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Alcohol - Fetal Alcohol Spectrum Disorder (FASD)

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Alcohol is a teratogen. There is no known safe amount of alcohol, or time to drink alcohol, in pregnancy. See the Ministry of Health Alcohol and Pregnancy Guide for Health Professionals.

Infants identified as at-risk from the effects of alcohol consumption in the mother are at risk of Fetal Alcohol Spectrum Disorder. This includes Fetal Alcohol Effect, Fetal Alcohol Syndrome and Alcohol Related Neurodevelopmental Disorders. Fetal Alcohol Spectrum Disorder is difficult to diagnose in the newborn period.

They are also at risk of withdrawal, particularly if the mothers are drinking alcohol during labour and delivery.

The prevalence is thought to be 1%, although no local data exists and it is thought to be underestimated.

There is also the risk of respiratory depression in these circumstances.


If a mother identifies herself or is identified during pregnancy as posing a risk to the fetus through alcohol consumption, the management should be as follows:

  • Paediatric attendance is recommended at delivery. The initial assessment should include careful head, length and body weight measurements and any dysmorphic features should be noted. The baby would normally be able to go to the postnatal ward with the mother.
  • Urine toxicology is recommended (there may be polydrug abuse).
  • Consider using a drug withdrawal nursing chart as for narcotic withdrawal.
  • Paediatric Consultant review should be arranged non-urgently.

Follow-up arrangements

These may need to be in conjunction with Social Worker if already involved. Social work evaluation is usually required to look at child protection issues and for referral of mother to a detoxification programme if appropriate.

  • Paediatric Clinic at four months of age and at one year.
  • Parents should be made aware of potential late effects of alcohol, e.g. attention difficulties and where to seek help if concerned.

More protracted follow up although desirable, is probably not practical.

If neurodevelopmental problems are evident, then appropriate referral to Child Development Services should be made.

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Document Control

  • Date last published: 20 September 2018
  • Document type: Clinical Guideline
  • Services responsible: Neonatology
  • Owner: Newborn Services Clinical Practice Committee
  • Editor: Sarah Bellhouse
  • Review frequency: 2 years