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Medical Author:

David Perlstein, MD, MBA, FAAP

David Perlstein, MD, MBA, FAAP

Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• What is fetal alcohol syndrome?
• What are fetal alcohol syndrome symptoms and signs?
• How is the diagnosis of fetal alcohol syndrome made?
• What is the diagnosis "fetal alcohol effects"?
• What problems are peculiar to children with fetal alcohol syndrome?
• What causes fetal alcohol syndrome?
• How much alcohol is safe during pregnancy?
• Fetal Alcohol Syndrome At A Glance
• Fetal Alcohol Syndrome Index

Two approaches can be taken to this important question. One is the rigorously scientific approach. It does not go beyond the facts: that most children diagnosed with frank FAS have had overtly alcoholic mothers (who drank at least eight to 10 drinks a day); that children born to women who had four to six drinks a day have had subtle signs of FAS/FAE; that at two drinks a day, the only indisputable effect noted has been subtly lower birth weight; and that below two drinks a day there is no concrete evidence for an effect on the fetus. Thus, from a strictly scientific viewpoint, one cannot say that one drink a day during pregnancy is dangerous to the baby.

The more common approach, and the favored one, is the better-safe-than-sorry approach. This pragmatic position is espoused by public-health experts. Witness the warning label on all alcoholic beverages in the U.S. indicating that "according to the surgeon general, women should not drink alcoholic beverages during pregnancy because of the risk of birth defects." This conservative approach is also followed by most individuals and groups concerned with preventing FAS/FAE. For example, the National Organization on Fetal Alcohol Syndrome states, "No amount of alcohol has been proven safe to consume during pregnancy. FAS and FAE...are 100% preventable when a pregnant woman abstains from alcohol."

• Alcohol is capable of causing birth defects.
• FAS (fetal alcohol syndrome) always involves brain damage.
• FAS always involves impaired growth.
• FAS always involves head and face abnormalities.
• No amount of alcohol has been proven safe during pregnancy.
• Women who are or may become pregnant are advised to avoid alcohol.

REFERENCES:

American Academy of Pediatrics. Committee on Substance Abuse and Committee on Children With Disabilities. "Fetal Alcohol Syndrome and Alcohol-Related Neuro-developmental Disorders." Pediatrics 106.2.1 Aug. 2000: 358-361.

Dorris, Michael. The Broken Cord. New York: Harper Collins, 1990.

Floyd, R.L., et al. "Prevention of Fetal Alcohol Spectrum Disorders." Dev Disabil Res Rev. 15.3 (2009): 193-199.