Foetal Alcohol Spectrum Disorder (FASD)

Drinking in pregnancy

Drinking alcohol at any stage of pregnancy can harm a baby’s development. Alcohol passes through the placenta, exposing the baby to the same levels as the mother. Because a baby’s liver is not fully formed, it cannot process alcohol, leading to lifelong effects.

The safest choice is no alcohol at all.

Although there is very little up to date, accurate data on the number of alcohol-exposed pregnancies in the UK, studies have shown that: 

• 40% of women continue drinking during pregnancy
• The UK had the 4th highest rate of drinking during pregnancy in the world

Drinking when planning a pregnancy also makes it harder to conceive and increases the risk of miscarriage and premature birth.

What is FASD?

FASD is a spectrum and each person with FASD is affected differently. FASD is often misunderstood or misdiagnosed. Many people with FASD never receive a formal diagnosis, meaning they do not get the support they need. FASD is often called a hidden disability because most people with it do not have visible signs.

People with FASD may struggle with:

• Learning new things
• Memory and attention
• Controlling emotions and behaviour
• Understanding consequences
• Sensory issues (noise, lights, touch)

Every individual with FASD is different:

• Some may have mild difficulties, while others need lifelong support.
• Some may struggle with memory and attention, while others may have difficulty regulating emotions or motor skills.

FASD is a lifelong condition. The challenges don’t disappear with age, and many people with FASD need ongoing support throughout their lives. But the right help at the right time can make a big difference. With early diagnosis and the right strategies, children can learn to manage their difficulties, gain independence, and build a brighter future.

FASD diagnosis and misdiagnosis

How is FASD diagnosed?

There is no single test for FASD. Instead, doctors look at:

• Evidence of prenatal alcohol exposure (if available)
• Cognitive and behavioural difficulties, including memory, learning, and impulse control.
• Physical signs (in some cases).

Key Facial Features (Seen in Less Than 10% of Cases)

• Thin upper lip
• Smooth philtrum (the area between the nose and upper lip)
• Short palpebral fissures (smaller eye openings)

When these features are present, doctors may diagnose FASD even without proof of alcohol use in pregnancy.

Importantly, because FASD shares many symptoms with other conditions, it is often misdiagnosed. Many people are wrongly told they have ADHD or autism because they also struggle with attention, social skills, and behaviour. But FASD is different, and getting the wrong diagnosis can mean missing out on the right support.

Getting a diagnosis in South Yorkshire

In South Yorkshire, FASD diagnosis can be difficult due to a lack of specialist services.

If you think your child may have FASD, speak to your GP or health visitor. They may refer you to:

• Paediatricians (specialists in child development)
• Psychologists (to assess learning and behaviour)
• Speech and language therapists (to check communication issues)

Doctors look for:
 ✔ Proof of alcohol exposure during pregnancy
 ✔ Challenges in thinking, learning, and behaviour

A 2 year multi-agency project was started by One Adoption Agency in South Yorkshire in 2023 to develop and implement an FASD pathway supporting Adopted Children with FASD.  The project has looked at how to implement the NICE quality guidelines for FASD particularly around raising awareness and prevention, intervention and support and assessment and diagnosis.