Fetal alcohol syndrome anyone?

I would just like to know if anyone knows of anyone who drank very moderately (say 2-3 drinks a week) and ended up having a baby with any symptoms. I can't remember how much I drank when I was pregnant. I think it was 1 to 2 a week, just wine with dinner, although once when I was gardening I had a beer. At Christmas I had a glass of champagne and a glass of wine. Our kid is wicked smart and an excellent dancer and master of the iPad. I don't believe that 2 to 3 drinks causes fetal alcohol syndrome, but I do know someone whose baby does appear to have those symptoms (developmental delays, but there are also pretty clear physical indications) and I know that she took a lot of medication while pregnant, and it wouldn't surprise me to know she drank a hell of a lot because she drinks a hell of a lot anyway. When I was pregnant I did some research, read a bunch, talked to Mr. Llama and decided that that's what I was comfortable with. For me, it was a really good decision because it made me feel more adult, less medicalized and infantilized (which seemed the goal of my care providers). And I love wine and food. But again, my mother drank while pregnant and so did Mr. Llama's. My mom also smoked her head off. Mr. Llama's mom supported me, my mom was mildly scandalized but not too confident making a big deal out of it as she probably spent a good amount of time when she was pregnant sitting out in the back yard with a Genny Cream Ale.

I don't think that drinking an occasional beer while pregnant is harmful except for the slippery slope argument. Rationalizations can be insidious. But as for the actual existence of FAS kids, just go to any adoption/foster care website and look at some of the kids. I adopted two "crack babies." I can handle that, but I don't have the training to handle an FAS kid. A kid whose mom abused cocaine has it way better than over a kid whose mom abused alcohol. FAS is fucked up.

I once transcribed the talks at a conference on fetal alcohol syndrome. The remark I remember most clearly was from a doctor who said, essentially, that the problem is that they know what the alcohol does to the fetus, but they don't know how it does that. Therefore, it's impossible to say how much alcohol is okay, and how much isn't.

http://contexts.org/socimages/2010/02/23/fetal-alcohol-syndrome-and-the-social-control-of-mothers/, particularly in re. Wroksie's excellent comments (via the "Sociological Images" blog). Also http://dovercanyon.typepad.com/women_wine_critics_board/2006/01/wine_and_pregna.html. Not the full paper, but an abstract: http://www3.interscience.wiley.com/journal/119360177/abstract?CRETRY=1&SRETRY=0 I had a drink perhaps twice a month; kid's a genius.

I was just at a conference yesterday about reforming drug policy, and one of the presenters, who works with mothers whose children are removed from their care because they used drugs while pregnant handed out some references that I have not had a chance to look into yet. The three that caught my eye about FAS are: Armstong, Elizabeth, Diagnosing Moral Disorder: The Discovery and Evolution of FAS, 47 Soc. Sci Med 2025-42 Armstong, Elizabeth & Ernest Abel, FAS: The Origins of a Moral Panic, 335 Alcohol and Alcoholism 276, 277 (2000) Bingo, Nesrin et al., The Influence of Socioeconomic Factors on the Occurrence of FAS, 6 Advances in Alcohol and Substance Abuse 105 (1987) The thesis seems to be that the prevalence of FAS is much higher among poor and minority women, and therefore might well be explained by other factors. I'm not vouching for the research as I have not read it.

