Fetal Alcohol Syndrome Health Promotion

Fetal Alcohol Syndrome Health Promotion

Fetal alcohol syndrome has been identified as a leading cause of mental retardation affecting.2-1.5% of live births. It also produces physical defects in the child. Pregnant and other women of childbearing age who drink have to be motivated into giving up the habit or at least reducing it. The future of these children and of the nation's health depends on what is being done today to insure it. Among the health promotion priorities of Healthy People 2000 concerns alcohol and other drugs and maternal and infant health is among its priority preventive service. This study seeks to initiate a social activity, which will promote maternal and infant health by bringing together sample pregnant alcoholics, reformed women alcoholics and health professionals in a direct encounter and exchange of information, motivation and insights.

Review of Literature

Belcher, Harolyn (2008). Fetal Alcohol Syndrome: an Undiluted Danger. Pediatric News: International Medical News Group. Retrieved on October 27, 2008 at http://findarticles.com/p/articles/mi_hb4384/is_8_42/ai_n2945915?tag=content,col1

Belcher writes that fetal alcohol syndrome or FAS is the leading but preventable and identifiable cause of mental retardation in the U.S. At 0.2 to 1.5% per 1,000 live births, mostly among minority groups. Effects on the fetus range from a full-blown syndrome to mild behavioral and cognitive delays. Not all children exposed to alcohol before birth with act or appear alike. Physical features range from sever to subtle to absent. Furthermore, some of these features may develop from other physical or behavioral disorders.

No studies have determined how much alcohol produces harmful effects on children. What is known is that women who are long-term alcoholics face a greater risk of producing a child with FAS. No specific test has been established for FAS, either. The only basis has been maternal history, which is not always possible to obtain. Assessments have been made generally on the basis of behavioral and mental health. Children afflicted with FAS have moderately deficient IQ levels, are not too responsive to social cues or rules on hygiene and generally do not learn from past experiences. The disease is detected most often at around age 3 when the child becomes hyperactive and then again at age 6 or 7. When diagnosed, management can be complicated. His or her symptoms resemble other disorders. The best approach is adjusted to the child's personal and family circumstances. Early intervention is most desirable as children diagnosed before age 6 appear to do better than if found later. The cooperation of pediatricians and at-risk families is thus very important and elicited.

Valuable information on central nervous problems concerning alcohol in the womb has recently evolved. Public awareness on the dangers of alcohol during pregnancy has increased and improved. Pediatricians have also developed more varied modes of treating emotional and behavioral disorders with children. Overall, early diagnosis and long-term intervention provide the best chances for children with FAS to hope for some future.

Walling, Anne D. (2006). Prevention and Diagnosis of Fetal Alcohol Syndrome. American Family Physician: the American Academy of Family Physicians. Retrieved on October 27, 2008 at http://findarticles.com/p/articles/mi_m3225/is_10_73/ai_n26885596?tag=content;col1

Walling points to a lack of awareness of alcoholism in the mother and her physician's lack of expertise in the condition as the main reasons for an under-diagnosis of FAS. Om addition, a newborn's symptoms may be so subtle that they go undetected. A diagnosis of FAS is based on abnormalities in facial features, growth and nerve function. No specific criteria for the diagnosis have been established. Two short screening instruments, the T-ACE and TWEAK, have been used and recommended by the Agency for Healthcare Research and Quality. These take less than a minute to use and determine alcohol use more effectively than the routine physician questioning of the patient.

Recommended approaches consist of postponement of pregnancy, contraception and alcohol reduction in non-pregnant women. Intervention can be in the form of discussing the risks, evaluating the woman's readiness to change and offering support to reduce the drinking up to 25%. Regular follow-ups are also suggested for both groups to document changes in drinking patterns and to reinforce measures to reduce alcohol intake, especially among high-risk women. Such measures have been observed to have reduced alcohol intake and improved infant conditions.

Bertrand, Jacquelyn, et al. (2005). Guidelines for Identifying and Referring Persons with Fetal Alcohol Syndrome. Morbidity and Mortality Report: U.S. Government Printing Office. Retrieved on October 27, 2008 at http://findarticles.com/p/articles/mi_m0906/is_11_54/is_11_54/ai_n5894729?tag=content,col1 scientific working group of experts on FAS issued diagnostic guidelines on when and how to refer women suspected of prenatal alcohol exposure. These include existing practices, which offer support environments long-term consequences of FAS in children afflicted with it.

Referral should be made as soon as the exposure becomes known. The suspected person should be subjected to full FAS evaluation as soon as alcohol abuse is determined. If the exposure is unknown, the person or child should still be subjected to a full FAS evaluation if the parent reports a suspicion of FAS. Evaluation should also be resorted to in the presence of facial features characteristic of FAS, or growth problems, and certain social and family history factors to prenatal exposures to alcohol. These include maternal death relating to alcohol abuse, living with an alcoholic parent, experience of abuse or neglect, previous or current involvement with children of alcoholics, a history of care-giving, foster or adoptive care. Certain circumstances warrant a diagnostic referral. These include a known prenatal alcohol exposure, valid suspicion of FAS from a parent or caregiver or the presence of the general physical features or family history and conditions earlier mentioned.

