Fetal Alcohol Syndrome

Overview

In fact, alcohol (beer, wine, or hard liquor) is the leading cause of preventable birth defects and developmental disabilities in the United States.

These disorders include a wide range of physical, behavioral, and learning problems. [2]

This syndrome causes brain damage and growth problems. The problems caused by fetal alcohol syndrome vary from child to child, but defects caused by fetal alcohol syndrome are not reversible.

Early diagnosis of this syndrome may help to reduce problems such as learning difficulties and behavioral issues. [1]

Based on studies of the Centers for Disease Control and Prevention and others, it is estimated that in the United States, somewhere between 800 and 8,000 babies could be born each year with FAS. [3]

Any amount of alcohol can harm a developing fetus and increase the risk of miscarriage.

Alcohol easily passes through the placenta, the organ that nourishes a baby during pregnancy.

Alcohol exposure during the first trimester; perhaps before a woman even knows she is pregnant can cause major birth defects.

Later in the pregnancy, drinking alcohol can cause poor growth and brain damage that could lead to learning and behavioral problems.

These problems can be prevented by not drinking any alcohol during pregnancy.

Do not drink if you are trying to get pregnant or think you may be pregnant. [2]

Causes

When you’re pregnant and you drink alcohol:

• Alcohol enters your bloodstream and reaches your developing fetus by crossing the placenta
• Alcohol causes higher blood alcohol concentrations in your developing baby than in your body because a fetus metabolizes alcohol slower than an adult does
• Alcohol interferes with the delivery of oxygen and optimal nutrition to your developing baby
• Exposure to alcohol before birth can harm the development of tissues and organs and cause permanent brain damage in your baby

The more you drink while pregnant, the greater the risk to your unborn baby. However, any amount of alcohol puts your baby at risk. Your baby’s brain, heart and blood vessels begin to develop in the early weeks of pregnancy, before you may know you’re pregnant.

Impairment of facial features, the heart and other organs, including the bones, and the central nervous system may occur as a result of drinking alcohol during the first trimester. That’s when these parts of the fetus are in key stages of development. However, the risk is present at any time during pregnancy.

Types

There are different types of fetal alcohol syndrome. They are as follows:

• Partial fetal alcohol syndrome
• Alcohol-related birth defects
• Alcohol-related neurodevelopment disorder
• Neuro behavioural disorder associated with prenatal alcohol exposure (1)

Risk factors

The more alcohol you drink during pregnancy, the greater the chance of problems in your baby. There’s no known safe amount of alcohol consumption during pregnancy.

You could put your baby at risk even before you realize you’re pregnant.

Don’t drink alcohol if:

• You’re pregnant
• You think you might be pregnant
• You’re trying to become pregnant.

Pathophysiology

The exact mechanisms underlying FAS are not fully understood, but several key factors contribute to its development:

1. Direct Toxicity: Alcohol and its metabolite, acetaldehyde, are directly toxic to developing cells. They can interfere with cell growth, migration, and differentiation, leading to structural and functional abnormalities in various organs, particularly the brain.

2. Oxidative Stress: Alcohol metabolism generates reactive oxygen species, which can damage cellular components like DNA, proteins, and lipids. This oxidative stress can disrupt cellular processes and contribute to cell death.

3. Nutritional Deficiencies: Chronic alcohol consumption can lead to nutritional deficiencies in the mother, further impairing fetal development. For example, alcohol interferes with the absorption and utilization of essential nutrients like folic acid, which is critical for neural tube development.

4. Epigenetic Modifications: Alcohol exposure can alter gene expression through epigenetic mechanisms, such as DNA methylation and histone modifications. These changes can have long-lasting effects on gene function and contribute to the developmental abnormalities seen in FAS.[6]

Clinical Features

Fetal Alcohol Syndrome (FAS) is a preventable condition that occurs when a pregnant woman consumes alcohol, which then passes through the placenta and affects the developing fetus. The severity of FAS can vary, but it often leads to a range of physical, cognitive, and behavioral problems.

