'Pregnant women don't know they're harming their babies by drinking' - the truth about Foetal Alcohol Spectrum Disorders

Real Life: Foetal Alcohol Spectrum Disorders are the greatest cause of developmental delay in children - and Dublin foster mother Michelle Savage has seen the heartbreak first-hand, she tells our reporter

Foster mum Michelle Savage has seen first-hand how children are affected by their mothers drinking during pregnancy. Photo: Tony Gavin

Arlene Harris

Everyone knows that smoking during pregnancy is wrong - even the most ardent smoker would be somewhat reluctant to light up when pregnant, or at the very least would abstain from doing so publicly, as it is deemed totally unacceptable.

However, drinking alcohol during pregnancy is not so vehemently opposed and there has been much confusion over whether or not it safe to have an 'occasional drink' while expecting. But the latest guidelines stipulate that women should abstain from alcohol as soon as they find out they are pregnant, as even a small amount can have a negative impact on a growing foetus.

It is estimated that about 600 Irish babies are born each year with Foetal Alcohol Syndrome (FAS) and that over 40,000 Irish people are currently living with the condition.

This Saturday is International Foetal Alcohol Spectrum Disorders (FASD) Day and its aim is to make people aware of how drinking can - and does - cause lasting-damage to unborn babies.

According to Dr Mary T O'Mahony, specialist in public health medicine, pregnancy needs to be totally alcohol-free to prevent FASD. "There is no safe amount and no safe time for alcohol during pregnancy," she warns. "There is no low risk-drinking of alcohol during pregnancy, only-lower risk.

"Ideally, a woman would abstain from alcohol when she is trying to conceive a baby as this provides the best chance for healthy foetal brain growth and development. As 40pc of pregnancies are not planned, stopping alcohol once a woman realises that she is pregnant limits the dose, and it is still very worthwhile to stop drinking alcohol at any stage of pregnancy as the brain continues to grow and develop. The adult brain can show signs towards recovery during alcohol-free periods and this provides substance for hope for the foetal brain also to recover during the remainder of an alcohol-free pregnancy."

Dr O'Mahony says FASD is the greatest cause of developmental delay in children and it is often very hard to diagnose. "In the developed world, we all know someone, adult or child, with the invisible characteristics of FASD," she says. "These include attention deficits, memory deficits, hyperactivity, difficulty with abstract concepts (e.g. maths, time, money), poor problem-solving skills, difficulty learning from the consequences of actions (repeating the same mistake), poor judgement, immature behaviour and confused social skills. Pregnancy needs to be alcohol-free in order to prevent FASD."

According to recent research in The Lancet, out of every 67 women who drink alcohol during pregnancy, at least one will go on to have a baby affected by this condition. And Michelle Savage knows only too well the damage alcohol can do to unborn babies.

Together with her husband, David, the Dublin woman has been fostering children for almost 30 years and says many of those who have lived with her and her family (she is also a mother and grandmother) over the years have been severely affected by alcohol during their antenatal development, both by FAS (Foetal Alcohol Syndrome) and Alcohol Related Neurodevelopmental Disorder (ARND).

"We have had 28 children live with us over the years and quite a few have been obvious cases of FAS," she says. "This is easier to spot than FASD or ARND, as it is recognised by characteristics such as a flattened bridge of the nose, varying degrees of thinness in the lips, a fold in the corner of the eye and various physical impairments depending on the level of alcohol they were exposed to, and the duration.

"ARND [and FASD] is harder to diagnose, as it doesn't become apparent until much later, and we had a child who we suspected had problems due to drinking during pregnancy, but the GP said there were no apparent signs of FAS. I agreed, as he had none of the facial characteristics but, while he met his milestones, when it came to school, there were all sorts of problems - from having no friends, not being able to deal with homework to being anxious all the time, unable to grasp simple concepts and really not flourishing at all. So I decided to do some research and realised that it was probably ARND."

This condition, according to the experienced foster mother, is similar to autism or ADHD and is often "misdiagnosed as such".

"There is so little awareness around FASD and ARND, and it is often only when children get older that the effects become apparent," she explains.

"And at this stage, it can be seen as too late to do anything about it, particularly when the child becomes 18, as they are literally left to their own devices but really need long-term care. So they will continue to have issues regarding boundaries for safety, anxiety, behaviour and generally not being able to do the things they should be doing at their age -and too often this then leads them down a path they might otherwise never have got onto."

Dr O'Mahony agrees. "FASD is associated with physical, mental, educational, social and behavioural difficulties," she says. "This can lead to a breakdown in family relations, disruption of schooling and, as an adult, unemployment, homelessness, alcohol and drug abuse, and coming into conflict with the law.

Children with FASD are over-represented among children in State care and many end up before the courts and in prison. They have diminished awareness of the consequences of their actions and have difficulty adhering to rules and structure. Standard conditions of parole pose a challenge, resulting in recommittal to prison - like a revolving door."

Looking after your own children is difficult enough, but Michelle says that when caring for children from often "dysfunctional families" who are not your own, there is a limit to what can be done. But she says by making people more aware of the dangers of alcohol while pregnant, many would not intentionally put their unborn babies at risk.

"Being a foster parent, I am always somewhat compromised because I don't have complete autonomy," she says. "I have to get permission from the local authorities and either the parent or legal guardian before I can get further help for a child who is suffering from something like FASD.

"And, of course, it is a really delicate subject, as some mothers have no idea that they are damaging their child by drinking and, to be honest, I think there is a real failure on behalf of the Government to act and make people aware of just how dangerous alcohol can be to an unborn baby. They have been able to take the lead out of paint and hammer home the message about smoking, so why are they not telling people the truth about what alcohol can do?"

And, indeed, Dr O'Mahony says this is something that International FASD Day aims to achieve. "The aim is to raise awareness towards the prevention of FASD," she says. "We need to make the healthy choice an easier choice for pregnant women. Given that it is a social norm to drink alcohol - including during pregnancy - it will not be an easy choice. However, we must all strive to make it easier for pregnant women and those planning a pregnancy."