The Stunted Children of Alcohol

There's a lifetime of sobering news for women who drink while pregnant

By Julia McNamee Neenan
HealthSCOUT Reporter

FRIDAY, April 14 (HealthSCOUT) -- Seventeen years ago, when Linda LaFever was eight months pregnant, she went on a drinking binge. For two weeks, she drank a half bottle of vodka a day.

Five years later, she learned the price of that binge. A panel of experts told her that her son, Daniel, with an IQ of 58, had Fetal Alcohol Syndrome.

"My world stopped. It took about three seconds to link those words. I picked up my child and put him on my lap and rocked him," LaFever recalls. "I'm still trying to get over it."

Today Daniel is a 17-year-old whose high school curriculum in Hawaii includes learning to make his own bed and doing laundry.

"Any time alcohol is mixed in with pregnancy, it's going to cause some damage," LaFever says. "Don't think it can't happen to your child. And when it happens to your child, it happens to you."

Fetal Alcohol Syndrome is a diagnosis that means a child will probably suffer stunted growth and facial deformities, attention and behavior problems, and, in some cases, mental retardation. Worst of all, it's a diagnosis that's never outgrown; adults with FAS will never function normally.

It's also a diagnosis that's becoming increasingly common -- up six-fold since the mid 1980s.

An estimated 5,000 babies are born each year with full-blown Fetal Alcohol Syndrome; another 50,000 have real disabilities stemming from maternal use of alcohol during pregnancy. FAS is the leading known cause of mental retardation, and some experts estimate that each FAS child will cost $1.4 million over a lifetime in institutional and medical costs.

A heartbreaking adoption

Vicky McKinney, the co-director of the FAS Family Research Institute in Seattle, Wash., also knows first-hand what the emotional cost can be.

After giving birth to three sons, McKinney adopted a 2½-year-old little girl. There were problems early on, McKinney recalls. Jessie would color on the walls, and she couldn't seem to understand that it wasn't OK, no matter how many times McKinney tried to teach her. Each time, they'd talk and Jessie would then have to wash the walls as punishment.

"It must have happened four or five times a day," says McKinney, who lives in Seattle. "I put that poor little girl through hell because I thought she was normal."

When she finally learned Jessie had FAS, McKinney felt an odd combination of devastation and relief.

"I thought I had adopted the first woman president of the United States," she remembers thinking. "And to get the knowledge that because of something she had no choice over, she will suffer the consequences of for the rest of her life ...," McKinney's voice trails off.

Compounding the problems of FAS children, diagnosis is often slow and preceded by inaccurate assessments. A couple who recently adopted a Russian baby saw six pediatricians before discovering their baby's problems were rooted in Fetal Alcohol Syndrome, according to Kathleen Tavenner Mitchell, national spokesperson for the National Organization on Fetal Alcohol Syndrome (NOFAS), and the mother of a FAS child.

Many FAS children are diagnosed with attention deficit disorder, which has some similar characteristics, Mitchell says. Some doctors simply have not received adequate training to recognize the syndrome. And then there are others who hesitate to apply the FAS label, because of the stigma it attaches to the family if the baby lives with its birth mother.

FAS was first described as a syndrome in America in the early 1970s. Before that, doctors actually recommended that women drink beer to put on weight during pregnancy, says Dr. John Larsen, professor of obstetrics, gynecology and genetics at George Washington University, in Washington, D.C. Today, NOFAS literature says, 57 percent of women under 45 have never even heard of FAS.

More devastating still are statistics from the Centers for Disease Control and Prevention that suggest pregnant women are drinking more now than in the past.

FAS cases on the rise

The CDC estimates there's been a six-fold increase in the number of FAS babies in the last 15 years. And a 1998 CDC survey found that the numbers of pregnant women who reported any alcohol use rose from 9.5 percent in 1992 to 15.3 percent three years later. At the same time, "frequent" alcohol use by pregnant women, defined as at least one episode of binge drinking or at least seven drinks per week, rose from 0.9 percent to 3.5 percent.

The incidence of drinking during pregnancy had actually declined in the late 1980s, when there was a burst of publicity about FAS, according to Louise Floyd, acting chief for the CDC's Fetal Alcohol Branch. But the passage of time and recent publicity touting the health advantages of certain types of alcohol, like red wine, seem to have eroded the gains.

One problem, Mitchell and others say, is that many women tend to view alcohol as more benign than other drugs.

"They think, 'If I'm not using heroin or cocaine like the people down the street, if I'm just using beer, that's OK,' " Mitchell says.

The evidence suggests otherwise. In the first trimester of pregnancy, alcohol can create limb and facial deformities and, perhaps, neurological damage, Mitchell says. In the second trimester, alcohol consumption can lead to preterm delivery and stillbirths. In the third trimester -- when many women think they're home free - a baby's brain development peaks and is at risk from alcohol.

So how much is too much alcohol? No one is sure. Amounts certainly matter -- but so do specific time frames, individual tolerances and genetics.

A University of Washington study showed that the 4-year-old children of middle-class mothers who'd taken three or more drinks a day during pregnancy scored, on average, five points lower than children whose mothers hadn't touched alcohol during their pregnancies.

And a study in Alcoholism: Clinical and Experimental Research last summer showed that alcohol imbibed during a single day in a mouse's 19-day pregnancy greatly increased the likelihood of early -- and dangerous -- labor.

"A drink a day during pregnancy can be associated with adverse effects, like miscarriage, and other selected birth defects," the CDC's Floyd says. Minimal amounts of alcohol can result in "subtle changes in cognition," she adds. "The question is, why take a risk?"

What To Do

To be perfectly safe, you'll want to avoid alcohol entirely if you're pregnant. Ohio State University provides additional information on the effects of alcohol on pregnancy. For other recent news on women's health issues, especially pregnancy, check out the American College of Obstetricians and Gynecologists.

If you've adopted a child, you're at a special disadvantage if you don't know the birth mother's history during pregnancy; FAS experts estimate that 80 to 90 percent of all FAS babies are adopted. If you're worried that your child may suffer from FAS, you can learn more about the syndrome at The National Organization on Fetal Alcohol Syndrome. For links to other sites, symptoms of FAS, and more information, try the Fetal Alcohol Syndrome Family Resource Institute.

SOURCES: Interviews with John Larsen, M.D., professor of obstetrics, gynecology and genetics at George Washington University, Washington, D.C; Linda LaFever, restaurant manager; Vicky McKinney, co-director of the FAS Family Research Institute, Seattle, Wash.; Kathleen Tavenner Mitchell, national spokesperson for the National Organization on Fetal Alcohol Syndrome, Washington, D.C.; Louise Floyd, PhD, acting chief for the CDC's Fetal Alcohol Branch; Alcoholism: Clinical and Experimental Research, vol. 23, no.11.

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