Counseling Sheet

Agatha M. Thrash, M.D.
Preventive Medicine

There are many abnormalities in babies having no presently recognizable cause. I believe there are a number of lifestyle problems in women which are easily associable with these abnormalities, or would be if we had sufficient knowledge to properly investigate the lifestyle and its corresponding defects in children. Women should start thinking about mothering at an early age, not waiting until the time of conception of their own children. What a young girl is exposed to in the way of drugs, alcohol, stresses, nutrition, and the like all have to do with the quality of her offspring. It is weak and immoral to say to a pregnant woman that she should be careful not to drink more than one ounce of absolute alcohol per day. We should carefully teach little girls from their birth up that the quality of their babies is intimately related to the quality of their own health, the number of protoplasmic toxins they encounter throughout their lives, and the level of health which they maintain. No one knows the drug level at which harm begins to the fetus. Since the stakes are so high, we should take no chances about this matter. It is known that damage to the fetus is the same, whatever the form of alcohol taken is beer, wine, or hard liquor. ¹

The cause of fetal alcohol syndrome is beverage alcohol (ethanol) or some metabolic by-product thereof.

The ancient recognition of damage to babies by maternal drinking had been dismissed by most researchers as superstition until recently.²

The fetal alcohol syndrome has been understood in modern medicine only since 1968 when it was studied by the French worker Lemoine and coworkers who reported on 127 offspring from 69 alcoholic families. These individuals are characterized by a protruding forehead, prominent nasal bridge, shortened upturned nose, thin upper lip and ear and eye malformations.

The abnormalities are of four distinct types: central nervous system dysfunction, growth deficiencies, distinctive facial appearance, and a variety of major and minor malformations affecting the eyes, ears, mouth, heart, kidneys, genitals, skin, bones, and muscles. These infants have mental retardation, poor coordination, and hyperactivity. Dislocation of the neck is an important result of some of the skeletal abnormalities associated with fetal alcohol syndrome (FAS). Any kind of rough and tumble activity can cause such dislocations.³ Jones and his coworkers confirmed Lemoine's findings in 1973.

In Bible times, individuals who were set aside for a special purpose were never exposed to alcoholic drinks from conception to death. Judges 13:4, 7.

Babies with the FAS have retarded growth before birth and show failure to thrive during infancy and childhood. The growth retardation is more evident in weight than in height. A small head (microcephaly) generally starts before birth and occurs in more than 80% of the cases. Decreased adipose tissue is almost universal among persons with FAS. Other developmental abnormalities include cardiovascular defects, renal abnormalities, hairiness, underdeveloped nails and irregularities in the genitals. Poorly formed ears, drooping eyelids, drifting eyes, blood vessel tumors, and musculoskeletal deformities such as limited joint movement and hip dislocation, abnormalities of the diaphragm, and abnormal creases in the palms are also found. Mental deficiency is one of the most universal symptoms. There is an increased incidence of hyperactivity, even in children who have normal ranges of intelligence. Hyperactivity is not limited to humans, but also occurs in rat pups whose mothers were given ethanol during pregnancy. A high incidence of minimal brain dysfunction occurs, with learning disorders and deficits in attention and memory.

In America after the repeal of prohibition, along with the rejection of the good features of the slowing of the soaring rates of crime and alcoholism, there was a general ridicule and rejection of earlier observations concerning the deleterious effects of maternal alcohol consumption on the fetus. As far back as ancient Greece the early Carthagenians had recognized this phenomenon and thus forbade alcohol to newlyweds to prevent conception of malformed children. Aristotle is said to have stated, "Foolish and drunken and hair-brained women most often bring forth children like unto themselves, morose and languid." It was recognized in England in the 18th century that parental drunkenness was "a cause of weak, feeble, and distempered children." Around 1900, the observation was made in the Liverpool jail that female inmates who drank alcohol had 2 and 1/2 times greater mortality rate in their children than their non-drinking female relatives.⁴

The blind spot in the understanding of modern physiologists is illustrated by the following items. In 1955, the Yale Center for Alcohol Studies released a pamphlet stressing that "the old notions about children of drunken parents being born defective can be cast aside." Goodman and Gilman's pharmacology text in the 1975 edition states "Alcohol gains free access to the fetal circulation but it does not seem to harm the fetus."

Two important questions should be answered: At what time in the age of a mother can the use of alcohol be harmful to her offspring? Apparently the use of alcohol by pregnant women, or women before they become pregnant, can result in abnormalities in their offspring.⁵ The second question is how much alcohol is associated with abnormalities? The answer to that question probably should be "Any amount."

The ingestion of an average of one ounce of absolute alcohol per day has been associated with measurable birth weight reduction of 91 grams if the ingestion occurred before pregnancy, 95 grams if it occurred in early pregnancy, and 150 grams if it occurred in late pregnancy.⁶ Long before there are grossly measurable defects, there have already been subtle damages at a cellular level. Alcohol seems to interfere with cell and tissue growth in the fetus. Study results indicate that alcohol may be the third most common recognizable cause of mental retardation, the first and second being Down's syndrome and neural tube defects.⁷

Alcohol withdrawal symptoms may occur after delivery, characterized by tremors, irritability, and convulsions.⁸

There is a high incidence of speech problems in the offspring of women who drink alcohol.⁹

REFERENCES

1. American Family Physician, 16 (1):162.
2. Drug Therapy (Hospital), January 1978, page 53.
3. Medical World News, August 6, 1979, page 9.
4. Journal of the Medical Association of Georgia, 68 (9): 799-809, September 1979.
5. Medical Tribune Sexual Medicine Today, April 27, 1977, page 17.
6. American Journal of Public Health, December 1977, page 1154.
7. American Family Physician, November 1976, page 219.
8. The Lancet, April 4, 1981, page 788.
9. Pediatrics, 68 (4): 475, October 1981.