The Center for Disease Control (CDC) has issued important, if controversial, new guidelines regarding alcohol consumption and pregnancy.
First, some background. Fetal Alcohol Syndrome (FAS) is a serious, and one of the most common, neurodevelopmental disorders diagnosed in the US. It’s incidence in the population is still unclear–anywhere from 0.5-2/1,000 to 6-9/1000 people. There is a related disorder–Fetal Alcohol Spectrum Disorder (FASD)– which is somewhat less specific and severe, and occurs in an estimated 24-28/1,000. Both conditions are more commonly associated with heavy/binge drinking during pregnancy. But here is a very important point: there is no amount of alcohol consumption considered “safe” during pregnancy.
FAS causes a spectrum of abnormalities;
- Facial–small eyes, flat cheekbones, underdeveloped upper lip
- Nervous system–small head, low intelligence, developmental delay
- Growth– low birth weight, poor growth
- Other–heart defects, sometimes severe
There is no cure for FAS and FASD, of course. Children with these conditions will require early and intensive learning and behavior therapies to maximize their achievement potential. Nevertheless many of these people will struggle with lifelong disabilities. And we should note that the cost to society–in remedial education and training, lost income from unsuccessful lives and its effects on those in the family, as well as the costs to society of criminal activities from too may of those unfortunately affected by FAS– is vast.
So the only real treatment is prevention and that’s where the latest CDC recommendations come in . They now say that women of child bearing years who are sexually active and not using birth control should refrain from any alcohol consumption. The basis for this new, strong position are 3 important facts:
- As mentioned, any alcohol consumption can be associated with FAS or FASD
- 50% of pregnancies are unplanned
- The earliest a woman is likely to become aware of her pregnancy is 4-6 weeks of gestation.
So the above makes for considerable uncertainty and that is the nature of the risk and the subsequent strong proscription. Now, I understand that these recommendations seem somewhat unrealistic in the real world. Young women have a right to live their lives and, as mature citizens, to “the pursuit of happiness.” And, there are lots of legitimate reasons why various birth control methods may prove problematic in given young women’s lives. But on the other side , with FAS and FASD, we are talking a lifetime of difficulty and disability, and not just for some random person but rather for the most important person in that young woman’s life–her own child.
So, yes, these rec’s may seem a bit over the top. But I applaud the CDC for having the courage to state the case in such direct terms to highlight the importance of the issue. Hopefully, it will help our younger citizens to educate themselves about FAS/FASD and can lower the risk for our society and for people themselves and their families.
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