Four of those children had short palpebral fissures, a smooth philtrum (see previous article by Blackburn), and "microcephaly" (a situation where a child's head is far smaller than the heads of children the same age), all manifestations of a child whose mother drank alcohol during pregnancy. Dr. Smith and other doctors that got involved began checking the various maladies these children suffered from with other children whose disabilities hadn't been labeled or fully understood, and hence, this research led to the identification of FAS. That said, there still is no "clear-cut alcohol-specific neurobehavioral phenotype for 'Alcohol Related Neurobehavioral Disorders' (ARND)" (378). Smith, along with professor Jones, in fact coined the phrase, fetal alcohol syndrome.
Kvigne, Valborg L., Leonardson, Gary R., Borzelleca, Joseph, Brock, Ellen, Neff-Smith,
Martha, and Welty, Thomas K. (2008). Alcohol Use, Injuries, and Prenatal Visits During
Three Successive Pregnancies Among American Indian Women on the Northern Plains
Who have Children with Fetal Alcohol Syndrome or Incomplete Fetal Alcohol Syndrome.
Maternal and Child Health Journals, Vol. 12, S37-S45.
The authors in this article compared three sequential pregnancies of Northern Plains American Indian children who had FAS and children that had "incomplete FAS" with Indian women who had children free of the FAS malady. Two studies are presented in this paper, one with three successive pregnancies that ended in live births -- using 43 case mothers with children with FAS and 35 case mothers whose children had incomplete FAS -- and the second study using the pregnancies of 86 and 70 "control" mothers whose children did not have FAS. The results of this research showed that when compared with the mothers of children did not have FAS (the "control mothers") "…significantly more case mothers used alcohol before and after all three pregnancies" (S37). One hundred percent of mothers whose children had FAS used alcohol during pregnancy; 60% of mothers whose children had "incomplete FAS" used some alcohol during pregnancy and only about 9% of mothers whose children did not have FAS used alcohol during their pregnancy. The bottom line for this research is very obvious: Women who are of childbearing age should be screened for potential use of alcohol "whenever they present for medical services" (S37). In other words, when a woman of childbearing age goes to the doctor for any reason, she should be screened and advised or counseled as to the need for her to not drink if and when she becomes pregnant. The good news that comes from this article is that women with an FAS child "decreased their alcohol consumption" during the following pregnancy (S37).
Kvigne, Valborg, L., Leonardson, Gary R., Borzelleca, Joseph, and Welty, Thomas K. (2008).
Characteristics of Grandmothers who have Grandchildren with Fetal Alcohol Syndrome or Incomplete Fetal Alcohol Syndrome. Maternal and Child Health Journals, 12(6), 760-765.
The authors in this journal article researched the characteristics of Northern Plains American Indian maternal grandmothers that had grandchildren with fetal alcohol syndrome or "incomplete FAS" (760). The point of the research was to determine how to more effectively "prevent fetal FAS and alcohol use during pregnancy" among Native Americans (760). The research took place in four Indian service hospitals or clinics; once the grandchildren were identified with either FAS or incomplete FAS, the medical records of the grandmothers were carefully examined to discover her use of alcohol and any injuries, problems, or trauma she may have gone through. It turned out 92.6% of the grandmothers of the FAS grandchildren had used alcohol and also 45% of the women who drank alcohol during pregnancy "had parents who drank" (762). Hence, it was shown that parents pass along their habits (bad or good) to their children, and in turn the children pass those habits along as well, even in cases where habits negatively affect newborn children. The bottom line is that alcohol use by maternal grandmothers is definitely "a risk factor for FAS"; and so, screening women during their pregnancy "is essential to intervene" so counseling can be offered and hopefully children can be saved from the ravages of FAS (763).
Toutain, Stephanie, and Lejeune, Claude. (2008). Family Management of Infants with Fetal
Alcohol Syndrome or Fetal Alcohol Spectrum Disorders. Journal of Developmental
Physical Disabilities, 20(5), 425-436.