The clinical features of FAS can be broadly categorized into:

1. Facial dysmorphology:

   • Smooth philtrum: The philtrum is the vertical groove between the base of the nose and the upper lip. In FAS, this groove is often flattened or smoothed out.
   • Thin vermilion border: The vermilion border is the red part of the lips. In FAS, this border is often thin.
   • Short palpebral fissures: Palpebral fissures are the openings between the eyelids. In FAS, these openings are often short.

2. Growth deficiencies:

   • Prenatal and postnatal growth retardation: Children with FAS often have low birth weight and may continue to grow slowly throughout childhood.
   • Microcephaly: This refers to a smaller than normal head circumference, which may indicate underlying brain abnormalities.

3. Central nervous system (CNS) dysfunction:

   • Structural brain abnormalities: FAS can lead to structural abnormalities in the brain, such as a smaller overall brain size and changes in the corpus callosum (the band of nerve fibers connecting the two hemispheres of the brain).
   • Neurodevelopmental delays: Children with FAS may experience delays in reaching developmental milestones, such as sitting, crawling, walking, and talking.
   • Intellectual disability: FAS is often associated with intellectual disability, ranging from mild to severe.
   • Behavioral problems: Children with FAS may exhibit a range of behavioral problems, including hyperactivity, impulsivity, attention deficits, and difficulty with social interactions.[7]

This book provides a detailed overview of the clinical features, diagnosis, and management of FAS, as well as the broader social and policy implications of this condition.

Please note that the clinical features of FAS can vary widely from individual to individual. Some individuals may exhibit all of the characteristic features, while others may have only a few. A diagnosis of FAS is typically made by a healthcare professional based on a comprehensive evaluation of the individual’s medical history, physical examination, and developmental assessments.

Sign and Symptoms

Clinical features of this syndrome may include any mix of physical defects, intellectual or cognitive disabilities, and problems functioning and coping with daily life.

https://www.mayoclinic.org/diseases-conditions/fetal-alcohol-syndrome/diagnosis-treatment/drc-20352907

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• https://www.healthychildren.org/English/health-issues/conditions/chronic/Pages/Fetal-Alcohol-Spectrum-Disorders.aspx
• https://hpathy.com/cause-symptoms-treatment/fetal-alcohol-syndrome/

Diagnosis

It can be difficult to diagnose fetal alcohol syndrome. There isn’t a direct test for FAS and pregnant people may not give a complete history of all alcohol intake during pregnancy.

Pediatric providers can often make a diagnosis of FAS based on the size of a child, specific physical signs and symptoms that develop through childhood, including:

• History of alcoholic beverage consumption by the child’s mother during pregnancy.
• Abnormal facial features — a smooth connection between the nose and upper lip, a thin upper lip and small eyes.
• Small size at birth and throughout childhood.
• Emotional and behavioral issues like difficulty paying attention, hyperactivity and poor judgment.

Symptoms of FAS can resemble those found in other disorders, including:

• Autism spectrum disorder (ASD).
• Attention-deficit/hyperactivity disorder (ADHD).
• Williams syndrome.

Differential diagnosis

• Aarskog syndrome
• Williams syndrome
• Noonan syndrome
• Brachman-DeLange syndrome
• Fetal hydantoin syndrome
• Fetal valproate syndrome (2)

Complication

Problem behaviors not present at birth that can result from having fetal alcohol syndrome (secondary disabilities) may include:

• Attention deficit/hyperactivity disorder (ADHD)
• Aggression, inappropriate social conduct, and breaking rules and laws
• Alcohol or drug misuse
• Mental health disorders, such as depression, anxiety or eating disorders
• Problems staying in or completing school
• Problems with independent living and with employment
• Inappropriate sexual behaviors
• Early death by accident, homicide or suicide.

Treatment

Fetal alcohol syndrome isn’t curable, and the symptoms will impact your child throughout life.

However, early treatment of some symptoms can lessen the severity and improve your child’s development.

Treatment options can include:

• Using medications to treat some symptoms like attention and behavior issues.
• Undergoing behavior and education therapy for emotional and learning concerns.
• Training you as a parent to best help your child.

Parental training is meant to help parents to help families cope with behavioral, educational and social challenges.

