There is NO 100% safe amount of alcohol during pregnancy.

About FASD

What is Fetal Alcohol Syndrome?

A more complete term is Fetal Alcohol Spectrum Disorders or FASD, which is a range of effects that can occur in an individual whose mother consumed alcohol during pregnancy. FASD can include physical disabilities as well as difficulties with behavior and learning. There conditions are permanent and lifelong, and there is no cure.

We would like to acknowledge and thank the Minnesota Organization on Fetal Alcohol Syndrome for allowing us to leverage much of their FAQ content for this section. 

About FASD

What is FASD?

Consuming alcohol during pregnancy can cause irreversible damage to an unborn baby.  If a baby is prenatally exposed to alcohol, they are at risk for having Fetal Alcohol Spectrum Disorders (FASD).  FASD is not a diagnosis, but is an umbrella term describing the range of effects that can occur when a developing baby is prenatally exposed to alcohol. These effects may include physical, mental, behavioral, and/or learning disabilities with possible lifelong implications. There are many terms under the FASD umbrella, including these medical diagnoses:

  • Fetal Alcohol Syndrome (FAS)
  • Alcohol Related Neuro-developmental Disorders (ARND)
  • Alcohol Related Birth Defects (ARBD)
  • Partial Fetal Alcohol Syndrome (pFAS)

FASD is a lifetime disability that affects each child differently. Some children with an FASD have specific facial features and tend to be smaller in height and weight. They often have a brain injury that never goes away. This means both the child’s thought process and behaviors may be very different than a child who was not prenatally exposed to alcohol. The brain damage is the most challenging part of this disability.

Find support for and learn more about FASD in your family, as an expectant woman, or as a professional.

What causes FASD?

The only cause of FASD is alcohol use during pregnancy. There is no known safe amount of alcohol to consume during pregnancy. There is also no safe time to consume alcohol during pregnancy. Alcohol can affect the baby during every trimester of pregnancy.

Consuming alcohol up to the 13th week of pregnancy can cause:

  • severe brain damage;
  • problems with the heart, liver and kidneys;
  • miscarriage;
  • facial malformations.

Consuming alcohol between weeks 14 and 26 can cause:

  • brain damage;
  • miscarriage;
  • damaged muscles, skin, teeth, glands and bones.

Consuming alcohol between weeks 27 and 40 can cause:

  • brain and lung damage;
  • low birth weight;
  • early labor and delivery.

Are you an expectant mother and worried about your drinking? Find support.

What factors increase the risk of FASD?

There are many factors contributing to whether a child will be permanently damaged during pregnancy with alcohol use. These include:

  • Genetic make up of the biological mother and father
  • History of alcoholism in the biological grandparents and parents
  • General health of the mother
  • Nutrition of the mother
  • Level of prenatal care
  • Trauma surrounding the pregnancy
  • Amount and type alcohol consumed
  • Time when the fetus is exposed

This is by no means is an exhaustive list of factors but enough to realize that it is simply not worth the risk…

Binge drinking or having 4 drinks within a 2 hour period presents the most risk to the fetus

Is there a cure for FASD?

Unfortunately, FASD cannot be cured. The brain damage that occurs to an unborn baby when a pregnant woman consumes alcohol cannot be changed or reversed.  However, people with an FASD can function very well in life when given the right supports.  Supports include a stable and loving home or a job coach and placement program.

What we cannot change about FASD are called Primary disabilities and include:

  • Facial features associated with FAS;
  • Height and weight (small in stature);
  • Brain damage (learning disabilities, memory problems, poor impulse control).

Secondary characteristics are the ones that can be prevented when we deal with the Primary disability properly. Secondary characteristics can include:

  • Mental health problems;
  • Disruptive school experience;
  • Trouble with the law;
  • Confinement (includes jail, mental health and chemical dependency treatment);
  • Inappropriate sexual behavior;
  • Alcohol/drug problems;
  • Dependent living;
  • Employment problems.

Find more information in our resource section.

How many people have an FASD?

Fetal Alcohol Spectrum Disorders (FASD) is the leading cause of developmental disabilities in the U.S. Recent research shows the rates of Fetal Alcohol Syndrome (FAS) and FASD are higher than previously thought.

  • Up to 1 in 20 US school children may have FASDs [1]
  • In Indiana, 848 babies are born each year with a fetal alcohol spectrum disorder (FASD) [2]
  • In Indiana, 42,400 people are living with a fetal alcohol spectrum disorder (FASD) [2]
  • For some groups, prevalence of FAS is estimated to be 6 – 9 per 1,000 children.  Previous estimates where 0.5 – 1.5 per 1,000. [3]
  • For some groups, prevalence of FASD is estimated to be 2 – 4 % or 24-48 per 1,000 children.  Previous estimates were 10 per 1,000 or 1%. [3]

Sources:  

  1. CDC Vital Signs, February 2016. American Journal of Preventative Medicine, November 2015. 
  2. Susan Elsworth, “Just So You Know: Fetal Alcohol Spectrum Disorders”, May, 2017
  3. Philip A. May, et al, “Prevalence and Characteristics of Fetal Alcohol Spectrum Disorders,”, Pediatrics, Volume 134, Number 5) 

Do I have an FASD?

