How Long Has FASD Been Around?

How long has FASD been around?

The link between alcohol and harm to a developing fetus has been recognized throughout the centuries. The ancient Greeks and Romans believed that drinking alcohol at the time of conception would produce inferior children. In the Old Testament, the future mother of Sampson was warned, “Behold, you shall conceive ... drink no wine or strong drink ..." (Judges 13:7). These warnings against alcohol were not based on the scientific evidence that we have now, but people saw a connection between alcohol and negative effects on a child.

England’s Gin Epidemic
In the 1700s gin was cheap, there was plenty of it, and it was easy to get. At one point, the College of Physicians warned about the deadly effect of distilled liquor and that it is “too often the cause of weak, feeble, distempered children” (Warren and Bast, 1980). Various writers, doctors, and social commentators in the 18th and 19th Centuries made connections between alcohol and harms to children such as death, low birth weight and poor development, but they still did not understand how the baby was harmed or when.

Science and FASD
In 1899, Dr. William Sullivan documented 600 children born to female prisoners who were alcoholics. He compared these children to those of their female relatives who did not drink. His work has been described as one of the earliest descriptions of what was later called Fetal Alcohol Syndrome (Warren & Bast, 1980). He found that:

• The rate of stillbirths and early deaths of children of alcoholic women in prison was much higher
• Women who had already had “impaired” children had healthy ones when they were forced to stop drinking in prison

When prohibition started in the 1920s, research about alcohol and babies slowed down or stopped. After prohibition ended, researchers tried to prove there was no connection between alcohol and damage to babies, perhaps a backlash against prohibition. In fact, until the late 1960s, alcohol was accepted and even prescribed to pregnant women (Warren & Bast, 1980).

In 1968, Dr. Paul Lemoine and his colleagues in France examined children whose mothers drank heavily while pregnant. They found that a significant number of these children had similar facial features, smaller growth, and neurological problems.

In the early 70’s, three studies were published in an influential journal called the Lancet. These studies had looked at children born to mothers who drank heavily while pregnant. They found similarities between these children such as:

• developmental delays
• unique facial characteristics
• lack of growth

In 1973, the diagnostic term “Fetal Alcohol Syndrome” (FAS) was introduced to describe these similarities. This made FAS the first syndrome to be named after the cause and not after the doctors who discovered it.

Since the 1970’s, research and work have exploded in a variety of areas related to prenatal alcohol exposure, including:

• brain research
• research on effective interventions and supports
• screening, assessment and diagnosis
• the impact of social determinants of health on women's drinking

In 1996, the Institute of Medicine introduced the term of Fetal Alcohol Spectrum Disorder. This is not a diagnosis but includes the range of diagnoses for children who have been affected by their mother drinking while pregnant.

FASD is not new. Earlier generations understood that alcohol could hurt future children; however, it was not until the late 20th Century that the effect alcohol has on a developing fetus was truly understood. Where do you think this field of research will be 10 years from now?

References
Abel, E. L. (1999). Was the fetal alcohol syndrome recognized by the Greeks and Romans? Alcohol and Alcoholism, 34(6), 868-872.

Gilbert, S. F. Knowledge of alcohol as a teratogen. (Devbio: A companion to developmental biology (ninth edition). Retrieved from http://9e.devbio.com/article.php?id=202

Golden, J. (2005). Message in a bottle: The making of fetal alcohol syndrome. Cambridge, MS; Harvard University Press.

Malbin, D. V. (2008). Fetal alcohol spectrum disorders: A collection of information for parents and professionals (2nd ed.). Portland, OR: FASCETS.

Oba, P. S. History of fasd. Retrieved October 29, 2012 from http://beintheknownj.org/history-of-fasd-by-peggy-seo-oba-rdh-mpa-mba/

Sullivan, W. C. (1899). A note on the influence of maternal inebriety on the offspring. Journal of Mental Science, 45, 489-503.

Warren, K. R. & Bast, R. J. (1980). Alcohol related birth defects: An update. Public Health Reports, 103, 638-642.

Warren, K. R. (2009). Fetal alcohol syndrome and fetal alcohol spectrum disorders. (PowerPoint slides). Retrieved from http://www.apa.org/about/gr/science/.../2009/warren-presentation-5-09.ppt