Fetal Alcohol Spectrum Disorder (FASD)

Fetal alcohol spectrum disorder (FASD) is a diagnostic term used to describe the range of mental and physical effects on the developing unborn baby that are caused by drinking alcohol during pregnancy. These effects range from brain damage and poor growth to birth defects and learning problems [31432].

There is no single internationally accepted classification system for FASD [31432]. In Australia, the 

was developed to standardise diagnosis of FASD in Australia as well as to assist clinicians in the referral and management of FASD.

FASD may be diagnosed at birth, but in many cases, the diagnosis occurs later, when the child is having problems with learning or behaviour [27251]. Early diagnosis and management improves outcomes and quality of life for individuals with FASD and their families [26090] [25672].

Is there treatment for FASD?

The effects of FASD are life-long. However, there are a range of strategies which help to improve the long term outcomes for individuals and families affected by FASD [25906].

These include:

• confirming that a child has FASD with the child’s doctor
• monitoring
  • growth and development
  • hearing
  • behaviour and mental health
• referral to support services
• supporting the child’s family.

A diagnosis helps parents and carers to understand their child’s behaviours and needs and may help with securing support services in the community [31432]. Supporting women with alcohol dependency with health services that address their substance use problems and promote the health and wellbeing of the mother and child is beneficial for the family. Providing support to the mother may also prevent alcohol use in subsequent pregnancies and so avoid FASD in future children [18926].

How can you prevent FASD?

FASD can be prevented by not drinking alcohol during pregnancy. There is no safe time to have alcohol during pregnancy [15411]. For women who are planning to have a baby, are pregnant or breast feeding, the safest choice is not to drink alcohol.

Early identification of women who drink alcohol by health workers, GPs, and maternity services can reduce the risks of FASD [18926]. Routine screening of all women of child bearing age can be done using assessment tools such as Audit-C. This assists in establishing levels of drinking and creates opportunities to provide information, brief intervention or referral to support services. If a woman has been drinking while pregnant, it is never too late to reduce harm to the baby by stopping drinking [32807]. Where abstinence from alcohol is not possible for women of child bearing age, support to access contraception is also a strategy to prevent pregnancy and children being born with FASD.

The role of men in supporting women who are pregnant or breastfeeding to not drink alcohol during pregnancy and breastfeeding is also important [23933].

At a community level, FASD can be prevented by promoting awareness of the harmful effects of drinking alcohol while pregnant, reducing unplanned pregnancies through the use of contraception and reducing the ready availability of alcohol [18926].

What is being done about FASD?

The most recent policy in response to FASD, the National Fetal Alcohol Spectrum Disorder (FASD) Strategic Action Plan 2018-2028 outlines four national priorities [35916].

These are:

• prevention
• screening
• support and management
• priority groups and populations at increased risk.

A number of projects and health resources are being developed to help prevent and respond to FASD in Aboriginal and Torres Strait Islander communities. For information on FASD relevant for Aboriginal and Torres Strait Islander people, please see the Knowledge Centre’s listing of publications, policies, programs, resources and organisations for FASD.

For more information about FASD for carers and health professionals please also visit the FASD Hub Australia.