On the occasion of the international day for the fight against disorders caused by fetal alcohol, Why Doctor takes stock of these pathologies with Denis Lamblin, pediatrician and president of the SAF France association.
- Only 24% of general practitioners state that they know precisely the disorders caused by fetal alcohol.
- 33% do not systematically talk about alcohol consumption during pregnancy follow-up.
– What is fetal alcohol syndrome (FAS)?
Denis Lamblin- FAS represents the major form of Fetal Alcohol Disorder (FASD) that can occur when the mother-to-be has consumed alcohol during her pregnancy. Alcohol is a toxic teratogen (causing malformations) that very easily crosses the placenta and damages the baby’s developing cells, especially those of the brain.
– What are the impacts on baby?
The damage is multiple and diverse depending on the stage of development of the fetus, the amount and duration of alcohol consumption. Facial malformations, central nervous system abnormalities causing psychomotor delays, intellectual deficit, behavioral and learning problems… In most cases, the disorders are not visible on the baby who is just born but appear later, when entering nursery or school, sometimes even around 6-8 years old and in adulthood, when the brain becomes more mature.
– Is “cooked” enough?
Unfortunately yes, if it occurs at the wrong time! Although we are all unequal in the face of risk, it is proportional to the quantity of alcohol ingested.
This is why it is absolutely necessary to ban alcohol, and above all “binge drinking” type behavior (massive alcohol consumption), when you are planning a pregnancy, to protect your baby and give him the best chance for the future.
– Is alcohol consumption more dangerous at the beginning or at the end of pregnancy?
All consumption is dangerous, there is not a moment when there is no risk. It’s the lottery, some make it through, others don’t. Many factors come into play, including genetic factors, and it is unclear who is more vulnerable. What we are sure of is that when we take alcohol, we take a risk.
– What if I drank before I knew I was pregnant?
If you have had one or two moderate alcohol intakes, rest assured, the malformation risk is very low. Do not dramatize and above all, stop consuming alcohol immediately. If you are worried, talk to your obstetrician who will follow your pregnancy closely, in particular by morphological ultrasound.
– How do I know if my child has FASD?
If he is suffering from the most severe form – FAS – the evidence is quite clear: growth retardation, facial malformations, psychomotor retardation and major cognitive disorders. This concerns 1 child in 1,000 in France.
For the others, whose attack is milder, the diagnosis is often more difficult. The child has memory and attention disorders (DYS), a source of school difficulties. It also presents behavioral attacks: lack of empathy, impulsivity, difficulty in controlling oneself… It is a diagnosis of elimination that must be made by a multidisciplinary team (geneticist, psychomotor therapist, speech therapist, neuro-paediatrician, psychologist… ) during a complete assessment.
– Can a child with FASD be cured? How to take care of it?
FASD is lifelong. It is necessary to support affected children as early as possible in order to help them integrate socially and avoid a life of rejection and exclusion.
This is why making the diagnosis as soon as possible is essential. To achieve this, health professionals must listen to women and not be judgmental.
– Are many people affected by this problem?
Today in France, it is estimated that 15,060 children per year are born with FASD, or one baby every 30 minutes. This is much more than the number of children with trisomy 21 (400 births per year), which is to say if the problem is significant!
The National Academy of Medicine recognizes that alcohol consumption during pregnancy is the leading cause of mental deficiency and non-genetic social maladjustment, and moreover preventable.
– Why such a large scale? How to prevent?
The culture, the view of women who drink, all of this makes the problem of alcohol taboo. It is very difficult today for women faced with this addiction to talk about it. Isolated, victims of mistreatment, they often only have alcohol as a medicine for their ill-being. Society is judgmental of them.
But they must know that there are compassionate people who will be able to listen to them without making them feel guilty, as in our association for example. I have met hundreds of women in this case. By our side, some mothers of children with FAS have managed to experience a second pregnancy without a drop of alcohol and give birth to a perfectly healthy child. This is proof of the benefits of solidarity!
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