcoholic beverages while pregnant. The birth defects last for life and affect the baby's brain (often causing mental retardation)' nerves, growth, development, and facial features. Damage may also occur to other parts of the body include the heart, kidney, joint, genitals, ect. The effects of FAS/FAE are permanent-any child born with FAS/FAE will have it for life. Any child born with birth defects that are known to be caused by the mother's drinking is said to have Fetal Alcohol Effects (FAE). If the child has a certain number and combination of these birth defects than the child is said to Fetal Alcohol Syndrome (FAS) which is more severe form of FAE. Since it is often difficult to tell whether a child has FAE or FAS, people most often refer to them together as FAS/FAE.

People have known about FAS/FAE for centuries but it was only named 1973 when several doctors in Seattle noticed that certain babies, born to mothers who drink, Had similar Facial features. After further study these doctors – Jones, Smith and Ulleland, noticed that these babies also had similarities in size, intelligence, development, ect. Since that time, much research has been done in FAS/FAE and much new information has been discovered.

The Greeks, the Romans, and the Bible, all cautioned against women drinking while pregnant, for fear that it could harm the baby. Doctors in the 18th century England, urged Parliament to restrict the sale of gin because it seemed to be harming babies. The temperance movement of the 19th century noticed the children of drinkers were puny and had low intelligence. Dr. Sullivan, and English physician studying pregnant female prisoners, reported that alcohol caused miscarriages, stillbirths and birth of sickly babies. Despite all these warnings, most people felt that alcohol could not harm the baby because the womb protected it. The 1973 studies, and later ones, showed the error of this way of thinking. It is now known that the more alcohol a woman drinks during pregnancy, the greater her risk of having FAS/FAE children. There is no safe level or drinking for a pregnant woman and most FAS/FAE literature urges women to abstain from alcohol for the entire pregnancy. In other words, “NO DRINK! NO RISK”.

Researchers do not have all the answers about FAS/FAE but they do know that the combination of birth defects known as FAS/FAE is caused by alcohol and happens only if woman drinks while she is pregnant. When she drinks, alcohol enters her blood where it circulates in her body and reaches the unborn baby in a very short time. If a pregnant woman can feel the effects of alcohol, so can her baby. Alcohol crosses the placenta and enters the baby's blood and also mixes with the fluid surrounding the baby. In adult terms, this may be similar to being kept in a bathtub of alcohol and made to stay there several hours while also being injected with alcohol. Alcohol in the baby's blood stays there until the mother's body gets rid of it

. Some research shows that alcohol affects the baby directly. When alcohol is placed on an open cut it stings, because it takes water out of the skin cells. It kills germs on the skin because it causes them to dry up. In some way, alcohol that the unborn baby gets may cause some of the baby's cells to dry up and die. Brain cells are the easiest to damage with alcohol and FAS/FAE children often have brain damage. The human body changes alcohol to acetaldehyde (ALDH) when it breaks down alcohol in the blood. Chronic alcoholic women, many oriental groups and some North American Indians produce high levels of acetaldehyde when they drink. These groups of people cannot quickly get rid of all this acetaldehyde because of the way their bodies work. The acetaldehyde builds up in the blood and may be responsible for much of the damage done to the unborn baby. There is no easy way of knowing who has this condition and research s do not all agree on the amount of damage acetaldehyde can do. Researchers have also noted that older women and women who have been drinking for several years are more likely to have FAS/FAE children, if they drink during pregnancy. Smoking and drugs are known to affect the unborn baby; though they cannot cause FAS/FAE children, they may make the problem worse. Regardless of the other risk factor or whether it is alcohol or acetaldehyde that causes damage to the unborn baby; no damage can occur to the baby if a pregnant woman does not drink alcohol.

What does FAS/FAE mean to the baby? A baby born with FAS/FAE can have any of a large number of possible birth defects. The three major groups of birth defects are (1) poor growth and development, before birth and after birth, (2) damage to the brain and central nervous system, and (3) certain deformities of the face as well as other abnormalities. Children with FAS/FAE can be born underweight and undersized; even with the proper food can care they never catch up in weight, height or size to other children the same age. They may take longer to walk and talk; many FAS/FAE children have low intelligence and may be mentally retarded. Brain and central nervous system damage can occur even when there are no other signs of FAS/FAE since these parts of the body are easily affected by alcohol. Most FAS/FAE children are hyperactive, have poor attention spans and often tend to be more nervous and jumpy. In more severe cases, the head of FAS/FAE children may be smaller than normal; this indicates brain damage and many of these children are mentally retarded. FAS/FAE children often have certain face deformities such as flat mid faces (i.e. Flat cheeks) and have an upturned noses. Their upper lip may be flat (i.e. No groove [philtrum]) and have a very narrow red part. Their eyes are often small (i.e. Appear wide set), often have epicanthic folds (i.e. Appear slanted), and are droopy. In some cases FAS/FAE children are cross-eyed and are nearsighted. Their ears may be children are cross-eyed and nearsighted. Their ears may be large and malformed. The chin and jaw may be small and rounded though the jaw tends to look “stuck out” later in life; some FAS/FAE children may have a cleft lip or palate. Other abnormalities include heart defects such as heart murmurs, small, bent or joined fingers or toes, kidney defects, genital malformations, excess hairiness as an infant and strawberry birthmarks. Many of these birth defects may happen because of other causes; but, when some of them occur together and the mother has drunk alcohol while she was pregnant, then the cause is usually FAS/FAE.

