Getting the message out strongly: avoid alcohol in pregnancy and prevent FASD
Today and every day, the message is simple: no amount of alcohol consumption is known to be safe in pregnancy.
Each year, September 9 is dedicated to raising awareness of FASD internationally. For nearly half a decade, the harmful effects of drinking alcohol on the brain of a developing fetus have been known. Yet, organizations around the world are still raising awareness in 2014, because “we clearly haven’t gotten the message out strongly enough,” says NeuroDevNet FASD research group co-lead Joanne Weinberg. “Babies are still being born with FASD, and women are still drinking.”
“This is the sad reality,” acknowledges James Reynolds, co-leader of the FASD research group. “While our focus is secondary prevention - early diagnosis and intervention - we support the front-line efforts of our partners doing outreach. They face an uphill battle, getting their voices heard, he said, because a lot of mixed messages are coming from credible sources - including physicians.
Following an address at a conference this summer for obstetricians and gynecologists, a member of the audience stood up and told Reynolds that recommendations to tell women not to drink were “unrealistic.”
“A question we always get asked is: ‘is there a safe level?’ We know it’s the wrong question. Given the risk factors, we can’t tell you what level is relatively safe for any particular woman, given variations in genetics, diet, and environmental exposures that all add to or modify risk. It’s a very complicated story to tell, and a problem area,” adds Reynolds. “It’s actually why we had a session in the Research Society on Alcoholism Conference as part of the FASD Study Group meeting this past June, that focused on the state of the evidence, and what the real risks are.
“Where we have a significant role to play in NeuroDevNet is in identifying kids with exposure, or at risk, and introducing interventions that decrease the severity of common co-occurring conditions, Reynolds says. “Secondary prevention is one of the key research areas proposed in the application for our renewal research program for cycle II of NeuroDevNet, if the Network gets funded for an additional five years.”
“Ultimately, I would like to see more research on primary prevention, and, of course, the development of better tests to diagnose children at the earliest possible time,” adds Dr. Albert Chudley, a clinician-researcher, and co-lead of the FASD research group along with Reynolds and Weinberg.
“Our FASD research group has made tremendous strides in early identification and intervention,” says NeuroDevNet Scientific Director Dan Goldowitz. “These priorities for the entire network were identified through consultation with a wide range of stakeholders, and by our Board. There is much to be done for families and children already affected by FASD. Joanne Weinberg’s work helps us understand some of the mechanisms that create increased vulnerability to a wide range of health conditions later in life.
“James Reynolds’ work in identifying new therapeutic targets for treating children with FASD will help manage behavioural and cognitive deficits, as well as comorbid conditions, such as ADHD,” adds Goldowitz.
“Two initiatives emerging from the FASD research group I’d like to highlight are the eye tracking screening tool, and the Strongest Families FASD study. With the eye tracker, we have an inexpensive, portable and efficient means of identifying children and fast-tracking children who need a more formal diagnosis and prompt intervention.
“Strongest Families FASD is recruiting participants to evaluate a customized version of a highly effective, home-based intervention that provides resources and support to families, specifically around challenging behaviours.
“Our work in FASD is vital because, despite decades of evidence that drinking during pregnancy can lead to children with learning disabilities, speech and language delays, poor social skills and trouble with self-regulation and executive functioning, babies are still being born with alcohol exposure. People with FASD across the lifespan are struggling.
“Three hundred and sixty-four days a year,” concludes Goldowitz, “our piece in this is focusing on early life, when we can make a transformative difference. But today, on International FASD Awareness Day, we are joining our colleagues from CanFASD, the US NIH, the American Academy of Pediatrics, and others in the effort to emphasize the message that women who are, who may be, or who are trying to become pregnant, should not drink alcohol.”
Dr. Goldowitz will be one of three experts featured in a Public Health Agency of Canada-sponsored “Fireside Chat” webinar, scheduled Sept 9 at 1 p.m. Eastern Standard Time.