Effects of alcohol on unborn children can last a lifetime

PEORIA — While Dr. James Hocker knows that nearly any mother would never knowingly harm her child, up to 1 in 20 children could suffer lifelong effects because of decisions made by their pregnant mothers.

On Thursday morning, Hocker, medical director of the Neonatal Intensive Care Unit at Children’s Hospital of Illinois, talked to a group of physicians and residents about the prevalence of Fetal Alcohol Spectrum Disorders, an umbrella term to describe the effects of prenatal alcohol exposure that affects children not just as newborns, but throughout school and adulthood in ways that even doctors still are learning about.

“We have to be better about prevention and detection,” said Hocker, also an associate professor of clinical pediatrics at the University of Illinois College of Medicine at Peoria.

It’s not just alcohol abuse, which can lead to a more refined diagnosis of Fetal Alcohol Syndrome, that doctors are worried about. Even moderate or occasional social drinking during pregnancy can cause issues, and there’s worry that even drinking before a woman learns that she’s pregnant can cause FASD.

The observation that pregnant women use alcohol and drugs is no new phenomenon, Hocker noted, pointing to examples from Aristotle and literature from the early 1700s. But the scope, perhaps, still is being realized.

The Centers for Disease Control and Prevention issued a report earlier this year containing its recommendation that any woman who is sexually active and not using birth control avoid alcohol to minimize the risk in the event of an unplanned pregnancy.

While diagnosis of Fetal Alcohol Syndrome is based on a defined set of characteristics, FASD can be much more difficult to detect. In newborns, its characterized by slow growth both before and after birth and other anomalies, symptoms that can be indicative of a number of different diagnoses.

And unlike neonatal abstinence syndrome — the problems that occur when babies are exposed to opiates in a mother’s womb — which is much more severe at birth, those babies will often go on to live healthy, normal lives. Babies exposed to alcohol, however, even small amounts, can have cognitive and behavioral issues that will last their entire lives.

The long-term effects of FASD, he said, include behavioral issues, cognitive impairment and lower achievement, and are often misdiagnosed as learning disorders, hyperactivity or mental illness, when in fact they are brain injuries incurred before birth.

The task of preventing and treating FASD will be two-fold: first, to educate women about the serious risks of drinking even a little while pregnant and better equipping doctors to recognize the symptoms, appropriately diagnosis children and get them the therapies that can improve their outcomes. To doctors, Hocker stressed the value in being aware of FASD symptoms so that obstetricians, pediatricians and physicians can screen for impairment and call in specialists when necessary.
To potential mothers, he states emphatically that while there’s evidence that alcohol exposure affects some fetuses more than others, there’s no known amount of alcohol or alcoholic beverage that is safe for pregnant women to consume without risk to their unborn child.

“Wine coolers, whatever, that’s just as bad as drinking whiskey,” Hocker said.

He advises women who are pregnant or planning to become pregnant should not drink. Women who experience an unplanned pregnancy should stop drinking alcohol as soon as they learn that they are pregnant. Those struggling with drug or alcohol addiction should seek treatment.

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