Fetal Alcohol Spectrum Disorder (FASD) Guide: Symptoms, Causes

October 2021

Fetal Alcohol Spectrum Disorder (FASD) or Fetal Alcohol Syndrome (FAS) can affect your baby in three ways; first, the way your baby develops and grows in the womb, second, your baby’s health at birth, and third, your baby’s long-term health as a child and beyond.

Diagnosing FASD or FAS is difficult. There are currently no medical tests or blood tests for either of these conditions.

Alcohol and baby’s development

When you drink wine, beer or spirits, alcohol is passed from your blood through the placenta and to your baby. A baby’s liver is one of the last organs to develop and does not mature until the later stages of pregnancy. Your baby cannot process alcohol as well as you can, so too much exposure to alcohol can have serious implications for their development.
Drinking alcohol during pregnancy is linked to a number complications and can:

  • Affect the way your baby grows and develops in the womb and, in particular, the way your baby’s brain develops
  • Increase your chances of miscarriage
  • Increase the risk of premature labour
  • Increase the risk of stillbirth
  • Make your baby more prone to illness in infancy and in childhood, and also as an adult
  • Cause Fetal Alcohol Spectrum Disorder (FASD) or Fetal Alcohol Syndrome (FAS)

Problems that can last a lifetime

While FASD is less severe than FAS, children with FASD can have learning difficulties, problems with behaviour, physical disabilities, and emotional and psychiatric problems that can last a lifetime.
A child, teenager or adult person with FASD or FAS might experience different conditions, such as:

  • Affect the way your baby grows and develops in the womb and, in particular, the way your baby’s brain develops
  • Sleep and sucking problems as a baby
  • Low body weight
  • Small head size
  • Poor coordination
  • Hyperactive behaviour
  • Difficulty with attention
  • Poor memory
  • Learning difficulties in school, especially with numeracy
  • Speech and language delays
  • Intellectual disability or low IQ
  • Poor reasoning and judgment skills
  • Vision or hearing problems
  • Problems with the heart, kidneys, or bones
  • Shorter-than-average height
  • Abnormal facial features

These conditions can affect each person in different ways and can range from mild to severe.

What happens if you drink more alcohol?

The more you drink, the more your baby’s growth will be affected and the less healthy your baby will be. Drinking later in pregnancy can also affect your baby after they are born.

What happens if you drink less alcohol?

However, if you cut down or stop drinking altogether, your baby will start to grow at a normal rate. Stopping drinking at any point during pregnancy can be beneficial. However, in some instances, the effects of heavy drinking on your baby cannot be reversed.
Most women do give up alcohol once they know they’re pregnant or when they’re planning to become pregnant.

There is uncertainty about how much alcohol is safe to drink in pregnancy, but at this low level there is no evidence of any harm to their unborn baby.

Women who find out they’re pregnant after already having drunk in early pregnancy should avoid further drinking. However, they should not worry unnecessarily, as the risks of their baby being affected are likely to be low.
Women should be advised that if they choose to drink alcohol while they are pregnant they should drink no more than 1-2 UK units once or twice a week.

Women should be advised not get to drunk or binge drink (drinking more than 7.5 UK units of alcohol on a single occasion) while they are pregnant because this can harm their unborn baby.

If you’re pregnant and drinking heavily (more than 6 units of alcohol a day) or you’re struggling with an alcohol problem, talk to a midwife or doctor. It’s never too late to stop drinking: Stopping drinking at any point during your pregnancy can help reduce the risk of problems in your baby.

What is a unit of alcohol?

If you do decide to drink when you’re pregnant, it’s important to know how many units you are consuming.
One UK unit is 10 millilitres (ml), or 8 grams, of pure alcohol.

Units of alcohol in drinks

  • 1 glass (175 ml) of white or red wine contains about 2.3 units of alcohol
  • 1 large glass (250 ml) of average white or red wine contains about 3.2 units
  • A single shot (25ml) of 40% ABV spirit (Vodka, Gin etc.) is about 1 unit.
  • 1 pint of beer is around 2.3 units
  • 1 pint of cider is around 2.6 units
  • 1 glass of champagne is around 1.5 units
  • 1 alcopop is around 1.1 units

Concerned about your drinking?

If you’re concerned about your drinking, talk to a midwife or doctor. The organisations listed below offer confidential help and support.

Drinkline: The national alcohol helpline; if you’re worried about your own or someone else’s drinking, call this free helpline on 0300 123 1110 (weekdays 9am to 8pm, weekends 11am to 4pm).

We Are With You: A UK-wide treatment agency that helps individuals, families and communities manage the effects of alcohol and drug misuse.

Alcoholics Anonymous (AA): A free self-help group; its 12-step programme involves getting sober with the help of regular support groups.

NOFAS: UK helpline on 020 8458 5951

For more information, see the RCOG patient information leaflet ‘Having a Small Baby’, which is available online.