What is fetal alcohol spectrum disorder?

Fetal Alcohol Spectrum Disorder (FASD) is a term used to describe a range of health and behavioural problems affecting people exposed to alcohol during pregnancy.

FASD is the leading developmental disability in Canada. It can include lifelong physical, learning and behavioural disabilities. Children, youth and adults with FASD will be affected in different ways, each with their own strengths and challenges. Common problems include learning, memory, attention, language, social skills, behaviour, hearing and vision.

How much alcohol causes FASD?

FASD is prevented by avoiding drinking any alcohol during pregnancy. There is no safe amount, safe time or safe type of alcohol to drink during pregnancy. It is not known how much alcohol it takes to cause harm. Your baby's brain and nervous system develop throughout your pregnancy.

All types of alcohol, including beer, wine, hard liquor, coolers and ciders, can harm your baby. Binge drinking, that is, drinking more than 3 standard drinks at any one time, and drinking throughout your pregnancy, are the most harmful to your baby. See the Canadian Low-Risk Alcohol Drinking guidelines at www.ccsa.ca/sites/default/files/2019-04/2012-Canada-Low-Risk-Alcohol-Drinking-Guidelines-Brochure-en.pdf (PDF 1.40 MB) to find out what a standard drink means.

The potential to harm a developing baby during pregnancy is also influenced by the following factors:

• The birthing parent’s overall health and well-being
• Alcohol drinking patterns such as binge drinking and heavy drinking
• If illegal or street drugs, or medications are being used at the same time
• Genetics and many other factors

For more information on pregnancy and alcohol use, see HealthLinkBC File #38d Pregnancy and Alcohol Use.

An Alcohol Counselor, BC Alcohol and Drug Information and Referral Service is available 24 hours per day for information on where counseling is available in your area. Lower Mainland/Greater Vancouver 604 660-9382; Outside Lower Mainland, toll-free in B.C. 1 800 663-1441.

Does drinking during breast/chest feeding cause FASD?

No, drinking alcohol while breast/chest feeding or expressing human milk to feed by bottle does not cause FASD. However, your baby is exposed to a small amount of the alcohol that passes into your milk when you drink. Alcohol can also impact the taste and reduce the amount of milk available to your baby This can affect your baby's sleep-wake pattern, your milk letdown, the amount of milk your baby takes at feeding time and your baby’s behaviour.

It is best to avoid alcohol if you’re breast/chest feeding, but if you want to have an occasional drink, it does not mean you need to stop nursing. Breast/chest feeding is important for the health and well-being of both lactating parents and babies. If you choose to drink alcohol while feeding your baby, it is important that you plan around it. If you are going to have a drink, it is recommended that you feed your baby and store milk before you start drinking. How soon you can start breast/chest feeding again will depend on how many drinks you have had. Ideally, it is best to avoid breast/chest feeding for about 2 hours after drinking for each alcoholic beverage consumed. For example, if a person has 2 alcoholic drinks, they should wait at least 4 hours before breast/chest feeding.

You can pump or express as needed to relieve any discomfort from engorgement, but "pumping and dumping" milk will not lower the level of alcohol in your milk faster. Only time allows the alcohol level in the milk to drop.

When can FASD and other effects of alcohol be diagnosed?

If you are worried about your infant or child, speak to your health care provider. A referral can be made to have your child assessed by a specially trained team who can provide suggestions on how to best support them.

Recognizing FASD early can give a child with FASD the best chance to reach their full potential. Early diagnosis and support in a safe and healthy family situation may help prevent future issues such as difficulty at school, mental health or other health concerns.

Where can families and caregivers go for help?

Community resources in your regional health authority, such as child development programs, may help support families and children. Examples of available services include:

• Key Workers - helps families understand FASD by providing information and connecting them to support services
• Parent Support - includes mentoring, offering support groups, and FASD training for parents and grandparents

Some communities have additional support services and groups for parents / caregivers, and their children with FASD.

For more information on these and other local programs and services in your area, visit Fetal Alcohol Spectrum Disorder (FASD) at www2.gov.bc.ca/gov/content/health/managing-your-health/child-behaviour-development/special-needs/fetal-alcohol-spectrum-disorder-fasd.

For contact information to your local public health unit and to find services that are available in your area visit the HealthLink BC Services and Resources Directory at www.healthlinkbc.ca/find or call 8-1-1. When you call the public health unit, ask for a public health nurse.

For more information

Canadian FASD Research Network (CanFASD) FASD Fact Sheet

https://canfasd.ca/media/fasd-fact-sheet/.

The Society of Obstetricians and Gynaecologists of Canada (SOGC)

Alcohol – Pregnancy Info.