Fetal alcohol syndrome and FASD: symptoms, causes and support

The NHS says FASD can cause problems across several areas of development. The type of symptoms and how severe they are differs depending on how often and how much the mother drank during pregnancy. The greater the amount of alcohol consumed, the more severe the symptoms tend to be.

• 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.

• The joints, muscles, bones and organs such as the kidneys and heart.

People often search for this as fetal alcohol syndrome. The NHS uses the term fetal alcohol spectrum disorder (FASD) for the whole range of mental and physical problems in a baby that can result from alcohol exposure in the womb, and this page does the same.

NICE's quality standard on FASD covers assessing and diagnosing FASD in children and young people and support during pregnancy to prevent it. Its statements refer to probable or confirmed prenatal alcohol exposure, significant physical, developmental or behavioural difficulties, and three facial features associated with prenatal alcohol exposure.

The cause is alcohol drunk during pregnancy. The NHS says alcohol in the mother's blood passes to her baby through the placenta. The baby cannot process alcohol well because, as the NHS pregnancy page puts it, the baby does not have a fully developed liver, so alcohol can stay in their body for a long time.

Alcohol can damage the brain and body and stop them developing normally in the womb. The NHS says it can result in the loss of the pregnancy, and that babies who survive may be left with lifelong problems. Drinking during pregnancy also increases the risk of miscarriage, premature birth and low birthweight.

The NHS says there is no proven safe level of alcohol in pregnancy, and not drinking at all is the safest approach. It recommends that if you are pregnant or planning to become pregnant you should not drink alcohol, which keeps any risk to your baby to a minimum. The risk of FASD is higher the more you drink.

If you drank before you knew you were pregnant, the NHS says to avoid further drinking for the rest of the pregnancy but not to worry unnecessarily, as the risk of your baby being affected is likely to be low. If you are concerned, talk to a midwife or doctor, and if you have difficulty stopping, a midwife, doctor or pharmacist can help in confidence.

The NHS says to speak to a GP or health visitor if you have any concerns about your child's development or think they could have FASD. A doctor or health visitor will need to know if your child was exposed to alcohol during pregnancy to help make a diagnosis.

A child may be referred to a specialist team for assessment, which usually involves physical examinations and blood tests to rule out genetic conditions with similar characteristics. NICE's quality standard says children and young people with probable prenatal alcohol exposure and significant physical, developmental or behavioural difficulties should be referred for assessment, and that those with a diagnosis should have a management plan to address their needs.

The NHS says there is no particular treatment for FASD and the damage to a child's brain and body cannot be reversed. But early diagnosis and support can make a big difference. Once diagnosed, a team of healthcare professionals can assess the child's needs and offer educational and behavioural strategies.

The NHS points to support groups, including FASD Network UK and the National Organisation for FASD, as a source of advice and a way to connect with others in a similar situation. If the condition is not diagnosed early and the child does not receive support, the NHS says they are more likely to face bigger challenges such as difficulties with learning, challenging behaviours, mental health problems, and finding it hard to get a job and live independently as an adult.

On the NHS, concerns start with a GP or health visitor, who can refer to a specialist assessment team. NICE says services should refer children with probable prenatal alcohol exposure and difficulties for assessment. Private paediatric and neurodevelopmental assessments exist; check that the assessors have experience of FASD and that the report will be accepted by your child's school and health teams.

Anyone struggling with an alcohol problem during pregnancy can talk to their midwife or doctor, and the NHS lists confidential support including Drinkaware, We Are With You and Alcoholics Anonymous.