Monday 18 December 2017

Test babies to check if pregnant mums had been drinking: doctor

Dr Sam Coulter-Smyth, Master of the Rotunda Hospital, and neo-natal consultant Dr Adrienne Foran at the Oireachtas Joint Committee on Health and Children yesterday
Dr Sam Coulter-Smyth, Master of the Rotunda Hospital, and neo-natal consultant Dr Adrienne Foran at the Oireachtas Joint Committee on Health and Children yesterday
Eilish O'Regan

Eilish O'Regan

The extent to which babies are being harmed because their mothers are drinking alcohol during pregnancy needs to be publicly acknowledged, a specialist warned yesterday.

Dr Adrienne Foran, a neonatologist in the Rotunda and Temple Street hospitals in Dublin, described the risks faced by unborn babies whose mothers are drinking as the "elephant in the room". She said: "It is something very controversial at the moment."

The after-effects are seen in children who are come back at age two or three with learning difficulties, she told the Joint Oireachtas Committee on Health and Children.

The social acceptability of having "one or two", compared to the conventions of their grandmother's generation, was part of the problem, she said.

Women who are pregnant are advised to avoid drinking because it can put their child at risk of fetal alcohol syndrome, which can cause mental and physical problems.

Dr Foran said she was now looking for research funding to carry out anonymous tests on newborns to determine if they were exposed to alcohol during their mother's pregnancy.

The tests can be carried out on the baby's first bowel movement and can find long-term markers revealing if the mother drank earlier in the pregnancy.

"We might have seen one or two babies a year with full-blown fetal alcohol syndrome but their mothers are alcoholics," she said.

The wider problem is much more subtle and the likelihood is that mothers are not telling the truth about the extent of alcohol they are consuming.

Dr Sharon Sheehan, master of the Coombe maternity hospital, said their mothers were asked about alcohol use and the latest reports suggested just 1.4pc of women drank.

"Do we believe that? I don't think so," she added.

Dr Foran said it was human nature for women to underestimate the number of cigarettes they smoked in day.

They might say five to ten but doctors would suspect it might be as many as 20.

Until we know how widespread the problem of drinking during pregnancy is, health authorities will not be able to deal with it, she added.

Researchers have found that the presence of certain fatty acid ethyl esters (FAEEs) in the baby's meconium (bowel movement) may provide a dependable biomarker of fetal alcohol exposure.

People characteristically under-report the amount of alcohol they drink. It is possible to measure blood alcohol but it disappears from the blood relatively quickly after drinking stops, so only very recent intake can be documented.

But FAEEs are 'long-term markers' of alcohol intake because they stay much longer in blood than alcohol itself .

Dr Foran also cares for pregnant women who are addicted to illicit and prescription drugs.

She said that while some advocate these women abstained from the drugs, this was not the wisest course because the evidence was that they would stay away from services and get into more trouble.

Around 100 of these women a year are admitted to Dr Foran's drugs service. A total of 68 delivered babies last year. Around 15 to 20 babies have to undergo a full programme in the hospital neonatal unit because of being exposed to drugs.

Ideally they should be placed in a quiet room with dimmed light but this is not possible in the Rotunda Hospital because of a lack of facilities, she said.

"They are not being managed as appropriately as they should be," she added.

The problem of cocaine use in pregnant women has reduced, but it appears to be resurfacing in women from middle-class areas, she said. Tests can be carried out on babies for traces of the drug.

Irish Independent

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