I wanted to revisit my http://ask.metafilter.com/157055/Fetal-alcohol-syndrome-anyone#2251169 about some of the research regarding FAS, as I’ve actually had an opportunity to read one of the articles I provided a citation for, and a few other things as well. I would generally suggest that the anecdotes presented here don’t really address the substance of this question. There is no doubt that Fetal Alcohol Syndrome exists, and that when it is present that it really damages everyone affected. As tragic as this is, and it really is tragic, it begs the question of how prevalent FAS is and how easy it is to inflict on a fetus. People win the lottery every month but it’s still not a good retirement strategy to “invest” in lottery tickets. I’m not trying to be flip, I’m trying to point out that statistics don’t matter to the rare person affected by something rare. They should matter to other science literate people, though, even if they are only one aspect worth considering. The CDC in “Trends In FAS—United States 1979-1993” puts the prevalence of FAS at 0.67/1000 births. And according to Robin Room in a book review from The Lancet (Book: Fetal alcohol syndrome: a biography of a diagnosis Robin Room The Lancet; Jun 11-Jun 17, 2005; 365, 9476) the WHO comparative risk analysis estimates that FAS accounts for just “0.2% all disability-adjusted life years lost due to drinking globally, and 0.1% in developed countries.” For comparison CDC says that http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5701a2.htm (a much higher number!). I was not able to get Elizabeth Armstrong’s first paper on FAS (Diagnosing Moral Disorder), but I have appended the abstract below. She seems to argue that the diagnosis is tied into several social trends and concerns that serve to overstate both its prevalence and the etiology of FAS. I have read her second paper, FAS: The Origins of a Moral Panic, and she expands on that argument by basically suggesting that while we focus on social drinkers we fail to address the true causes of FAS. She points out that while since 1981 the US Surgeon General has recommended NO drinking for pregnant women, in 1996 the British Royal college of OB/GYN stated “no adverse effects on pregnancy outcome have been proven with a consumption of less than 120 grams of alcohol a week.” They go on to recommend no more than one drink per day. Armstrong makes the point that most US FAS research uses average drinks/day as a measure, but does not distinguish between a single drink every day and seven drinks on one day of the week. The former has apparently not been shown to be harmful, while there is robust evidence that the latter is harmful. I want to stress that Armstrong is not arguing that FAS does not exist, just that effectively treating it requires paying attention to the real etiological constituents of the disease, rather than those that combine moral judgments about alcohol (remember Prohibition was only 77 years ago in the US) with medical concerns. Armstrong extensively cites E.L. Abel who has done a lot of research on FAS. The book reviewed in The Lancet is http://www.amazon.com/exec/obidos/ASIN/0674022378/metafilter-20/ref=nosim/. Room gives it a good review, but also says that she assumes too much about the science of FAS, and so presents FAS as more of a problem than it is (the WHO quotes come from the final, critical section of the review.) Diagnosing moral disorder: the discovery and evolution of fetal alcohol syndrome Elizabeth M. Armstronga a Department of Health Management and Policy, University of Michigan, 109 S. Observatory, Ann Arbor, MI 48109, USA Abstract The diagnosis of fetal alcohol syndrome (FAS) was invented in 1973. This paper investigates the process by which a cluster of birth defects associated with exposure to alcohol in uterocame to be a distinct medical diagnosis, focusing on the first ten years of the medical literature on FAS. Fetal alcohol syndrome was “discovered” by a group of American dysmorphologists who published the first case reports and coined the term FAS. However, the nature of the diagnosis and its salient symptoms were determined collectively over time by the medical profession as a whole. The paper traces the natural history of the diagnosis in the U.S. through five stages: introduction, confirmation and corroboration, dissent, expansion, and diffusion. FAS serves as an example of the social construction of clinical diagnosis; moral entrepreneurship plays a key role and the medical literature on FAS is infused with moral rhetoric, including passages from classical mythology, philosophy, and the Bible.FAS is a moral as well as a medical diagnosis, reflecting the broader cultural concerns of the era in which it was discovered, including a greater awareness of environmental threats to health, the development of fetal medicine, an emphasis on “the perfect child,” and a growing paradigm of maternal–fetal conflict.

I adopted two "crack babies." I can handle that, but I don't have the training to handle an FAS kid. A kid whose mom abused cocaine has it way better than over a kid whose mom abused alcohol. FAS is fucked up. Tangentally related, but WaPo recently had a http://www.washingtonpost.com/wp-dyn/content/article/2010/04/15/AR2010041502434.html about how many of our assumptions about the long-term prospects of these children have proven to be completely incorrect, and many of the crack babies have grown up to be unremarkable, well-adjusted adults.

My Mom was a suburban, closeted alcoholic in our upper-middle-class family. We don't really know how much she drank, except that there was always supper on the table, and she seldom appeared drunk. My youngest brother has FAS, with the distinctive facial characteristics and seriously delayed development. His IQ is low, just within the "normal" range. He has significant http://en.wikipedia.org/wiki/Dystonia, speech impairment, is unable to process alcohol. His growth was seriously delayed and he was given human growth hormone as a child, and is consequently at some risk for http://en.wikipedia.org/wiki/Creutzfeldt%E2%80%93Jakob_disease. Just getting through life is exhausting for him, but he does work a few hours a week as a dishwasher. He's a sweet guy, and FAS screwed him, hard. No one knows what the safe pregnancy alcohol level is. Sadly, there's too much "blame the woman" around the issue, and not enough "We can research this." I drank a beer before the pregnancy test, and had 2 small drinks during pregnancy; 2 Christmas parties, and I can't resist homemade eggnog. I would not wish my brother's disability on anyone.

My SIL was very stressed during her pregnancy and, from what I saw being over there a couple times a week, seemed to be drinking multiple glasses of white wine (3/4 bottle?) every night. I'd been in recovery from drug/alcohol abuse for a number of years by then, so maybe I'm overly sensitive to these things, but I was pretty nervous about if the child would has FAS. The 'baby' is now 8 and she's fine. Well, my brother is giving her an eating disorder, but other than that, she's fine.