Does this sound like you?

  • Raised in foster care or adopted
  • History of chemical dependency/child protection
  • Received many diagnoses such as ADHD, Autism, Reactive Attachment Disorder, Bi-Polar Disorder, Depression, Anxiety, etc.
  • Easily distracted, hyperactive, inattentive, impulsive
  • Consistently displays extreme behavior (aggression, emotional instability)
  • Been involved with the criminal justice system
  • Has trouble remembering rules
  • Makes the same mistakes repeatedly
  • Displays difficulties in holding a job

Do you know if your birth mother drank during pregnancy?

  • Mother received treatment for alcohol/drug problems
  • Mother was diagnosed with alcohol/drug problems
  • Child was removed from home due to alcohol/drug related problems
  • Mother died due to complications from alcohol/drug abuse
  • Other high risk behaviors such as DUI’s, job or legal problems related to drinking
  • Medical records indicate presence of alcohol/drugs at birth

Are there services that I can receive if I have an FASD?

Access to services for those who may have an FASD can be difficult in Indiana for a variety of reasons. Indiana NOFAS is working with key stakeholders to better coordinate existing services, and to identify areas where additional services are required.

We’ve also established our online Community Resource Directory. We are working to grow our list of FASD friendly providers around Indiana.

If you have additional questions or needs, please feel free to contact us directly using this form.

For Families

How do you know if you/your child has an FASD?

These are some things to look for if you suspect someone you know may be affected:

Infants:

  • low birth weight
  • sensitivity to light, noise and touch
  • irritability
  • unable to suck effectively
  • slow to develop
  • ear infections
  • poor sleep/wake cycles

Toddlers:

  • poor memory
  • hyperactivity
  • no fear
  • no sense of boundaries
  • need for lots of physical contact

School-Age Children:

  • easily distracted
  • short attention span
  • poor coordination
  • trouble with large and fine motor skills
  • need lots of one-on-one attention

Older Children:

  • low self-esteem
  • trouble keeping up in school
  • poor impulse control
  • difficulty with public versus private environments
  • must be reminded of concepts on a daily basis

These signs may also be present in children without an FASD, however you will notice that “typical” parenting will not result in changes in behavior for children prenatally exposed to alcohol.

If you think it’s possible that you or your child has an FASD, visit our Resource Directory to find the resources you need near you.

Where can I find health care providers who understand FASD?

Indiana NOFAS maintains a Resource Directory of articles, research, training and other information. This directory also contains contact information for FASD-friendly professionals and programs such as diagnostic clinics, therapists and support groups.

Access to services for those who may have an FASD can be difficult in Indiana for a variety of reasons. Indiana NOFAS is working with key stakeholders to better coordinate existing services, and to identify areas where additional services are required. We are also working to grow our list of FASD friendly providers around Indiana.

If you have additional questions or needs, please feel free to contact us directly using this form.

What’s the difference between FASD and Autism?

Similarities Between Fetal Alcohol Spectrum Disorders (FASD) and Autism
Dan Dubovsky MSW SAMHSA FASD Center for Excellence

Both are developmental disabilities. Both affect normal brain function, development, and social interaction. In both, the individual often has difficulty developing peer relationships. In both, there is often difficulty with the give and take of social interactions. In both, there are impairments in the use and understanding of body language to regulate social interaction. In both, there is difficulty expressing needs and wants, verbally and/or non- verbally. A short attention span is often seen in individuals with Autism and an FASD. In both, we may see an abnormal sensitivity to sensory stimuli, including an over- or under-sensitivity to pain.