Parents might learn different routines and rules that can help their child adapt to different situations.

Often, having a stable and supportive home can help children with FAS avoid developing mental and emotional difficulties as they get older.

There are also certain “protective factors” that help reduce the negative impact of FAS on a child. These factors can include:

• Diagnosis before age 6.
• A loving, supportive, stable home environment during the school years.
• Absence of violence in the child’s life.
• Use of special education and social services.

Prevention

Experts know that fetal alcohol syndrome is completely preventable if women don’t drink alcohol at all during pregnancy.

These guidelines can help prevent fetal alcohol syndrome:

• Don’t drink alcohol if you’re trying to get pregnant- If you haven’t already stopped drinking, stop as soon as you know you’re pregnant or if you even think you might be pregnant. It’s never too late to stop drinking during your pregnancy, but the sooner you stop, the better it is for your baby.
• Continue to avoid alcohol throughout your pregnancy- Fetal alcohol syndrome is completely preventable in children whose mothers don’t drink during pregnancy.
• Consider giving up alcohol during your childbearing years if you’re sexually active and you’re having unprotected sex. Many pregnancies are unplanned, and damage can occur in the earliest weeks of pregnancy.
• If you have an alcohol problem, get help before you get pregnant- Get professional help to determine your level of dependence on alcohol and to develop a treatment plan.

Homoeopathic treatment of Fetal Alcohol Syndrome

Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines selected after a full individualizing examination and case-analysis.

Which includes

• The medical history of the patient,
• Physical and mental constitution,
• Family history,
• Presenting symptoms,
• Underlying pathology,
• Possible causative factors etc.

A miasmatic tendency (predisposition/susceptibility) also often taken into account for the treatment of chronic conditions. 

What Homoeopathic doctors do?

A homeopathy doctor tries to treat more than just the presenting symptoms. The focus is usually on what caused the disease condition? Why ‘this patient’ is sick ‘this way’?

The disease diagnosis is important but in homeopathy, the cause of disease not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness also looked for. Now a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition.

The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can greatly improve with homeopathic medicines.

Homeopathic Medicines for Fetal Alcohol Syndrome:

The homeopathic remedies (medicines) given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathy treatment of this condition. The symptoms listed against each homeopathic remedy may not be directly related to this disease because in homeopathy general symptoms and constitutional indications also taken into account for selecting a remedy, potency and repetition of dose by Homeopathic doctor.

So, here we describe homeopathic medicine only for reference and education purpose. Do not take medicines without consulting registered homeopathic doctor (BHMS or M.D. Homeopath).

Medicines:

Nux vomica:

• It is an excellent remedy for the bad effects of alcohol.
• It covers the nervous tremors, indigestion, and headache due to alcohol.
• This remedy is useful for both short-terms as well as long-term effects of alcohol.
• Patient suffers from delirium, has extreme irritability and episodes of extreme rage or anger.
• Abdominal symptoms, nausea and vomiting.
• Vertigo with momentary loss of consciousness.
• Stomach is very sensitive to pressure when applied externally, feeling is worse in the morning.
• When patient has tremor, headache, and bad taste.
• The tremor is marked with ugliness and irritability and gastric disturbance.
• Headache, morning-after drinking.

Sulphuricum Acidum:

• This is the homeopathy medicine for chronic alcoholism.
• Patients who are pale and shriveled and cold, whose stomach will not tolerate the slightest amount of food.
• They cannot drink water unless it be well whisked.
• Homeopathic medicine for drug addiction with a craving for alcoholic stimulants.
• Hot flushes, trembling, and cold sweats, accompanied by humming and tickling in the ears.
• It suits the sour breath and vomiting of alcoholic dyspepsia.

Arsenic album:

• Wonderful homeopathy medicine for alcoholism.
• Moreover, It has visions of ghosts, with great weakness.
• Diseases from overuse of alcohol. Liver cirrhosis.
• Patients must have their accustomed drinks
• Great tremulousness also weakness.
• Suicidal tendency and constantly annoyed by bugs and vermin that he sees on his person and unceasingly tries to brush them off.
• All in all, Arsenic patient is restless, anxious and chilly.