How much alcohol can pregnant woman drink before causing all this damage? Researchers have not yet found an amount of alcohol that a pregnant woman can drink without risking FAS/FAE to her child. Brain damaged has been observed in children whose mothers drank one drink (i.e. 1 bottle of beer, one 4-5 oz. Serving of wine, one 1-1 oz. Shot of whiskey, gin etc.) per day. A woman who drinks 1-2 drinks a day can easily drink 45 or more drinks in a month (about 4 dozen, 6-8 bottles of wine or two 26 oz. Bottles of gin, vodka, etc.); drinking more than 45 drinks a month causes a 50% chance that the baby will be born with some FAS/FAE birth defects. Saving up drinks for a party or a weekend binge may be worse for the baby than regular drinking because it can cause a lot of damage at one time to particular part of the unborn baby. Since the baby's brain is forming or developing during the entire pregnancy, much of the alcohol damage will happen to the brain; this damage will stay with the FAS/FAE child for life. The father's drinking may also affect the baby. Most researchers feel that FAS/FAE is caused only by the mother's drinking during pregnancy. Further research shows that if the father is a heavy drinker, the woman is more likely to have a miscarriage, a stillborn baby or pregnancy complications. Alcohol affects the man;s fertility and makes him less able to father a child. By far, the strongest influence of the father is over the drinking habits of the mother. Although she may not care to drink during pregnancy, he may feel that she should celebrate with him or should drink to relax. He may not want to encourage her to stop drinking and may indirectly increase the risk of having a FAS/FAE child. In a similar way friends and family could indirectly influence a woman to drink while she is pregnant.

What can be done to prevent FAS/FAE? The only sure prevention is FOR THE WOMAN NOT TO DRINK WHILE SHE IS PREGNANT, if she is considering pregnancy or not using birth control to prevent pregnancy. Researchers have not found any safe level of drinking during pregnancy. If a woman reduces her drinking at this time, she will reduce her risk of having FAS/FAE children, but only abstinence from alcohol can prevent FAE/FAS. Many women find they cannot drink or do not feel like drinking during pregnancy, while others stop as soon as they find our about the risk of FAE/FAS. If a pregnant woman needs help to stop drinking m her doctor, health nurse or social worker may be able to find counselling services for her. She may decide to join organization such as Alcoholics Anonymous or enter a treatment centre. Whatever the means, a woman should not drink while she is pregnant. Some methods of relaxing without alcohol include walking, talking with friends, taking warm baths; listening to music and/or working on hobbies. FAE/FAS is completely preventable if a woman does not drink alcohol during pregnancy- NO DRINK! NO RISK! Other people may help in the prevention of FAE/FAS even the entire community can become involved. Community groups may sponsor awareness presentations on FAE/FAS to inform their citizens. They may urge restaurants, bars and liquor stores to post notices that warn of danger of drinking alcohol during pregnancy. Junior or senior high school teachers can include presentations on FAE/FAS during their regular courses. Such presentations may fit in with courses in chemistry, physics, biology, general science, home economics, physical education, sex education, guidance, etc. Teachers may also involve the students in poster or informational projects that may be displayed at local science fairs, parent- teacher night, or at community presentations on FAE/FAS. Medical personnel in the community have a very strong influence on the behaviour of pregnant women, since many women look to doctors, nurses and other health care givers for advice during pregnancy. If they discover that a woman is at risk of having a FAE/FAS child, they should advise her of the risk, refer her to appropriate counselling or treatment and follow up on the patient's progress. As can be seen, FAE/FAS prevention can become the task of the whole community, which may work together to stop damaging the health and well-being of the community's children and our future.

In summary, FAE/FAS is a group of birth and developmental defects that can happen to a baby in a mother's womb when the mother drinks alcohol. People have suspected for many centuries that alcohol can affect children, but since 1973 that there is a name and proof for these effects (FAE/FAS). Children born with FAS and FAE have birth defects, especially brain and central nervous system damage which cause mental retardation for life. These defects can be entirely prevented if women do not drink while they are pregnant. However, prevention of FAE/FAS is not only the responsibility of women but also fathers, teachers, service groups, healthcare workers and in fact, ALL people in the community!

Report compiled by: The Oromocto Indian Nation

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