Differences Between Fetal Alcohol Spectrum Disorders and Autism
Dan Dubovsky MSW SAMHSA FASD Center for Excellence
FASD Autism
  • Occurs as often in males as in females
  • Occurs in males 4 times as often as in females
  • Able to relate to others
  • Difficult or impossible to relate to others in a meaningful way
  • Restricted patterns are not commonly seen
  • Restricted patterns of behavior, interests, and activities as a core area
  • Verbal communication may be slow to develop but is not commonly significantly impaired
  • Difficulty in verbal and non-verbal communication
  • Difficulties begin at birth
  • Difficulties may begin after a period of normal growth
  • Difficulty in verbal receptive language; expressive language is more intact as the person ages
  • Difficulty in both expressive and receptive language
  • Spoken language is typical
  • Some do not develop spoken language
  • Spontaneously talkative
  • Robotic, formal speech
  • Echolalia not common
  • Echolalia-repeating words or phrases
  • Stereotyped movements not seen
  • Stereotyped movements
  • Ritualistic behaviors not commonly seen
  • Ritualistic behaviors
  • Repetitive body movements not seen; may have fine and gross motor coordination and/or balance problems
  • Repetitive body movements e.g., hand flapping, and/or abnormal posture e.g., toe walking
  • Social and outgoing
  • Remaining aloof; preferring to be alone
  • Difficulty with change and transitions
  • Inflexibility related to routines and rituals
  • Can share enjoyment and laughter
  • Lack of spontaneous sharing of enjoyment
  • Can express a range of emotion
  • Restricted in emotional expression
  • Funny; good sense of humor
  • Difficulty expressing humor
  • Microcephaly more common
  • Macrocephaly more common
  • Considered a medical disorder in the ICD.  Not in the DSM-IV
  • Considered a mental disorder in the DSM-IV

For Expecting Parents

I drank alcohol before I knew I was pregnant. Now what?

First, don’t panic!  The best thing to do, is stop consuming alcohol as soon as you find out you are pregnant. It is never too late to stop drinking. The sooner you stop consuming alcohol, the better it will be for both you and your baby. Then make sure you are getting regular prenatal care and maximizing other good health practices like not smoking, eating healthy and getting plenty of sleep. If you drank any amount of alcohol while you were pregnant, talk with your child’s health care provider as soon as possible and share your concerns.

Half of all pregnancies are unplanned.  And many women do not know they are pregnant for several weeks or even months. There are many factors that determine if a fetus will be impacted by prenatal alcohol exposure. Often it is not just how much alcohol a woman consumes, but when she drank, her nutrition, genetics, age etc. The best advice is to not consume any alcohol during pregnancy if you are planning on becoming pregnant or are having unprotected sex.

If you are a mother of a child who was exposed to alcohol prenatally and would like to connect with other moms, please contact us.

For national support, visit the National Organization on Fetal Alcohol Syndrome (NOFAS) Circle of Hope at http://www.nofas.org/circleofhope/. The Circle of Hope are groups where women with incredible strength join together to share their stories, shed the shame and support each other through the challenges of raising children with Fetal Alcohol Spectrum Disorders (FASD).

“We do not know what, if any, amount of alcohol is safe. But we do know that the risk of a baby being born with any of the fetal alcohol spectrum disorders increases with the amount of alcohol a pregnant woman consumes, as does the likely severity of the condition. And when a pregnant woman consumes alcohol, so does her baby. Therefore, it’s in the child’s best interest for a pregnant woman to simply not consume alcohol”.

In addition, studies indicate that a baby could be affected by expsosure to alcohol while pregnant even within the earliest weeks after conception, and before a woman knows that she is pregnant. For that reason, the U.S. Surgeon General is recommending that women who may become pregnant also abstain from alcohol.

Find some resources for expectant mothers.

Why should I worry about alcohol use if I am not pregnant and not trying to get pregnant?

If you consume alcohol and do not use contraception (birth control) when you have sex, you might get pregnant and expose your baby to alcohol before you know you are pregnant.

Nearly half of all pregnancies in the United States are unplanned. And many women do not know they are pregnant right away. So, if you are not trying to get pregnant but you are having sex, talk to your health care provider about using contraception consistently.

Can an FASD be passed along through breast milk?

Alcohol in breast milk is not linked to FASD.  However, when a woman who is breastfeeding consumes alcohol, some of that alcohol does enter her breast milk. Research shows that alcohol in the milk can harm a child’s development, sleep, and learning.  For this reason, breastfeeding women should be very cautious about consuming alcohol, if they choose to consume alcohol at all.  According to the new 2010 Dietary Guidelines for Americans published by the USDA, a mother may consume a single alcoholic drink if she then waits a least 4 hours before breastfeeding.

Can a partner cause an FASD?

If my partner consumes alcohol will they cause the baby to have an FASD? No.

FASD is only caused when a woman consumes alcohol when she is pregnant.  However, a partner can be supportive of the mother by encouraging her not to consume alcohol while she is pregnant and by abstaining from alcohol themselves as a show of support for the mother.

If a woman has an FASD, will her children have it, too? Is FASD hereditary?

No. FASD cannot be “passed on” from a mother to a child like having brown eyes can be passed on. The only way for women with an FASD to have a child with an FASD is for that woman to consume alcohol when she is pregnant. Also, just because a woman has one child with an FASD does not mean she will have another with an FASD. As long as a pregnant woman does not consume alcohol, her child will not be born with FASD.

For Professionals & Community

Does Indiana NOFAS provide training?

