Fetal alcohol spectrum disorder (FASD) is a well known problem that occurs when a pregnant woman drinks too much alcohol during key parts of development for her unborn child. The damage often occurs without the pregnant woman knowing it, as key development in her unborn child (fetus) happens before she even realizes that she is pregnant. The effects of alcohol on the fetus are both physical and behavioural. Unfortunately no one knows how much alcohol is too much.

Looking at the amount of alcohol that is drunk and the number of cases of FASD that occur, an interesting comparison can be made between the United States (U.S.) and European countries. In France, they have the highest rates of alcohol consumption (almost double the U.S.) and yet their reported rates of FASD are lower at 1.3 cases per 1,000 people, while the U.S. sits at 1.95 cases per 1,000 people.

This is referred to as the “American Paradox.” People have thought of many reasons for this paradox. They have suggested that the U.S. over-diagnoses FASD, and that clinicians there are all too quick to decide that this is what a child’s problem is. Another theory is that the pattern of drinking in the U.S. trends towards binging, while in Europe, a glass of wine is had with dinner and drunkenness is not tolerated. Further, in the U.S. there is more beer and hard liquor that is drunk, while in Europe there is more wine drunk, and this may be why there is more FASD diagnosed in the U.S.

However, no scientific studies have been done to show if the type of alcohol has any effects on the severity of FASD. In Canada, studies have shown that our alcohol consumption is slightly higher than the U.S., but our incidence of FASD is lower (close to 0 out of 1,000.) Again, is this related to their over-diagnosing the problem, or are we under-diagnosing it?

People with FASD suffer from memory problems. They may have difficulty focusing on a task and may have hyperactivity. Learning disabilities are common as well. Children with FASD may have slower growth physically. It is shown that these kids often have smaller brains overall. They have difficulty following instructions. Facial features are often affected, giving a flattened and thin upper lip and smaller eyes.

Fetal alcohol spectrum disorder may cause problems with speaking, hearing, and seeing. Kidney and heart trouble is not uncommon in FASD as well. As an adult, a person with FASD is more prone to depression. These people often get into more trouble with the law and have difficulty holding down a job. Drugs and alcohol abuse are common too, making it even more likely that their children will have the same thing.

The amount of alcohol needed to cause FASD is unknown, and so it is best to avoid it altogether in pregnancy. Think of is as putting on a seatbelt or wearing a helmet while riding a motorcycle. Prevention is the best protection.