Agaricus muscaris:

• Homeopathy medicine for alcohol craving that has aggravation especially from motion, coitus, pressure touch.
• Headaches with sensation head swollen.
• Loquacity. Additionally, Agaricus has great mental excitement and incoherent talking, immoderate gaity alternates with melancholy.
• Perception of relative size of objects is lost, takes long steps and jumps over small objects as if they were trunks of trees-a small hole appears as a frightful chasm, a spoonful of water an immense lake.
• Physical strength is increased, can lift heavy loads.
• Chorea – involuntary muscle spasms also twitching that ceases in sleep.

Opium

• This is a remedy indicated in “old sinners” who have had the delirium tremens over also over again.
• There is a constant expression of fright or terror, they have visions of animals springing up everywhere, they see ghosts, the sleep is uneasy, the breathing is Sertorius.
• Opium has a choking sensation in throat which awakens suddenly from sleep.
• Besides this, The prevailing mental characteristic is terror, all hallucinations and illusions are fright and terror producing.
• It has visions of animals coming at him from every corner and he tries to escape.
• Lastly, Suicidal tendency constantly annoyed by bugs and vermin that he sees upon his person and unceasingly tries to brush them off.

Cannabis Indica

• A very reliable homeopathy remedy for alcoholism specially in acute alcoholism.
• Some violence, talkativeness and active mind
• Subjects crowd upon it,
• Delusions also hallucination relate to exaggerated subjects time, space, etc.
• Face flushed, pupils dilated, perspires easily.

Diet & Regimen

• Take enough sleep
• Eat healthy diet
• Do regular physical exercise
• Stay connected with healthy social supports
• Teach skills for daily living
• Avoid alcohol during pregnancy.

Terminologies

Fetal Alcohol Spectrum Disorders (FASD):

An umbrella term encompassing the range of effects that can occur in an individual whose mother drank alcohol during pregnancy. This includes physical, mental, behavioral, and/or learning disabilities with lifelong implications. FASD is not a clinical diagnosis itself but rather a term encompassing several diagnoses.

Fetal Alcohol Syndrome (FAS):

The most severe form of FASD, characterized by specific facial features (smooth philtrum, thin upper lip, small eye openings), growth deficits, and central nervous system problems (e.g., intellectual disability, learning difficulties).

Partial Fetal Alcohol Syndrome (pFAS):

Individuals with some, but not all, of the characteristic features of FAS. They may have facial abnormalities, growth problems, or neurodevelopmental issues, but not necessarily the full set of criteria required for an FAS diagnosis.

Alcohol-Related Neurodevelopmental Disorder (ARND):

This refers to individuals with intellectual disabilities or behavioral/learning problems resulting from prenatal alcohol exposure, but without the characteristic facial features of FAS.

Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE):

This relatively new term describes individuals with significant neurobehavioral impairments related to prenatal alcohol exposure, but who do not meet the full criteria for FAS or ARND.

Alcohol-Related Birth Defects (ARBD):

This refers to physical abnormalities in organs or body systems (e.g., heart defects, kidney problems, skeletal abnormalities) caused by prenatal alcohol exposure.

Prenatal Alcohol Exposure (PAE):

This simply refers to the exposure of a developing fetus to alcohol during pregnancy. Not all individuals with PAE will develop FASD, but it is a significant risk factor.

Dysmorphology:

The study of birth defects and abnormalities in physical development. In the context of FAS, dysmorphology focuses on the characteristic facial features associated with the condition.

Teratogen:

Any agent that can disturb the development of an embryo or fetus. Alcohol is a known teratogen, meaning it can cause birth defects and developmental problems.

Sentinel Facial Features:

The three characteristic facial abnormalities associated with FAS: smooth philtrum, thin upper lip, and small eye openings.

Other Terminologies Related to Homoeopathy

Potentization/Dilution:

This is a core principle of homeopathy. Homeopathic remedies are made by diluting substances in water or alcohol and then succussing (shaking) the mixture. The more diluted a substance is, the more potent it is considered to be in homeopathic philosophy.

