Services insufficient in supporting those affected

There is an urgent need to do more to recognize prenatal alcohol exposure at an early stage and to integrate better pathways for diagnosis, assessment and support, finds a special issue of the SAGE journal Adoption & Fostering. The issue highlights the importance of raising awareness of Fetal Alcohol Spectrum Disorders (FASD) as there are unclear protocols and guidelines in place to adequately support those directly affected.

FASD is a major health issue in the UK. Cases in which the damage is so great that it affects the infant's face as well as its brain occur in about one in every 100 babies in England and Wales, equating to about 7000 affected infants born every year, more than the combined total of children born with Down's syndrome, cerebral palsy, Sudden Infant Death Syndrome (SIDS), cystic fibrosis and spina bifida. Cases in which the brain is affected, but not the face, occur much more often but exact numbers are not known.

The UK lags behind other developed countries in research on FASD and there is a reluctance in the UK to accept the growing international consensus on its importance as Dr Mary Mather, a retired Community Paediatric Consultant and a Trustee of the FASD Trust, in her accompanying editorial, explains:

"A recent search for the term 'fetal alcohol' in an archive of worldwide medical publications produced more than 14,500 articles. Virtually none of them emanated from the UK and to highlight what is happening here has not been an easy task. This lack of research and definitive guidance in the UK has led to unconsidered and diverse opinions about alcohol, where every professional has a different view and pregnant women are left confused and uncertain."

This confusion is even more worrying as Dr Bill Phillips, Emeritus Professor of Neuropsychology at the University of Stirling, explains in his article "Prenatal exposure to alcohol causes enduring brain damage":

"It is clear that in our society, exposure to alcohol is one of the major risk factors faced by the human brain during prenatal development. The brain damage caused can have consequences that endure well into adult life."

Phillips lays blame on the drinking 'culture' of societies such as the UK that "bear a heavy burden of responsibility" and concludes that:

"Society needs to provide support, therapy and understanding for those exceptional people who bear the burden most directly."

Similarly, Mather highlights the need to raise awareness about the problems that can occur as a result of drinking alcohol during pregnancy, whilst at the same time bringing in measures to adequately respond to the needs to the individuals affected by the condition, concluding that:

"The UK is the binge drinking capital of Europe and 50% of pregnancies are unplanned; every day that alcohol is ignored or downplayed, more damaged babies are being born. There is an urgent need for action and research. [...] Clear national guidelines about totally avoiding alcohol during pregnancy are essential. [...] Many more diagnostic clinics are needed with doctors with the expertise to run them. Training for midwives, social workers, doctors, foster carers and others in preventing and managing FASD is essential."