By David Heitz
Very often, people decide once and for all to become sober not only for themselves but for their children.
Some may see the pain in their child’s eyes as they watch their parent battle the bottle. Others may have lost rights to see their children. And yet others may suddenly find themselves pregnant.
When that happens, alcohol use goes beyond endangering your own life. New research shows that even a small amount of drinking during pregnancy alters the shape of a baby’s head.
Certain facial features of babies born to alcoholics long have been associated with fetal alcohol spectrum disorder. A group of Australian researchers wanted to know if there were various gradients to these facial appearances – if various levels of drinking corresponded with certain features.
They discovered that it does. According to their research, even small amounts of drinking at any time during pregnancy can lead to malformations.
The original investigation was led by Jane Halliday of the Murdoch Children’s Research Institute in Victoria, Australia.
“Of the 415 children in the study (195 girls and 220 boys), mean age 363 days, a consistent association between craniofacial shape and prenatal alcohol exposure was observed at almost any level regardless of whether exposure occurred only in the first trimester or throughout pregnancy,” the authors found.1
“Regions of differences were concentrated around the midface, nose, lips and eyes. Directional visualization showed that these differences corresponded to general recession of the midface and superior displacement of the nose, especially the tip of the nose, indicating shortening of the nose and upturning of the nose tip.”
Even Small Amounts of Alcohol Can Lead to Facial Malformations
Compared to one-year-old babies carried by mothers who did not drink at all during pregnancy, those whose mothers drank small amounts in the first trimester had malformations to the forehead. Those who drank moderate or large amounts had babies with malformations to the eyes, face and chin. Binge drinking in the first trimester also led to deformities of the chin.
“Prenatal alcohol exposure, even at low levels, can influence craniofacial development,” the authors concluded. Although the clinical significance of these findings is yet to be determined, they support the conclusion that for women who are or may become pregnant, avoiding alcohol is the safest option.
That said, alcoholism is a disease. And pregnancies happen to women who have it, both planned and unplanned.
The good news is that great help is out there for pregnant women who want to stop drinking right now. An unborn child often gives mothers in recovery that “something bigger than yourself” that keeps them motivated to stay sober.
There may be no better time to quit once and for all, not only for the urgent need, but also to seize an opportunity for treatment and lasting recovery.
Why the Research Is Groundbreaking
In an editorial that accompanies the research by Halliday et al, Dr. Carol Bower of the University of Western Australia and Gareth Baynam of the Western Australian Register of Developmental Anomalies and Genetic Services lauded the research. They say it comes along at a time when new technology could help improve the diagnosis of fetal alcohol spectrum disorders.
“Several new approaches to diagnosis using promising biomarkers such as eye tracking, brain imaging and connectivity, genotype and three-dimensional facial analysis, all combined with machine learning (a type of artificial intelligence that provides computers with the ability to learn without being programmed), may delivery opportunities for an earlier, cheaper and/or more accurate diagnosis.”2
Typically, fetal alcohol syndrome is most recognizable if a child has all of the following: Small eyes, a thin upper lip, a smooth area between the nose and upper lip and developmental delays.
But the spectrum includes a range of disorders, from stunted growth to poor memory, speech impairments or hyperactivity. And it doesn’t always manifest itself in the typical facial appearance. So, fetal alcohol syndrome can be very difficult for doctors to diagnose.
Bower and Baynam also said the study’s methods revealed important new information. While previous scientific evidence has not shown a solid biological correlation between drinking small amounts of alcohol after the first trimester and fetal alcohol syndrome, this study has.
“Epidemiology…can be a blunt instrument at low levels of exposure, where measurement error of exposure, outcome and potential confounders may mask a true small, but important, effect,” they emphasized. “Most women who drink alcohol during pregnancy do so at low or moderate levels, and often reduce or stop their intake once the pregnancy is recognized.”
For the alcoholic, this likely is not possible. No one is to blame for an inability to stop drinking, and putting your own health and the baby’s first by seeking help immediately if you are pregnant and cannot quit is an obvious choice.
Maybe you have not yet become pregnant, but want to. If you stop drinking now, you can help keep your unborn baby alcohol-free.