Similia Similibus Curentur:

This Latin phrase means "like cures like" and is a fundamental principle of homeopathy. It suggests that a substance that can cause symptoms in a healthy person can cure similar symptoms in a sick person when given in a potentized form.

Miasm:

In homeopathy, miasms are believed to be underlying predispositions to disease. The three main miasms are psora (related to skin diseases and functional disorders), sycosis (related to overgrowth and chronic inflammation), and syphilis (related to destructive and degenerative diseases).

Repertory:

A homeopathic repertory is a reference book that lists symptoms and the homeopathic remedies associated with them. It helps homeopaths find remedies that match a patient’s symptoms.

Materia Medica:

A homeopathic materia medica is a reference book that describes the properties and symptoms associated with homeopathic remedies.

Constitutional Remedy:

In homeopathy, a constitutional remedy is chosen based on a person’s overall physical, mental, and emotional characteristics. It is believed to address the root cause of disease and promote overall well-being.

Aggravation:

A temporary worsening of symptoms after taking a homeopathic remedy. This is seen as a positive sign that the remedy is working.

Proving:

A method used in homeopathy to determine the symptoms associated with a remedy. Healthy volunteers take the remedy and record their symptoms.

Understanding these terminologies is crucial for interpreting scientific literature and clinical discussions related to Fetal Alcohol Syndrome. It is important to note that the field of FASD is constantly evolving, and new terms and classifications may emerge as research progresses.

Reference

1. Fetal Alcohol Syndrome: Symptoms, Causes, Risk Factors and Treatment (askapollo.com)
2. Fetal alcohol spectrum disorders–a case-control study from India (2011)
3. Fetal Alcohol Spectrum Disorder – Indian Pediatrics (2008)
4. Fetal Alcohol Syndrome – Pondicherry Journal of Nursing (2019)
5. Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment – 1st Edition.
6. Fetal Alcohol Spectrum Disorders: Management and Policy Perspectives 1st Edition.
7.  Fetal Alcohol Spectrum Disorders: Management and Policy Perspectives of FASD, Edward P. Riley, Joanne L. Kodituwakku, Sterling K. Clarren, and Paul D. Connor, 2011 by  Wiley-Blackwell
8. Fetal Alcohol Spectrum Disorders: Management and Policy Perspectives of FASD, 1st Edition, Kenneth R. Warren & Sterling K. Clarren, 2009, Cambridge University Press

You Can Also Search As

There are several ways people can search for homeopathic articles on Fetal Alcohol Syndrome (FAS):

Online Resources:

Homeopathic Databases and Journals: Reputable homeopathic databases like HomBRex or journals such as "Homeopathy" or "The Journal of the American Institute of Homeopathy" may contain articles on FAS. You can use search terms like "Fetal Alcohol Syndrome," "prenatal alcohol exposure," or specific homeopathic remedies known to be used in such cases.

Homeopathic Websites: Websites of homeopathic organizations (like the National Center for Homeopathy in the US) or practitioner websites may have articles or case studies related to FAS.

General Search Engines: Using search terms like "homeopathy Fetal Alcohol Syndrome" on general search engines (Google, DuckDuckGo, etc.) may lead you to relevant articles on websites, blogs, or forums.

Offline Resources:

Homeopathic Libraries: If you have access to a homeopathic library, you can ask the librarian for assistance in finding relevant books or journals.

Homeopathic Practitioners: Consult with a qualified homeopathic practitioner who may have access to resources or case studies related to FAS.

Tips for Searching:

Use specific search terms: Instead of just searching for "Fetal Alcohol Syndrome," try adding terms like "homeopathy," "homeopathic treatment," or specific remedies.

Look for reputable sources: Ensure that the information you find comes from reliable sources like established homeopathic organizations, journals, or experienced practitioners. Be cautious of anecdotal information or sources that lack scientific backing.

Consult with a professional: For personalized advice and treatment options, it’s always recommended to consult with a qualified homeopathic practitioner.

Please note: Homeopathy is a complementary and alternative medicine system. While some people find it helpful, it’s essential to consult with healthcare professionals for any health concerns, especially for conditions like FAS, which may require conventional medical treatment.