Fetal Alcohol Spectrum Disorder (FASD)

Drinking alcohol at any stage during pregnancy can cause harm to your baby and the more you drink, the greater the risk.^1,2

Miscarriage, stillbirth, premature birth and small birth weight are all associated with a mother’s drinking during pregnancy (although they can be due to other reasons too).^3,4 And drinking in pregnancy can result in life-long mental and physical problems for the child – a range of conditions known as Fetal (formerly spelt in the UK as ‘foetal’) Alcohol Spectrum Disorder (FASD).

That’s why the advice for pregnant women in the UK Chief Medical Officers' (CMOs) low risk drinking guidelines is that the safest approach is to not drink alcohol at all throughout pregnancy. 

Read our alcohol and pregnancy page for the full details of the CMOs’ advice about why you shouldn’t drink alcohol during pregnancy.

What is Fetal Alcohol Spectrum Disorder?

One possible outcome of drinking during pregnancy is the risk of the baby developing Fetal Alcohol Spectrum Disorder (FASD).⁵

FASD is a life-long condition that can affect a child’s brain development, behaviour and growth.⁶ It’s caused by a developing unborn baby (fetus) being exposed to alcohol in the womb.

The severity of the problems caused by FASD is wide-ranging, but there is no such thing as ‘mild’ FASD.⁹ No two children with FASD are exactly alike, either behaviourally or physically,¹⁰ but they all face serious, life-long implications for their health and wellbeing.

FASD can cause problems with:¹¹

• Movement, balance, vision and hearing
• Learning, such as problems with thinking, concentration, and memory
• Managing emotions and developing social skills
• Hyperactivity and impulse control
• Communication, such as problems with speech
• Joints, muscles, bones, and organs such as the kidneys and heart

These can create great difficulties for individuals in their childhood that persist throughout life, with a greater likelihood of facing problems at school, trouble with the law, substance misuse problems and risky or inappropriate sexual behaviours.¹²

In a minority of cases (fewer than one in 10)¹³ FASD may be associated with characteristic facial features too - small and narrow eyes, a small head, a smooth area between the nose and the lips and a thin upper lip.¹⁴

Among those children most severely affected, in addition to the problems listed above, they may have additional serious problems including:^15,16

• Epilepsy
• Hearing and ear problems
• Height and weight issues
• Hormonal disorders
• Liver damage
• Mouth, teeth and facial problems
• Weak immune system

How FASD is diagnosed

If you’re worried about your child’s development, you should speak to your GP or health visitor. They will need to know whether your child was exposed to alcohol while you were pregnant, and can refer you to a specialist for more help and support if they think FASD is a possibility.¹⁷

To diagnose FASD, as well as considering any exposure to alcohol before the child was born, the specialist will check if they have physical signs of FASD, like the facial features mentioned above. And because FASD affects development, they will assess whether the child has any severe, long-standing problems with their:¹⁸

• Motor skills
• Mental development
• Learning
• Language
• Academic achievement
• Memory
• Attention
• Impulse control and hyperactivity
• Ability to recognise emotions
• Social skills or social communication

Your specialist will also take into account whether these symptoms could be caused by anything else – like another health condition or genetic reason. They might also decide they need to monitor your child’s development to see whether any problems are temporary or get worse as they get older.¹⁹

The earlier a diagnosis of FASD can be made, the sooner support can be provided for the person affected and their family.

The terminology doctors use when talking about FASD has changed in the UK in recent years. The following conditions used to be diagnosed separately, but are now all considered part of the FASD spectrum:

• Fetal alcohol syndrome (FAS)
• Partial Fetal Alcohol Syndrome (PFAS)
• Alcohol-Related Neuro-developmental Disorder (ARND)
• Alcohol-Related Birth Defects (ARBD)

How Fetal Alcohol Spectrum Disorder develops during pregnancy

Alcohol can cause harm to a developing baby at any point during pregnancy.²⁰

When a pregnant woman drinks, the alcohol goes through the placenta to the fetus via the bloodstream. Alcohol is a type of substance known as a ‘teratogen’ – something that has been proven to affect the way a fetus develops²¹ (other examples of teratogens are cannabis and cocaine).

Alcohol has a number of harmful effects on a developing fetus, including destroying brain cells²² and damaging developing organs.²³

Treatment for children

There is lots of specialist support available for children with FASD, but there is no specific treatment, and any damage to the child’s brain and body can’t be reversed.

GPs can refer children with FASD to community paediatricians. They will work with psychologists, psychiatrists, speech and language therapists and specialists for organ defects, to determine the best course of action.

Early diagnosis is key. Research shows that many people who have FASD go on to experience preventable ‘secondary disabilities’ (conditions that weren’t present at birth) such as mental health issues and problems with substance dependency, which could be avoided with early support.²⁴

Advice for mums-to-be

Because drinking during pregnancy can lead to long-term health problems of FASD, the UK Chief Medical Officers advise that it’s safest not to drink alcohol at all if you are trying to conceive or are pregnant.

If you didn’t know you were pregnant and you drank alcohol during early pregnancy, talk to your GP or midwife about any concerns you have. You may have drunk alcohol, but that doesn’t necessarily mean your unborn baby has been harmed.

UK low risk drinking guidelines

More information

Visit the National Organisation for FASD website or call their helpline on 020 8458 5951 for support or information.

FASD Network is an organisation that specialises in providing information, support and training on FASD. Visit the FASD Network website here.