<div><p><span style="font-family: helvetica;">The joy of discovering one is expectant comes with numerous questions; where should I go for antenatal care? What should I eat? What can I drink?</span></p><p><span style="font-family: helvetica;">When it comes to alcohol consumption, there is a common public misconception that drinking during pregnancy is safe depending on the type and quantity of alcohol, or timing during pregnancy. But alcohol is harmful to a foetus.
</span></p><p><strong style="font-family: helvetica;">How it harms the baby</strong></p><p><span style="font-family: helvetica;">Alcohol easily passes from the mother to the baby through the umbilical cord. According to the Centre for Disease Control, there is no known safe amount of alcohol to drink and no known safe time to drink during pregnancy. There is no type of alcohol, either wine or beer, that is safe to drink during pregnancy.</span></p><p><span style="font-family: helvetica;">Fetal alcohol spectrum disorder (FASD) describes the effects alcohol has on the baby and the wide range of disabilities it causes. Prenatal exposure causes miscarriages, stillbirths, and lifelong effects on learning, behaviour, social-emotional development as well as causing physical abnormalities.</span></p><p><span style="font-family: helvetica;">New research is revealing there is a genetic risk for FASD. Studies on twins demonstrate exposure to identical levels of alcohol can have different levels of neurological damage.</span></p><p><span style="font-family: helvetica;">The risk of damage is dependent on both foetal genetics and alcohol consumption by the pregnant mother. The genetic vulnerability of a foetus to the effects of alcohol currently cannot be determined and hence impossible to determine which baby gets affected and which one doesn't. Hence it is unsafe to drink alcohol while pregnant.</span></p><p><strong style="font-family: helvetica;">Rising cases</strong></p><p><span style="font-family: helvetica;">The global trend of children with foetal alcohol spectrum disorder is on the rise. A global review on the prevalence of FASD placed the prevalence of FASD in Kenya at 6.1 percent.</span></p><p><span style="font-family: helvetica;">The numbers may be higher given the stigma behind admitting one drank alcohol while they were pregnant and the complexity of making the diagnosis of FASD.</span></p><p><strong style="font-family: helvetica;">Diagnosis</strong></p><p><span style="font-family: helvetica;">The diagnosis of FASD requires confirmation of prenatal exposure, a medical evaluation, and neurodevelopmental assessment.</span></p><p><span style="font-family: helvetica;">Confirmation of prenatal exposure involves; self-report, reports by a reliable source, positive blood alcohol concentrations, or medical or legal problems related to alcohol consumption during pregnancy.</span></p><p><span style="font-family: helvetica;">The medical evaluation looks at the physical manifestations of FASD and what are called sentinel facial features; the size of the upper lip, philtrum, and eyes. Neurodevelopmental assessments demonstrate brain dysfunction.</span></p><p><span style="font-family: helvetica;">Children with FASD have a broad-spectrum of presentations. The features may not be seen at birth and problems may manifest when the child joins school.</span></p><p><strong style="font-family: helvetica;">Effect on children</strong></p><p><span style="font-family: helvetica;">Children with FASD struggle with learning; short attention spans, difficulty with reading, comprehension and math, planning, memory, and organization.</span></p><p><span style="font-family: helvetica;">There are speech and language delays and understanding language is difficult. Behavioural and mood problems involve aggressive or defiant behaviour and depression or psychosis respectively. Physical problems involve delayed growth, heart defects, kidney defects, vision and hearing impairments, bone and muscle problems, and genital defects.</span></p><p><strong style="font-family: helvetica;">How to treat it</strong></p><p><span style="font-family: helvetica;">Managing the complications of FASD requires a multi-disciplinary team consisting doctors, speech therapists, physical and occupational therapists, social workers and psychologists. The financial burden for families and communities affected by FASD is enormous. The lifetime costs are devastating to families with regards to paying for special medical and educational resources. Unfortunately, there is no cure for FASD. Early diagnosis is important for it improves outcomes for the affected child when early interventions are in place.</span></p><p><span style="font-family: helvetica;">Do not consume alcohol if you are pregnant.
</span></p><p><span style="font-family: helvetica;"><strong><em>By Dr Susan Wamithi, a developmental pediatrician at Aga Khan University Hospital, Nairobi</em></strong>
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