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Substance and addiction prevention branch

Pregnant mother with young daughter

​Fetal Alcohol Spectrum Disorders (FASDs)​

What is it?

Fetal alcohol spectrum disorders (FASDs) is an umbrella term for a group of conditions that can occur in a person who was exposed to alcohol before birth when alcohol is passed to the fetus (developing baby) from the mother through the placenta and the umbilical cord.[1] Effects of FASDs range from mild to severe, including lifelong and permanent behavioral, intellectual, and physical challenges. Alcohol exposure during pregnancy is a leading preventable cause of birth defects and neurodevelopmental abnormalities in the United States. 

​How Common are FASDs?

We do not know exactly how many people have FASDs. The prevalence of FASDs is hard to measure because of the challenges with recognition, screening, and diagnosis. However, some studies suggest that as many as 1 in 20 U.S. school-aged children may have FASDs.[2​]

Are FASDs Preventable?

Yes, FASDs are preventable if a baby is not exposed to alcohol before birth. Anyone is at risk of giving birth to a baby with an FASD if they consume alcohol during pregnancy.

​​No Safe Amount

​There is no safe amount of alcohol that is considered safe at any st​age during pregnancy.

​​No Safe Timeframe

​There is no safe timeframe during pregnancy or while trying to get pregnant to drink alcohol. Alcohol can disrupt fetal development at any stage of pregnancy, including before a person knows they’​re pregnant since individuals could get pregnant and not know for up to 4 to 6 weeks.

​​No Safe Type

There is no safe type of alcohol use during pregnancy or while trying to get pregnant. All types of alcohol are equally harmful during pregnancy, including all wines and beer.


Because there is no safe amount, timeframe, or type of alcohol use during pregnancy, people who are pregnant, think they might be pregnant, or are trying to become pregnant should not drink alcohol.

It is never too late to stop alcohol use during pregnancy because a baby’​s brain continues to grow throughout pregnancy.

​What are the Signs and Symptoms?

FASDs may include a range of conditions that can affect each person in different ways. People with FASDs do not have the exact same combinations of symptoms. People with FASDs can have combinations of impairments that range from mild to severe and these can be recognized at birth or later in childhood or even adulthood. Signs and symptoms are generally in three categories:

  1. Changes in behavior such as increased irritability in infancy; sleep and sucking problems as a baby; hyperactivity in childhood; difficulty in school (especially with math); intellectual disability or low IQ; and issues with speech, language, learning, memory, reasoning, and judgement skills.
  2. Changes in organs such as the heart, brain, skeleton, kidneys, eyes, and ears. These changes can require simple or complex medical care.
  3. Changes in appearance, including a smaller midface, changes to eyes and nose area, smaller head size, low body weight, shorter-than-average height, and overall poor prenatal (before birth) and postnatal (after birth) growth.

How are FASDs Diagnosed?

​The term FASDs is not a clinical diagnosis but includes several specific diagnoses based on specific criteria for each. Diagnosing one of the FASDs can be hard because there is no medical test, like a blood test, for these conditions and other disorders (e.g., attention-deficit/hyperactivity disorder and Williams syndrome) have similar symptoms as FASDs.

To diagnose FASDs, specialists look for:Doctor, woman, child

  • Prenatal (before birth) alcohol exposure

  • Central nervous system problems (e.g., small head size, problems with attention and hyperactivity, poor coordination, behavioral impairment)

  • Lower-than-average height, weight, or both

  • Abnormal facial features

​How are FASDs Treated?

Although FASDs last a lifetime and there is no cure, studies show that treatment services in early childhood

can help the child’​​​s development. 

A boy and a woman

Types of treatment include:

  • ​​​​​Specialist medical care  

  • Medication to help with some symptoms

  • Behavior and education therapy

  • Parent/caregiver training

  • Alternative approaches (e.g., biofeedback, auditory training, relaxation therapy, creative art therapy, animal-assisted therapy, and others)

Certain protective factors (i.e., factors that may reduce impact of symptoms) can help reduce some of the effects of FASDs. These factors can help people with FASDs reach their full potential:

  • Diagnosis before 6 years of age

  • Involvement in special education and social services

  • Loving, nurturing, and stable home environment during the school years

  • Absence of violence

Get Help for Your Child

It is important to get help as soon as possible if you think your child may have an FASD or other developmental problem.

  • Ask your child’s doctor for a referral to a specialist (someone who knows about FASDs, e.g., developmental pediatrician, child psychologist, or clinical geneticist).

  • If your child is under age 3, contact the California Department of Development Services’​​​ Early Start program at 800–515–BABY (2229) or earlystart@dds.ca.gov.
    • ​There is no cost for evaluation, assessment, and service coordination. Learn more at the Early Start website.

  • If your child is age 3 or older, call any local public elementary school (even if your child does not go to school there) and ask to have your child evaluated through the school system special education services.

  • To find doctors or clinics in your area, speak to a FASD Family Navigator via phone at 202-785-4585 (available 9am–​10pm EST) or by completing a support request form at the FASD United website.

Get Help for Yourself  

It is important to stop drinking alcohol if you are pregnant or trying to become pregnant. If you are having a hard time not drinking alcohol, you are not alone and help is available:Want to check your alcohol use? This quick assessment can help you check. Visit https://bit.ly/3PdwBjj. ​

  • Talk to a trusted health care provider. You may experience signs of withdrawal when you try to stop drinking alcohol. Acute alcohol withdrawal poses a serious threat to both the mother and the developing baby and you will need medical support so you and your developing baby stay safe.

  • Call the Substance Abuse and Mental Health Services Administration’s (SAMHSA's) confidential, free, 24/7 National Hotline at 1-800-662-4357

  • Use SAMHSA’s treatment facility locator to find alcohol or drug treatment programs in your area at this link: Find Treatment

  • Use the National Institute on Alcohol Abuse and Alcoholism’s (NIAAA) Alcohol Treatment Navigator to find alcohol treatment in your area at this link: Treatment Navigator

It’s never too late to stop alcohol use during pregnancy and it’s important to ask for help.

Additional Resources and Information

​References

[1] Bertrand J, Floyed RL, Weber MK, et all “National Task Force on Fetal Alcohol Syndrome and Fetal Alcohol Effect”​ from the CDC www.cdc.gov/ndbddd/fasd/documents/fas_guidelines_accessible.pdf

[2​] May PA, Chambers CD, Kalberg WO, et al. Prevalence of Fetal Alcohol Spectrum Disorders in 4 US Communities​ JAMA. 2018;319(5):474-482. doi:10.1001/jama.2017.21896​​​​

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