Diagnosis

Diagnosing fetal alcohol syndrome requires expertise and a thorough assessment. Early diagnosis and services can help improve your child's ability to function.

To make a diagnosis, your doctor:

  • Discusses drinking during pregnancy. If you report the timing and amount of alcohol consumption, your obstetrician or other health care provider can help determine the risk of fetal alcohol syndrome. Although doctors can't diagnose fetal alcohol syndrome before a baby is born, they can assess the health of the mother and baby during pregnancy.
  • Watches for signs and symptoms of fetal alcohol syndrome in your child's initial weeks, months and years of life. This includes assessing physical appearance and distinguishing features of your baby and monitoring your child's physical and brain growth and development.

The doctor also may assess for:

  • Cognitive ability and learning and language development difficulties
  • Health issues
  • Social and behavioral problems

Many features seen with fetal alcohol syndrome may also occur in children with other disorders. If fetal alcohol syndrome is suspected, your pediatrician may refer your child to a developmental pediatrician, a neurologist or another expert with special training in fetal alcohol syndrome for evaluation and to rule out other disorders with similar signs and symptoms.

Fetal alcohol spectrum disorders

The range of consequences from drinking alcohol during pregnancy are collectively called fetal alcohol spectrum disorders, as not all signs and symptoms are present in all children with the disorder. This range includes:

  • Alcohol-related neurodevelopmental disorder — intellectual disabilities or behavioral and learning problems caused by drinking alcohol during pregnancy
  • Alcohol-related birth defects — physical birth defects caused by drinking alcohol during pregnancy
  • Fetal alcohol syndrome — the severe end of the fetal alcohol spectrum disorders, which includes both neurodevelopmental disorder and birth defects caused by drinking alcohol during pregnancy
  • Partial fetal alcohol syndrome — presence of some signs and symptoms of fetal alcohol syndrome caused by drinking alcohol during pregnancy, but the criteria for the diagnosis are not met
  • Neurobehavioral disorder associated with prenatal alcohol exposure — problems functioning due to neurocognitive impairments, such as problems with mental health, memory, impulse control, communication and daily living skills, caused by drinking alcohol during pregnancy

If one child in a family is diagnosed with fetal alcohol syndrome, it may be important to evaluate his or her siblings to determine whether they also have fetal alcohol syndrome, if the mother drank alcohol during these pregnancies.

Treatment

There's no cure or specific treatment for fetal alcohol syndrome. The physical defects and mental deficiencies typically persist for a lifetime.

However, early intervention services may help reduce some of the effects of fetal alcohol syndrome and may prevent some secondary disabilities. Intervention services may involve:

  • A team that includes a special education teacher, a speech therapist, physical and occupational therapists, and a psychologist
  • Early intervention to help with walking, talking and social skills
  • Special services in school to help with learning and behavioral issues
  • Medications to help with some symptoms
  • Medical care for health problems, such as vision problems or heart abnormalities
  • Addressing alcohol and other substance use problems, if needed
  • Vocational and life skills training
  • Counseling to benefit parents and the family in dealing with a child's behavioral problems

Treatment for problems with alcohol

Treating the mother's alcohol use problem can enable better parenting and prevent future pregnancies from being affected. If you know or suspect you have a problem with alcohol or other substances, ask a medical or mental health professional for advice.

If you've given birth to a child with fetal alcohol syndrome, ask about substance abuse counseling and treatment programs that can help you overcome your misuse of alcohol or other substances. Joining a support group or 12-step program such as Alcoholics Anonymous also may help.

Coping and support

The psychological and emotional problems associated with fetal alcohol syndrome can be difficult to manage for the person with the syndrome and for the family.

Family support

Children with fetal alcohol syndrome and their families may benefit from the support of professionals and other families who have experience with this syndrome. Ask your health care provider, social worker or mental health professional for local sources of support for children with fetal alcohol syndrome and their families.

