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September 09
LIFE’S MORE PRECIOUS THAN BOOZE: CONFRONTING THE TRUTH ABOUT FETAL ALCOHOL SYNDROME AND FETAL ALCOHOL SPECTRUM DISORDERS

By: Lunga Memela (Communications Officer)

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The latest report on levels and trends in child mortality by the United Nations Children's Fund (UNICEF) confirms that despite dramatic reductions in child and youth mortality over the last 30 years, the global burden of child and youth deaths remains immense. With this in mind, perhaps the most precious gift a mother can give her new-born baby is avoiding alcohol during pregnancy in order to afford them life-long health and to unlock their inherent development potential.  

According to the Association for Alcohol Responsibility and Education (aware.org), fetal alcohol spectrum disorders (FASD) remain the leading cause of preventable birth defects and developmental disabilities in children around the world. The key message is that the damage caused by FASD is permanent, but it is 100% preventable. "Their tomorrow starts when you don't drink… All you need to do is to NOT drink when you are pregnant," warns the organisation.

International Foetal Alcohol Syndrome Day (FASDay) is observed annually on 9 September. It was first commemorated on the date 9/9/99 – the day being chosen so that on the ninth day of the ninth month of the year, the world would remember that during the nine months of pregnancy a woman should abstain from alcohol.

Every parent wants what's best for their baby, and surely this shouldn't only begin once the baby arrives. Instead, because parenthood comes with the intrinsic joy and responsibility to love and care for new life created, why not treasure the gift, put down the bottle, and give your new-born the best possible future?

Defining FASD

Associate Honorary Professor at the University of KwaZulu-Natal and attached to the Fetal Unit at  Inkosi Albert Luthuli Hospital's Foetal Unit, Prof Ismail Bhorat said FAS is a condition in a child that results from alcohol exposure during the mother's pregnancy that causes brain damage, neurobehavioral developmental anomalies, growth problems and birth defects. The problems caused by FAS vary from child to child but defects caused by FAS are generally not reversible.

"The reason that it is crucial for women to know about the dangers of consuming alcohol in pregnancy is that many of the disabilities that it causes are not reversible. There are serious anomalies that can occur in the offspring, in particular, facial feature anomalies, cognitive anomalies (learning disabilities, attention deficit anomalies, intellectual problems) central nervous system anomalies, birth defects and growth problems. So the woman is exposing her offspring to serious problems," he explained.

Fathers should not be left out of the conversation

Bhorat said fathers-to-be are crucial to the discussion as they could play a vital supporting role and comfort base. "If the fathers are drinkers they should be able to stop too as a support statement to their partners. Also, as fathers, they too will be impacted by anomalies, both functional and anatomical, of their child so they are part and parcel of the unit."

If a pregnancy is being planned, the mother to be should stop alcohol consumption before conception. If the pregnancy was unplanned, alcohol consumption should stop immediately as the mother confirms the pregnancy. "Alcohol intake in the first trimester is associated with increased risk for abortions and stillbirths," Bhorat advised. "If the mother is breastfeeding after delivery, she should abstain from consuming any alcohol until after the lactating period."

The social impact of FASD

"The lives of families living with children affected by FAS varies and differs depending on the severity and degree of the anomalies expressed in the children," said Bhorat. "In severe cases where there is a substantial intellectual deficit it would have a massive impact both emotionally and financially on the family as these children may end up in a 'special needs' education track. Lesser problems of attention deficit disorder, learning disabilities, cognitive disorders and hyperactivity can still impact substantially on families."

Dealing with alcoholism and pregnancy

Alcoholics who fall pregnant will need to seek professional help. A multidisciplinary team involving the obstetrician, physician, counsellor, psychologist/psychiatrist and possibly her general practitioner should be assembled to deal with, treat, monitor and support the patient.

"The isolation and social distancing that comes with COVID could impact on women who consume alcohol as these social mechanisms to combat the disease in itself can induce stress and worsen the habit. It may make it even more difficult for these patients to access help. In these scenarios it is crucial for their partners and families to be involved in helping them cope and to be able to identify when professional help is required," said Bhorat,

Towards raising continuous awareness

FAS is the most common preventable form of mental disability in the world and South Africa has the highest reported rate of FAS in the world. Statistics reveal that on the west coast of South Africa, 64 children per 1000 are affected (6.42%) making it one of the highest in the world. While there are continuous and joint efforts from institutions of higher learning, non-governmental organisations and health practitioners and social workers to raise awareness about FAS, more work is to be done to undo the general ignorance of the effects of alcohol on pregnancies.

​Awareness can be increased by delineating special days of awareness, education at women's health clinics, and promoting media awareness programmes. Schools and universities, in particular, should be included in these awareness programmes.

 

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