Part of the research of fetal alcohol syndrome leads to a reader encountering pathos and sadness, and this article is an example of that. To wit, 28 infants that were born between 1995 and 2003 in a hospital near Paris, France were born to mothers who abused alcohol. When the authors of this article reviewed the obstetrical files of the 28 mothers, and conducted additional research through questionnaires and interviews with doctors it was revealed that all 28 mothers "…came from underprivileged backgrounds, had chronic health problems, and/or lived with alcohol abusers" (425). In France, the neonatology team must decide at the time the mother and child are discharged from the hospital, whether or not those mothers are capable to providing "a good environment" for their children. If the team determines that the mother cannot provide the care required, the courts take custody of the children. In this instance, 18% of the children were taken from their alcoholic mothers and placed in care centers. This is considered a "tragedy of the poor" in France, and has become a serious health issue. Some 7,000 infants are born to alcoholic mothers every year in France; and the socioeconomic status of most of these women is very low and these women are living in environments with malnutrition, conjugal violence, and poor access to healthcare facilities. This is a problem France has not solved, and the authors hint that France isn't the only nation that has this serious problem with FAS.
Warren, Kenneth R., Hewitt, Brenda G., and Thomas, Jennifer D. (2011). Fetal Alcohol
Spectrum Disorders. Alcohol Research & Health, 34(1), 4-14.
Warren and colleagues touch on two salient problems with reference to FAS. One, there needs to be more work in terms of healthcare professionals being able to correctly identify all individuals that are affected and their "individual patterns of alcohol-induced deficits"; and two, because "large numbers of women" continue to drink during their pregnancies, prevention efforts are obviously not succeeding and hence they need "further refinement to enhance their effectiveness" (4). As to the first problem mentioned, presently healthcare professionals are stuck with the fact that the only obvious condition -- that is "currently widely accepted" by the medical community -- is based on the "full presentation" of FAS. Clearly, there are some children that have FAS but because the full potential of this health issue is not always detectable, the correct diagnosis of their condition remains a mystery. One possible solution for the lack of specificity when it comes to incomplete FAS is the use of imaging technologies like magnetic resonance imaging (MRI). Put to full use with children suspected of suffering from some level of FAS, the MRI could allow investigators to "visually track changes in bundles of nerve fibers…in the brains of humans of any age" (7). The authors represent that the MRI seems to be a hopeful and positive advance in the FAS field.
Warren, Kenneth R, and Hewitt, Brenda G. (2009). Fetal Alcohol Spectrum Disorders: When
Science, Medicine, Public Policy, and Laws Collide. Developmental Disabilities Research
Reviews, 15(3), 170-175.
The authors go into a bit of history in this article. They explain that while alcohol has traditionally been viewed as a food, sometimes as a medicine, as a part of religious activities (in Christian communion services wine is served as "the blood of Christ"), and as a beverage. But the authors write that while these purposes have "not changed" and have often been "at odds with one another," the result has been a collision between practices and policies in science, in medicine, in the law and in public policies (170). The policy today is obviously not working well when it comes to teaching pregnant women, and those that are of child-bearing age, the dangers of drinking alcohol while pregnant. This, coupled with the fact that scientists "…do not know the dose at which we can unequivocally state that the fetus will not be harmed," makes the issue more complicated. The authors simply hope that as science continues to gather more information and obtain knowledge about the "consequences of exposure to alcohol during gestation," public health professions will be willing and able to "reach closure on what advice will best serve pregnant women and their future offspring" (174).
Wilson, Shannon E., and Cudd, Timothy a. (2011). Focus on: The Use of Animal Models for the study of Fetal Alcohol Spectrum Disorders. Alcohol Research & Health, 34(1) 92-96.
This scholarly article focuses on the use of animals in research on fetal alcohol syndrome. The authors explain that no matter how much public information has been presented in the media and elsewhere, the incidence of FAS has not been significantly reduced. Given that fact, new prevention…