Referrals can be made throughout one's lifespan, although the majority have been referred, diagnosed and managed during childhood.

Hankin, Janet R. (2002). Fetal Alcohol Syndrome Prevention Research. Alcohol Research & Health: U.S. Government Printing Office. Retrieved on October 27, 2008 at http://findarticles.com/p/articles/mi_mOCXH/is_1_26/ai_90681221?tag=content;col1

Hankin lists the three major prevention strategies established by the Committee to Study Fetal Alcohol Syndrome of the Institute of Medicine of the National Academy of Sciences. These are universal prevention of maternal alcohol abuse, the selective prevention of maternal alcohol abuse, and indicated prevention of FAS.

The initial step in the universal prevention is to increase public awareness of the effects of alcohol use during pregnancy, specifically FAS. This can include news reports, catchy magazine articles, public service announcements, billboards and warning labels.

It has been observed that the coverage of alcohol-related concerns in the five major national newspapers from 1985 to 1991 was insufficient to deal with the issue. The U.S. Congress passed the Alcoholic Beverage Warning Label Act, imposing the attachment of a label in all containers of alcoholic beverages. It warned about the risks of drinking alcohol on pregnancy. Awareness increased but, afterwards, gradually waned. In addition, the response to the increase in awareness was not too impressive.

Selective prevention addresses women of reproductive age and who drink. A study showed that brief intervention by the physician alone reduces the risk. A short session with a physician can lead the woman to state her reasons for drinking while pregnant, identify the risk situations for drinking, alternatives to it and recommendations for abstinence.

Indicated prevention is directed on populations at the highest risk for bearing children with FAS. The aim is to prevent the increased birth of children with alcohol-related defects. One brief session helped the women at risk to decide to abstain from, or limit, alcohol use.

Despite these efforts, many such women continue to drink during pregnancy. The author, thus, believes new and more effective ways are needed to reach those at-risk populations and to influence behavioral change in them.

Encyclopedia of Psychology (2001). Fetal Alcohol Syndrome. Gale Encyclopedia of Psychology: Gale Group. Retrieved on October 27, 2008 at http://findarticles.com/p/articles/mi_q2699/is_0004/ai_2699000467?tag=content;col1

Statistics show that FAS occurs in one to three babies every 1,000 births in the U.S. It has been identified as a leading and cause of mental retardation. It is also one of its few preventable causes. It remains unknown why some fetuses of alcoholic women are affected while others are now. Experts believe that combined genetic and environmental factors determine the condition. The characteristic physical and mental birth defects of both FAS and fetal alcohol effects or FAE are prenatal growth retardation, low birth weight, intellectual and attention deficiencies, behavioral problems and malformations in the skull, brain or face. FAS or FAE is a lifelong condition, which will limit the person's productiveness and capability. At this time, only early diagnosis and appropriate intervention offer a solution to the disease.

Gaby, Alan R. (2001). Can Nutritional Therapy Prevent Fetal Alcohol Syndrome? Townsend Letter to Doctors and Patients: The Townsend Letter Group. Retrieved on October 27, 2008 at http://findarticles.com/p/articles/mi_mOISW/is_2001_Nov/ai_79757209?tag=content;col1

Because the brain develops fast in the post-natal period, findings of a study suggest that nutritional intervention can prevent some of the effects of FAS in the offspring. The author writes about the benefits of postnatal supplementation of choline from the second to the 21st days post natal. Another research suggests the use of zinc supplementation for the mother in order to reduce the teratogenic effect of alcohol consumption. If pregnant women will not stop drinking, a broad-spectrum nutritional support may be an appropriate alternative.

Christensen, Damaris (2000). Sobering Work - Fetal Alcohol Syndrome. Science News: Science Service, Inc. Retrieved on October 27, 2008 at http://findarticles.com/p/articles/mi_mOISW/us_2001_Nov/ai_79757209?tag=content;col1

The author says that no safe amount of alcohol during pregnancy has been established in lieu of avoidance. Many pregnant women who drink heavily want to know how much they drink without harming their fetuses because they do not want to give the habit up. Some researchers say that even low doses of alcohol can bring harm. Animal studies may not be applicable to human subjects as species differ in developmental patterns. The general idea is that the safe drink for pregnant women is one without alcohol.

Rheinstein, Peter H. (1992). Healthy People 2000. American Family Physician: the American Academy of Family Physicians. Retrieved on October 27, 2008 at http://findarticles.com/p/articles/mi_m3225/is_n6_v46/ai_13358040?tag=content;col1

The overall aim of this program is to significantly improve the health of all Americans by the year 2000. It intends to achieve this goal by reducing preventable deaths and disability, to enhance quality of life and increase lifespan. The Healthy People 2000 engages the participation of professionals, private organization and public agencies. It aims at promoting healthy lifestyles and preventing disease. The goals set are th enhance the quality of life. The American Academy of Family Physicians is one of the almost 300 member-organizations in its national consortium. Its priorities are health promotion, health protection, preventive services and surveillance and data systems. Alcohol and other drugs are the sixth in the list of its health promotion priorities. And maternal and infant health is the first priority under preventive services. Fetal alcohol syndrome is a preventable disease and a top preventive service in the program.