DRINKING PROBLEM; EVEN A LITTLE BIT OF ALCOHOL CAN HARM AN UNBORN BABY.

Byline: Dru Wilson Colorado Springs Gazette

Many women in today's social whirl may have a beer or glass of wine after work; some may be aware of warnings on their labels that say drinking can harm a pregnant woman's unborn child.

What some women still don't realize, however, is how little alcohol it takes to cause damage and how early in the pregnancy it can happen, says Teddi Roberts, program coordinator for the Colorado Springs Chapter of the Arc, a national organization for mental retardation.

A drink a day - possibly even before a woman knows she's pregnant - could mean the difference between having a healthy baby and one doomed to a lifetime of learning and behavioral problems associated with fetal alcohol syndrome or fetal alcohol effects.

It doesn't matter if it's beer, wine or hard liquor; no one form is less potent then the other, says Dr. Sharon Davis, director of the Arc's national office.

Although statistics vary on how much alcohol it takes to harm a fetus, Roberts points out that FAS ``is 100 percent preventable. Simply don't drink while you are pregnant or possibly could get pregnant.''

Despite two decades of warnings, pregnant women are drinking at levels more dangerous to their unborn child; women in general also are drinking more, according to studies. At the same time, scientists have lowered the level of drinking they believe is risky to a point most people consider social drinking - although the experts don't always agree on the amount. Most, but not all, scientists do agree that seven drinks a week, or more than four drinks at one sitting is the level where they start to see measurable cognitive effects such as loss of IQ, difficulties in processing information and learning problems.

Fewer drinks not OK

At least one study has shown an increased risk of miscarriage, or children born with kidney and cardiac problems associated with the mother having as few as four drinks a week.

``We simply don't know what a safe level (of alcohol) is. It can vary depending on the chemical and physical characteristics of individual women,'' Davis says. Effects also may vary with the stage of pregnancy and the amount consumed in a specific time period.

According to the Atlanta-based Centers for Disease Control and Prevention, about 2,700 infants in the U.S. are born each year with FAS, or approximately 6.7 out of every 10,000 births. Since 1983, there has been a sixfold increase in the percentage of babies born with FAS. There are no solid figures on how many children are affected by FAE because there are many causes of birth defects, and unless a mother's drinking history is known, FAS or FAE may not be suspected, Davis says.

Research has shown that alcohol passes through the bloodstream via the placenta to the growing fetus. Since the baby's organs are immature, the alcohol is broken down much more slowly than in an adult. As a result, the alcohol level in the fetus's blood can be higher than that in the mother and can remain high for a longer period of time.

In FAS, the effects are obvious in the deformed physical features of the child, particularly through the face. The children also are generally small in stature and severely mentally retarded.

In FAE, the symptoms are more subtle; the child may have attention-deficit disorder, behavioral problems or a slow mental and physical development compared to his peers, Montgomery says.

Babies with FAE may have erratic sleep patterns and difficulty being consoled, which prevents bonding between mother and child, says Pam Gillen, registered nurse and FAS coordinator for prevention programs and parent-support groups.

``The mother may begin to think the baby doesn't like her or that she is a bad mother,'' Gillen says. Frustrations can build and in some cases result in child abuse.

Sometimes the effects of FAE may not be obvious for years, Gillen says.

By middle-school age, it may manifest itself as bad behavior, such as acting on impulse, poor decision-making abilities, problems with boundaries and poor peer relationships because FAE children mature slower.

``They are often kids who do something wild and outrageous because someone dared them to,'' she says.

For parents, natural or adoptive, caring for an FAS or FAE child with a multitude of physical and mental problems can be difficult.

Surgery corrected some of the deformity in her hands, but nothing can reconstruct Janice Benson's brain damaged by FAS, says her father, Dave Benson, a Colorado Springs occupational therapist.

Janice, 25, speaks with slurred speech that is sometimes hard for even her father to understand. She has poor cognitive skills and difficulty processing even the simplest information.

Benson was a single dad with two other children when he adopted Janice while serving as an Air Force officer in Mississippi. She had spent her first four years of life in foster care because her mother had been on drugs and alcohol when she was born.

``I was told I should not adopt her because she would be an institutional child,'' Benson says. ``I did not see that in her.''

Janice now lives in a group home and is preparing to start a volunteer job. Benson hopes some day she can get a paying job and earn at least part of her own living expenses. But her skills are limited.

