Jan Radford is a Registered Nurse with over 30 years of experience working with children as a clinician, administrator, researcher and educator. She worked with substance-exposed infants and children for many years as a Clinical Nurse Specialist at Sunny Hill Health Centre for Children and in Vancouver’s Downtown Eastside. In her recent “semi-retirement” she has returned to the Downtown Eastside to continue working with mothers and children whose lives are impacted by violence, substance misuse, mental illness and poverty.

Jan is the adoptive parent of four children, two of whom were substance-exposed. They were also foster parents to many substance-exposed children over the 10 years that they fostered.

Are some types of alcohol, such as beer or red wine, safe to drink occasionally during pregnancy?

Drinking any type of alcohol during pregnancy can affect the baby’s growth and development and cause FASD. Alcohol is a confirmed teratogen (that is, it causes birth defects) and is capable of interfering with the healthy development of the fetus. A 4-ounce glass of wine has the same amount of alcohol as a 12-ounce can of beer or a 1.5-ounce shot of straight liquor.

Lately, there have been some who claim “light drinking” during pregnancy is not harmful. This research comes out of the UK and Western Europe, where alcohol often plays a large role in the culture, so it may be an attempt to condone women’s existing lifestyle patterns. However, the extensive body of research from North America does link light drinking to developmental delays, increased rate of stillbirths and other birth defects. The safest choice is still to abstain from all alcohol during pregnancy.

Why is it that some women drink alcohol during pregnancy and their babies are healthy?

In fact, their babies may be physically healthy. Not all women who drink alcohol during pregnancy will have babies with birth defects. However, over 30 years of research has shown that alcohol has its greatest impact on complex brain functions. The risk of harm to the fetus by alcohol corresponds to the amount, timing, frequency, pattern, and type of alcohol consumed.

As well, there are other not yet clearly understood factors such as genetic predisposition, nutritional status and general health of the mother that play a role in long term outcomes for their children. Developmental problems associated with a mother’s drinking in pregnancy may not emerge until later in childhood and the full impact of their drinking may not be evident until the adolescent years.

Is it true that alcohol during pregnancy is more harmful to the child than drugs like heroin and cocaine?

Yes, prenatal alcohol exposure has consistently been shown to have the most serious consequences for unborn babies, and therefore, children. Birth defects (e.g. problems with the heart, kidney or bones) and central nervous system problems (e.g. poor coordination, learning disabilities, low IQ, memory problems, etc.) can occur from drinking alcohol anytime during pregnancy.

Research related to the long term outcomes for other drugs used during pregnancy is less consistent but suggests children may experience subtle learning difficulties, hyperactivity, distractibility and poor attention span.

Why is it important to diagnose FASD when there is nothing you can do about it?

But there is something you can do about it! Research has shown that diagnosis of FASD before the age of 6 helps prevent secondary disabilities, such as mental health problems, disrupted school experience, victimization, trouble with the law, inappropriate sexual behaviour, problems with employment/living independently and alcohol and drug problems. The reason for this is that children who are diagnosed early have the opportunity to receive the early intervention services they require for their often “invisible” disabilities. In the preschool years, these services may include occupational therapy, physiotherapy and speech and language therapy. As children grow older and go through school, many will require extra support for their learning and perhaps, their behaviour. These interventions help children to be more successful and maintain a positive self-concept which makes it less likely for them to drop out of school, get into trouble with the law, or turn to drugs and alcohol during their teen years.

What else can parents do to improve outcomes for their substance-exposed child?

Research shows that living in a stimulating, stable and loving home for most of a child’s life can do much to improve their long term outcome. In addition, receiving services for their disability will also make a significant difference.