Drinking mothers may damage unborn children

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Children born to mothers who drink heavily start life already disadvantaged.

They suffer from Fetal Alcohol Syndrome, and according to Dr. George Brenneman at Johns Hopkins University in Balitmore, Maryland, there are three main areas where the children have problems.

First, they are born small and never really catch up in size. Central nervous system damage means they may be retarded, have a smaller head or smaller brain than average and they may undergo behavioral changes.

Finally, they have certain facial deformities characteristic of FAS children: the natural bridge of the nose is flattened; the supper lip is thin and smooth - there is no indentation between the nose and upper lip.

"When those three groups of findings are present, then those together along with a history of the mother drinking alcohol, the diagnosis is FAS," Brenneman said.

Many children may have less obvious damage, which is called Fetal Alcohol Effects. FAE may be much more widespread than FAS.

"There may be 10 children with Fetal Alcohol Effects for every one FAS case, but that has not been successfully tested," added Brenneman, Associate Director, Centre for American Indian and Alaska Native Health at the university.

"It doesn't always show up at birth or early infancy - it may not show up until the individual has to rely on his intellect of cognition,"said Brenneman, who is also a pediatrician.

One FAE symptom is hyper-activity; another is a difficulty in the ability to reason through things in school, which may not show up until the third grade. FAE children may not be able to fully understand all the information they are given or they may be hyper-sensitive to stimuli such as bright lights and loud noises.

One of the most frightening things about FAS and FAE is that no one really knows how much alcohol a woman can safely drink without harming her unborn child.

"Women who abuse alcohol, who are addicted to alcohol, have a very high risk. The risk in women who drink rarely - that risk is very low," said Brenneman.

But the best prevention is abstinence.

"There should not be any second-guessing. The recommendations should be that all women avoid alcohol totally during pregnancy," he said.

Most of the preventive measures such as putting warnings on the dangers of alcohol consumption for pregnant women on liquor bottles, don't work for addicted women.

"The answer is to identify these women when they're pregnant, and get them to treatment. And to tell them that if they stop drinking at any time when they're pregnant, the risks to their baby are reduced."

What is also needed are treatment programs the women will willingly go into. Many women who drink are afraid to admit it in case authorities take their baby away.

A lot of alcohol treatment programs don't know what to do with the infants, so they put the children in foster care and send the moms to treatment.

The answer, Brenneman said, is to have treatment programs that allow mothers to keep their babies.

Although FAS seems to be more prevalent among Native populations in the States, Brenneman cautions people against taking those statistics too seriously. There are two FAS children per 1,000 born in the general population, but among some Native groups in the US. southwest, the number is six or eight per 1,000.

But the problem in some Native groups has been more heavily studied than in the general population.

"There may not be that much difference."