Indiana NOFAS provides many different types of training throughout the year that are open to the public, and Indiana NOFAS also does private trainings for individual agencies or organizations.  If you are interested in having someone from Indiana NOFAS come to your agency and speak, please contact us using this form.

Indiana NOFAS charges a fee of $150/hour to do trainings, plus mileage of .55 per mile for round trips of 100 miles or more. However, if your agency cannot afford the set fee, please still contact us. There are a certain amount of trainings we do throughout the year that are free, and we are willing to work within your budget. Once you have contacted Indiana NOFAS with your request, we will get back to you to confirm your information.

How is FASD Diagnosed?

There are a handful of methods to diagnose FASD:

  • 4 – digit code (Universty of Washington)
  • CDC (Center for Disease Control) method
  • Modified Institute of Medicine method
  • Combination method (MN approach)

Each method obtains information about four health parameters:

  1. Growth
  2. Facial features
  3. Brain development and functioning
  4. Exposure to alcohol in utero

The data obtained regarding these four parameters are ranked by degree of expression in the individuals being examined. That ranking is them compared to the defined criteria for FASD, and a diagnosis is given based on the evidence.

All of the methods of FASD diagnosis assess these same four health parameters. The difference in the methods is how they define the criteria for each of the three diagnostic categories, FAS, pFAS, and ARND. This can result in different diagnoses from one method to the next, although the medical evidence is the same. One method also subdivides the three categories into many smaller categories, giving a more specific description of the individual’s diagnosis.

As more research is done about FASD, diagnosis is becoming more standard. The CDC and FASD experts continue to work on honing one diagnostic model.

Screening & Diagnosis

What are some of the symptoms to watch for?

Only trained professionals can make an FASD diagnosis. FASD is often misdiagnosed because many of the characteristics look the same as mental health disorders.

Signs to look for that may indicate the need for an FASD assessment include:

  • Sleeping and sucking problems as a baby
  • Hearing or vision problems
  • Difficulty in school; especially in math
  • Poor coordination and fine motor skills
  • Sensitivity to light, touch, sound
  • Tremulousness (uncontrollable twitching or tremors)
  • Hyperactive behavior
  • Difficulty paying attention
  • Impulsivity
  • Poor memory
  • Poor reasoning and judgment skills
  • Perceptual Problems
  • Difficulty reading the social cues of others
  • Difficulty retrieving CNS information when stressed
  • Diminished Intelligence
  • Better expressive language than receptive language
  • Facial features (small eye openings, smooth philtrum, thin upper lip

Why is an FASD diagnosis important?

Getting an FASD diagnosis is important for both the individual being assessed, as well as their family.

Identifying individuals who may be affected by an FASD is the first step in getting them connected to the support they will need to reach their full potential.  A diagnosis helps to identify the strengths and deficits of the individual.  As a result, a meaningful and more effective intervention plan for relevant services and support can be created.  And for the family, a diagnosis can provided an overall greater understanding, acceptance and more realistic expectations.

Read an inspirational personal diagnosis story by Linda Rosenblaum, “What Can Testing Tell Us?”

What is the FASD diagnostic process like?

Unfortunately, there is not one medical test (like a blood test) to confirm a diagnosis under the FASD umbrella. FASD can be diagnosed by a team of professionals assessing four specific areas:

  • Growth issues
  • Brain function and structure
  • Facial features
  • Prenatal alcohol history

Depending on the clinic, the diagnostic process can take 3-6 hours and includes:

  1. History (Clinic Care Coordinator)
    A comprehensive history of the problem and any evidence of prenatal alcohol exposure is discussed.
  2. Physical Exam (Medical Provider)
    Measurements of the head, face and growth are taken along with a complete physical exam.
  3. Neurodevelopmental Assessment (Psychologist, Speech Therapist and Occupational Therapist)
    Comprehensive testing is done to evaluate 10 different brain functions including memory, executive functioning and motor skills.
  4. Diagnosis (Diagnostic Team)
    All assessments are reviewed by the diagnostic team and evaluated to see if they meet the criteria for a diagnosis under the FASD umbrella.
  5. Evaluation Report (Diagnostic Team)
    A summary of the findings is prepared along with any specific recommendations for follow up support and treatment. Information about CINOFAS is distributed.

What to do with FASD diagnostic results?

Remember, getting an FASD diagnosis is not about “labeling” a child. It is rather an opportunity for your child and family to get the services and support needed to be successful.

  1. Share the diagnosis with your child’s school to assist with the development of an Individualized Education Plan (IEP).
  2. Share this information with your child’s doctor to receive more appropriate medical and mental health services.
  3. Contact your county social service office to see what supports and services are available.

Check out our Resource Directory for more information

Contact Info

Indiana NOFAS, Inc.
1431 North Delaware Street
Indianapolis, IN 46202