Overview

Fetal Alcohol Syndrome (FAS) is a lifelong condition resulting from prenatal alcohol exposure. As the most severe disorder within the fetal alcohol spectrum disorders (FASDs), it causes a range of developmental, behavioral, and physical impairments. Though preventable, FAS still affects approximately 1 in every 1,000 newborns in the U.S. Raising awareness is key to prevention and support.

Common Symptoms

Children with FAS exhibit physical, neurological, and behavioral symptoms, which may include:

  • Small eye openings

  • Smooth philtrum (area between the nose and upper lip)

  • Thin upper lip

  • Low birth weight and slow growth

  • Small head circumference

  • Vision and hearing issues

  • Organ defects

  • Developmental delays

  • Learning and memory problems

  • Hyperactivity and mood swings

Brain scans often reveal reduced brain volume and abnormal development.

Developmental Impact

FAS causes central nervous system (CNS) damage, leading to:

  • Difficulty with attention and memory

  • Trouble with problem-solving and judgment

  • Language and speech delays

  • Hyperactivity and mood instability

  • Sleep difficulties in infants

  • Intellectual disabilities

These impairments can affect a person’s performance in school, work, and social relationships.

Causes

FAS is caused solely by alcohol consumption during pregnancy. Alcohol crosses the placenta and directly affects the developing fetus, especially the brain. Even minimal amounts can interfere with development. The most critical time for facial development is the first trimester, but the brain can be affected at any time during pregnancy.

Risk Factors

Factors that can increase the risk and severity of FAS include:

  • Heavy or frequent alcohol use

  • Binge drinking

  • Poor nutrition during pregnancy

  • Smoking or using other substances

  • High maternal stress

  • Limited access to prenatal care

  • Family or social environment encouraging alcohol use

Genetic predisposition may also play a role in susceptibility.

Diagnosis

There’s no definitive medical test for FAS. Diagnosis is made by evaluating a child’s:

  • Facial features

  • Growth patterns

  • Nervous system development

  • History of prenatal alcohol exposure

Evaluations are typically conducted by:

  • Developmental pediatricians

  • Clinical geneticists

  • Child psychologists

A formal diagnosis can provide access to services and support programs.

FASD Types

Fetal Alcohol Spectrum Disorders include various conditions with overlapping symptoms:

  • Partial Fetal Alcohol Syndrome (pFAS): Some symptoms of FAS without all criteria

  • Alcohol-Related Neurodevelopmental Disorder (ARND): Cognitive and behavioral symptoms, no physical traits

  • Alcohol-Related Birth Defects (ARBD): Physical issues such as heart, bone, or kidney defects

  • Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE): Behavioral and emotional symptoms tied to alcohol exposure

All FASDs stem from prenatal alcohol use but vary in how they present.

Treatment Options

There is no cure for FAS, but treatment can help manage symptoms and improve quality of life.

Early Intervention

Early intervention services (EI) are critical for developmental support. Programs often include:

  • Physical therapy

  • Speech and language therapy

  • Occupational therapy

  • Developmental therapy

  • Parent training and support

Children with FAS typically qualify automatically for these programs from birth to age 3.

Medications

Medications may help manage specific symptoms, such as:

  • Stimulants: Ritalin, Adderall (for attention issues)

  • Alpha-2 agonists: Clonidine, Guanfacine (for sleep/anxiety)

  • SNRIs: Strattera (non-stimulant ADHD treatment)

  • Anxiolytics: Buspirone (for anxiety)

  • Antidepressants: Zoloft, Prozac (for mood regulation)

  • Antipsychotics: Risperdal, Abilify (for aggression or severe behavior)

Medication is often combined with therapy for the best results.

Therapeutic Programs

Behavioral and educational programs include:

  • Good Buddies: Group-based social skills development

  • Families Moving Forward (FMF): Caregiver coaching and behavioral support

  • MILE: One-on-one math learning and parent training

  • PACT: Parent-child sessions for behavior and emotion regulation

Parent training is also essential and focuses on:

  • Structured routines

  • Strength-based approaches

  • Clear, simple language

Local clinics and FASD organizations can help families access these services.

Prevention

FAS is 100% preventable. Steps to reduce risk include:

  • Avoiding alcohol entirely during pregnancy

  • Using birth control if drinking and not planning pregnancy

  • Seeking help for alcohol use before or during pregnancy

Resources like Alcoholics Anonymous and FindTreatment.gov offer free, confidential support.

Associated Conditions

Individuals with FAS have a higher risk of developing:

  • ADHD

  • Substance use disorders

  • Depression

  • Anxiety disorders

  • Conduct disorder

Early mental health support can help prevent or manage these co-occurring conditions.

Living With FAS

Life expectancy for someone with FAS is significantly reduced, averaging around 34 years. Causes of early death include:

  • Accidental injuries

  • Substance abuse

  • Suicide

However, outcomes improve with:

  • Early diagnosis (before age 6)

  • Stable, violence-free home life

  • Educational and social support

  • Consistent involvement in therapy

Supportive environments help individuals with FAS reach their full potential.

Conclusion

Fetal Alcohol Syndrome is a serious, lifelong disorder caused by alcohol consumption during pregnancy. Although there's no cure, early diagnosis and intervention can significantly improve outcomes. Through proper medical care, therapy, educational support, and a nurturing home, children with FAS can thrive. Preventing FAS starts with awareness—spread the word, support expecting parents, and encourage alcohol-free pregnancies.