Parents need a lot of patience when raising a severely retarded FAS child, he says. Even simple things like learning to make a sandwich can take a lot of time.

``It is like getting dressed. She may know she has to do that, but choosing what clothes and whether they go on right side out or inside out may be another matter,'' he says.

Benson credits his two natural children, who are three and four years older than Janice, with teaching her a lot of skills, from making a bed to socializing.

Because of his profession, Benson had the skills and knowledge for coping with Janice's limitBations. But dealing with all the educational and social service agencies still required a lot of outside help and patience, he says.

That's where organizations like the March of Dimes and the Arc come in. Both provide support services to parents of children with birth defects - including FAS - and assist with local community awareness and education programs for teens and women.

Just a few drinks when you're pregnant may cost a lot - and not just in your child's suffering - later.

Because of the special education and medical needs, the total lifetime cost for a child born with FAS was estimated at $596,000 in 1980. Adjusted for inflation, that number has been revised to as much as $1.2 million, according to Dr. Ann Streissguth, professor at the University of Washington and a leading authority on FAS.

While most states concentrate on prenatal and health education to reach pregnant women and at-risk mothers through schools, clinics and county health departments, some states are taking tougher stands by regarding drinking while pregnant as a form of child abuse.

On July 1, South Dakota became the first state to allow judges to order pregnant women who drink into alcoholism treatment.

``It is so preventable and so devastating when it happens,'' Benson said. ``It you are a woman of child-bearing age, it's not worth the risk.''

Causes and consequences of fetal alcohol syndrome

Fetal alcohol syndrome is the name given to physical and mental birth defects that are the direct result of a mother drinking alcohol during pregnancy.

At least 2,700 infants in the United States are born each year with FAS, or approximately 6.7 out of every 10,000 births. Since 1983, there has been a sixfold increase in the percentage of babies born with FAS.

Q: Is there a safe amount of alcohol that a pregnant woman can drink?

A: It is best not to drink at all during pregnancy. Studies have not determined a safe level of alcohol, and the risk can vary depending on a woman's chemical and phBysical metabolism. The adverse effects may vary with the stage of pregnancy and the amount consumed.

Q: How does a mother's drinking affect a fetus?

A: Research has shown that alcohol passes through the bloodstream via the placenta to the growing fetus. Since the baby's organs are immature, the alcohol is broken down much more slowly than in an adult. As a result, the alcohol level in the fetus's blood can be higher than that in the mother and can remain high for a longer period of time.

Q: Can FAS be cured?

A: Birth defects related to alcohol use are permanent, although surgery can repair some physical problems, and some special-education programs can improve mental disabilities. However, children born with FAS remain below average in physical and mental development throughout their lives.

Q: Can a father's drinking cause FAS?

A: A father's drinking does not directly cause FAS, but a woman's drinking behavior is influenced by the drinking behavior of her partner, family and community. A partner, as well as families and friends, can play an important role in helping the pregnant woman refrain from alcohol.

Q: Can FAS adults have FAS children?

A: FAS is not a genetic disorder. However, there is debate over whether children of alcoholic parents have a predisposition to drink. Only by drinking can a mother cause FAS in her unborn child.

Q: Do other drugs cause FAS?

A: No drug or medication should be taken during pregnancy without first consulting a doctor. By definition, FAS is caused by alcohol, but drugs and smoking also may contribute to mental and physical birth defects.

Source: The Arc, a national organization on mental retardation.

WHAT ARE THE SIGNS?

Characteristics of a child with fetal alcohol syndrome may include:

Low birth weight and failure to catch up to peers in physical growth.

Small head size, narrow eye slits, flat midface.

Mental retardation.

Alcohol withdrawal at birth, possibly manifested in seizures.

Difficulty sleepinBg.

Restlessness, irritability.

Short attention span.

Developmental delays and learning disabilities.

Physical deformities in joints or poor muscle development.

Genital defects, heart defects and kidney defects.

CAPTION(S):

3 Photos, 2 Boxes

Photo: (1--Cover--Color) Tender, Loving Care

Protect your baby from the effects of alcohol use

David Sprague/Daily News

(2) no caption (Pregnancy)

(3) As an occupational therapist, Dave Benson has been better equipped than most parents to deal with fetal alcohol syndrome, from which his 25-year-old adopted daughter, Janice, suffers.

Stuart Wong/Knight-Ridder Tribune

Box: (1) WHAT ARE THE SIGNS? (See Text)

(2) Causes and consequences of fetal alcohol syndrome (See Text)