Dealing with behavioral problems

As a parent of a child with fetal alcohol syndrome, you may find the following suggestions helpful in dealing with behavioral problems associated with the syndrome. Learning these skills (sometimes called parent training) can include:

  • Recognizing your child's strengths and limitations
  • Implementing daily routines
  • Creating and enforcing simple rules and limits
  • Keeping things simple by using concrete, specific language
  • Using repetition to reinforce learning
  • Pointing out and using rewards to reinforce acceptable behavior
  • Teaching skills for daily living and social interactions
  • Guarding against your child being taken advantage of by others because many children with fetal alcohol syndrome are at risk of this

Early intervention and a stable, nurturing home are important factors in protecting children with fetal alcohol syndrome from some of the secondary disabilities they're at risk of later in life.

Preparing for your appointment

Call your child's doctor for an appointment if you have any concerns about your child's growth and development. Also, let your child's doctor know if you drank alcohol during your pregnancy, and if so, how much and how often.

Consider asking a family member or friend to come with you. Sometimes it can be difficult to remember all of the information provided to you during an appointment, especially if you've been told that there may be something wrong with your child.

Here's some information to help you get ready for your appointment.

What you can do

Before your appointment, make a list of:

  • Any symptoms you've noticed in your child, including any that may seem unrelated to the reason for the appointment, and when the symptoms began
  • All medications, vitamins, herbs or other supplements that you took during pregnancy, and their dosages
  • Questions to ask your child's doctor to help make the most of your appointment time

Basic questions to ask may include:

  • What's the most likely cause of my child's symptoms?
  • Are there other possible causes?
  • Should my child see a specialist?
  • Will my child's condition improve over time? Will it get worse?
  • What treatments are available, and which do you recommend?
  • Are there medications that may help? Are there medications that should be avoided?
  • How can I prevent this from happening in future pregnancies?
  • Are there any brochures or other printed material that I can have? What websites do you recommend?

Don't hesitate to ask other questions during your appointment.

What to expect from your doctor

Your child's doctor is likely to ask you a number of questions. Be ready to answer them to reserve time to go over points you want to spend more time on. Your doctor may ask:

  • Did you drink alcohol while you were pregnant? If yes, how much and how often?
  • Did you use any street drugs during your pregnancy?
  • Did you have any problems during your pregnancy?
  • When did you first notice your child's symptoms?
  • Have these symptoms been continuous or are they only occasional?
  • Does anything seem to improve the symptoms?
  • What, if anything, appears to worsen the symptoms?
May 25, 2017
References
  1. AskMayoExpert. Fetal alcohol syndrome. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2016.
  2. Fetal alcohol spectrum disorders (FASDs): Facts about FASDs. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/fasd/facts.html. Accessed March 13, 2017.
  3. Fetal alcohol spectrum disorders (FASDs): Alcohol use in pregnancy. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/fasd/alcohol-use.html. Accessed March 13, 2017.
  4. Fetal alcohol spectrum disorders (FASDs): Secondary conditions. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/fasd/secondary-conditions.html. Accessed March 13, 2017.
  5. Fetal alcohol syndrome. American Academy of Family Physicians. https://familydoctor.org/condition/fetal-alcohol-syndrome/#questions. Accessed March 13, 2017.
  6. Williams JF, et al. Fetal alcohol spectrum disorders. Pediatrics. 2015;136:e1395.
  7. Effects of alcohol on a fetus. Substance Abuse and Mental Health Services Administration. https://store.samhsa.gov/shin/content/SMA07-4275/SMA07-4275.pdf. Accessed March 13, 2017.
  8. Weitzman C, et al. Fetal alcohol spectrum disorder: Overview of management and prognosis. http://www.uptodate.com/home. Accessed March 13, 2017.
  9. Wilhoit LF, et al. Fetal alcohol spectrum disorders: Characteristics, complications, and treatment. Community Mental Health Journal. In press. Accessed March 13, 2017.
  10. Weitzman C, et al. Fetal alcohol spectrum disorder: Clinical features and diagnosis. http://www.uptodate.com/home. Accessed March 13, 2017.
  11. Hoecker JL (expert opinion). Mayo Clinic, Rochester, Minn. March 25, 2017.