The date 9/9 is a reminder to women who are or may be pregnant that during the nine months of pregnancy, there are significant and life-long risks due to alcohol for the child they carry. The Substance Abuse and Mental Health Services Administration (SAMHSA) has enhanced its message about Fetal Alcohol Spectrum Disorders (FASD) each year since the 9/9/99 observance of FASD Awareness Day.
According to SAMHSA, women with the disease of alcoholism are not the only ones risking fetal development: Even infrequent social drinking is dangerous. "There is no known safe level of alcohol use in pregnancy."
When an expecting mother drinks, the alcohol is passed directly to the fetus. The unborn will have the same blood alcohol concentration (BAC) as the mother, but lacks the ability to process the alcohol the way an adult does, so the BAC remains high for a long time. The alcohol causes a number of physical, cognitive, social and neurological problems in the infant that are permanent and irreversible. Alcohol also can kill a fetus.
FASD is a broad category conditions including FAS, alcohol-related neurodevelopmental disorder and alcohol-related birth defects. In the United States, about 130,000 pregnant women each year drink at levels shown to increase the risk of having a child with an FASD, according to the Center for Disease Control and Prevention (CDC). As many as 40,000 babies are born with an FASD annually, costing the U.S. up to $6 billion annually in institutional and medical costs. Costs of FAS alone are estimated at between 1 and 5 million dollars per child. This estimate does not include cost to society, such as lost productivity or incarceration, nor does it factor in the burden on families and poor quality of life.
Physical deformities (facial abnormalities, fused joints, organ problems) are one of the more obvious consequences of prenatal exposure to alcohol. However, the development of the brain is of particular concern. The brains of FASD babies are measurably smaller than otherwise healthy babies. Resulting impairments may include:
• Mental retardation
• Learning disabilities
• Attention deficits
• Problems with impulse control, language, memory, and social skills
The brain and nervous system are among the first to develop, beginning around week three of pregnancy when some women may not even realize they're expecting. In the U.S. 1 in 2 adult women reports any alcohol use in the past month: Some women might not even know if they're pregnant 30 days after conception. For those who know they're pregnant, SAMHSA's stats are cause for concern. One in 30 pregnant women drinks at levels shown to increase the risk of FASD and more than 20 percent of pregnant women report alcohol use in the first trimester. The latter number drops to five percent in the third trimester.
A 2004 University of Washington study found that children born with FASD have a lifetime of difficulties. More than 90 percent had mental health problems, 83 percent experienced dependent living into adulthood, 80 percent had employment problems as adults., 6 in ten of those age 12 and older had trouble with the law and more than a third had had alcohol and drug problems.
SAMHSA notes that protecting babies from alcohol goes beyond pregnancy. "When a woman uses alcohol, her baby does, too. That’s why abstaining from drinking throughout pregnancy and during breastfeeding is the best gift a mother can give her child—it’s a gift that lasts a lifetime."
FAS, a diagnosis that first gained national attention in 1973, has four major components:
• A characteristic pattern of facial abnormalities (small eye openings, indistinct or flat philtrum between nose and mouth, thin upper lip)
• Growth deficiencies, such as low birth weight
• Brain damage, such as small skull at birth, structural defects and neurologic signs, including impaired fine motor skills, poor eye-hand coordination and tremors
• Maternal alcohol use during pregnancy
The SAMSHA message is abrupt, but clear. "FASD is 100 percent preventable. If you get pregnant, don't drink. If you drink, don't get pregnant."