As a nurse or a midwife, there are always those patients that for whatever reason remain clearly in your memory. For me one of those patients as a midwife, was a baby on the Special Care Baby Unit who had been born into heroin withdrawal, probably because of the very distinct cry and the baby’s clear discomfort at being touched. I therefore wanted to write a post about foetal alcohol syndrome, which shares many symptoms of opioid withdrawal.
Foetal alcohol syndrome occurs when the baby has been exposed to maternal alcohol intake during pregnancy, and is responsible for various types of irreversible brain damage and growth problems. Alcohol crosses the placental barrier and the underdeveloped foetal liver is unable to metabolise it, hence it remains in the baby's system longer. There is no safe limit on alcohol intake during pregnancy.
Foetal Alcohol Spectrum Disorder (FASD) incorporates a range of issues:-
The issues that each child will face is dependant on the amount of alcohol and stage of pregnancy that it is consumed, ranging from severe facial deformities, growth retardation and nervous system dysfunction to mild behavioural deficiencies, which may not become apparent until the child is older. For example, research has shown that the lip and philtrum anomaly only occurs on the 19th or 20th day after conception.
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 and the baby could be at risk even before the pregnancy test shows positive.
CAUSES
DIAGNOSIS
Diagnosis of FASD is dependant on the following factors:-
Early diagnosis is important in terms of reducing the risk of long-term problems, so if you drank alcohol while pregnant your midwife should be informed.
For every child with FAS, there are 3 – 10 with neurodevelopmental disorders due to alcohol.
SYMPTOMS
Symptoms of FASD will include various combinations of physical and cognitive disabilities, dependant on the area of the brain affected, which result in different levels of functioning.
Eg. the corpus callosum, which connects the right and left hemispheres of the brain can be damaged with heavy prenatal alcohol consumption. This means that the child will know right from wrong(governed by the logic and thought centre in the left hemisphere), but even so may be unpredictable and act impulsively (governed by the right hemisphere).
PHYSICAL DEFECTS
SOCIAL AND BEHAVIOURAL ISSUES
Difficulty functioning and with social interaction:-
However the creative right hemisphere of the brain will often become dominant, resulting in extremely verbal and creative children.
COMPLICATIONS
Behavioural problems may not become apparent until the child is older and these are known as secondary disabilities:-
PREVENTION
BENEFITS OF MASSAGE
Research has shown to benefit both growth and developmental delays, helping with weight gain and developmental scores in premature babies. Also face-to-face interactions, emotional and social behaviour, and sleeping patterns were all improved, due to reduced stress hormones and increased serotonin levels. In older children, massage improves mental focus and concentration, mood and reduces hyperactive behaviours.
As with cases of autism, children with FASD may require a slow introduction to massage due to hypersensitivity and sensory processing problems, so avoiding over stimulation is essential to the success of a treatment.