What Every Pregnant Woman Needs to Know
Although the Australian study does not have the evidence to link the alcohol-associated facial deformities with brain damage, the correlation between the facial deformities and alcohol intake is strong and well-researched.
“The craniofacial measurements were performed by clinicians blinded to the knowledge of the PAE levels, none of the children had received a diagnosis of fetal alcohol syndrome spectrum disorder, and analyses took into account several variables that may affect craniofacial shape,” the authors of the editorial wrote.
“As the authors acknowledge, we do not know if the facial outcome measures are associated with neurodevelopmental impairment in these children. Although the evidence from the study by Sutter, et al, linking three-dimensional facial image findings with cognitive impairment in children with heavy PAE suggests that the association is plausible,” Bower and Baynam further explained.
The detailed collection of alcohol consumption data allowed the Australian researchers to suggest correlations to the facial malformations.
“Frequency and dose of alcohol consumption was measured at several time periods during pregnancy, including between recognition of pregnancy and on special occasions when alcohol intake was unusual,” Bower and Baynam wrote. “Another strength is the range of PAE in the study cohort of women, who were attending low-risk, public maternity clinics, from abstinence through low levels to moderate and high levels of drinking, and at different time periods during pregnancy (including only first trimester exposure).”
No Amount of Alcohol Is Safe for Pregnant Women
Federal guidelines are clear – no amount of alcohol is safe for pregnant woman to drink.
“Alcohol can cause problems for your developing baby throughout your pregnancy, including before you know you are pregnant,” The U.S. Centers for Disease Control and Prevention warns on a question and answer page about fetal alcohol spectrum disorders. “Every pregnancy is different.”3
The CDC emphasizes that just because someone drank with one baby and did not have any problems, that doesn’t mean the next baby will be born healthy.
“Drinking alcohol might affect one baby more than the other. You could have one child who is born healthy and another child who is born with problems.”
As for dads, there isn’t any scientific evidence to show that their sperm can be affected by alcohol consumption and therefore also harm an unborn baby.
However, there probably is no other person more critical to a mom’s recovery. And if dad has a drinking problem too, that could be a very big problem. A new or expecting mother greatly benefits from total support from her partner for a successful recovery.
“If a woman is drinking alcohol during pregnancy, it is never too late to stop,” the CDC reassures on another web page about alcohol use during pregnancy. “The sooner a woman stops drinking, the better it will be for both the baby and herself.”4
Heroes in Recovery is a website where people share their stories of getting sober. Sadly, but not surprisingly, the website is filled with stories from women who have lost babies because of their drinking.
Kate C. already had decided to give up booze once and for all when she became pregnant. Then she found out the baby had a birth defect.
“I had no other choice but to end the pregnancy and it was then that I went into a 12-Step meeting on my hands and knees,” she writes on the Heroes site. “I was done. My delusion broke, clarity came through, and I knew I was an alcoholic.”5
1 Muggli, E. et al. (2017, June 5). Association between pre-natal alcohol exposure and craniofacial shape of children at 12 months of age. JAMA Pediatrics. Retrieved July 5, 2017, from http://jamanetwork.com/journals/jamapediatrics/article-abstract/2630627
2 Bower, C. et al. (2017, June 5). New opportunities for evidence in fetal alcohol spectrum disorder. JAMA Pediatrics. Retrieved July 5, 2017, from http://jamanetwork.com/journals/jamapediatrics/article-abstract/2630625
3 U.S. Centers for Disease Control and Prevention. Undated. Fetal Alcohol Spectrum Disorders. Alcohol and pregnancy questions and answers. Retrieved July 5, 2017, from https://www.cdc.gov/ncbddd/fasd/faqs.html
4 U.S. Centers for Disease Control and Prevention. (2016, July 21). Fetal Alcohol Spectrum Disorders. Alcohol Use in Pregnancy. Retrieved July 5, 2017, from https://www.cdc.gov/ncbddd/fasd/alcohol-use.html
5 What is the risk of trying? (2016, Jan. 1) Kate C. Heroes in Recovery. Retrieved July 5, 2017, from http://heroesinrecovery.com/stories/what-is-the-risk-of-trying/