When I wrote my book, The Silent Epidemic: A Child Psychiatrist’s Journey beyond Death Row, I naively thought that I could stem the tide of public awareness about alcohol use during childbearing years – helping unknowing young women understand the importance of contraception if using alcohol. Articles like this one recently in the Washington Post are a big reason people are missing the message that a lot of damage happens to babies before you find out you’re pregnant. And alcohol doesn’t just cause Fetal Alcohol Syndrome! https://www.washingtonpost.com/opinions/five-myths-about-pregnancy/2017/05/12/7cf6e12a-3666-11e7-b373-418f6849a004_story.html?nid&utm_term=.fddddfca9788#comments
I can’t help but wonder what responsibility the media has for creating the confusion and societal ambivalence about alcohol use during reproductive years. Like some other drugs, alcohol is a neuroteratogen – a chemical solvent that causes birth defects of the brain and nervous system. Yes, it’s a solvent. Like household cleaning supplies, dry cleaning solution, gasoline, paint thinner, and rubbing alcohol. Alcohol kills the tiny cells migrating out of the neural tube as early as the 3rd week after conception – well before most women know they are pregnant.
In my book, I indicate the role of the alcohol industry, the medical community, and the government in preventing brain damage caused by our social drug of choice in 1 in 20 American children. The article in the Post reminds me of the media forces keeping the waters muddy about use of alcohol for women who are pregnant or planning pregnancy. So much more can and should be done to help them as well, as women who are sexually active and using alcohol but not preventing pregnancy.
One risk of the “Five Myths” article and the book is that women will become confused by the stance that a little alcohol is okay. What is a little alcohol to one woman is a long island iced tea to another (equivalent of 6 shots). As a board certified child/adolescent and adult psychiatrist, I see patients adopted from foster care in the U.S., Eastern Europe, South/Central America, China, and Southeast Asia with a range of neurodevelopmental problems (learning, attention, memory, anxiety/arousal, mood, sensory, motor, social/communication, etc.) stemming from prenatal alcohol exposure. Psychiatrists see these patients, not obstetricians. The condition is called “Neurodevelopmental Disorder associated with Prenatal Alcohol Exposure” (ND-PAE, ICD-10 code F88).
Most people know that alcohol abuse during pregnancy can cause “The Fetal Alcohol Syndrome” (FAS). What is less known is that as little as 4-5 servings of alcohol mistimed in the late 3rd week post conception is enough to cause the full FAS. Most women don’t know they are pregnant then. Our genetics, health factors, nutrition status, and other lifestyle behaviors can protect us and our babies or make the situation worse. We also know that a man’s sperm DNA is methylated by alcohol consumed up to 3 months prior to conception (it takes 3 months for sperm to develop from the earliest stages to “fertile”). Methylation of DNA has been linked to a variety of mental health, learning, medical, and other conditions.
I am a believer in educating alcohol consumers about the risks of unintentional prenatal alcohol exposure before knowing you are pregnant and to use contraception (prevent pregnancy) if using alcohol. Preconception health is the best way to prevent ND-PAE. I believe it’s time for the alcohol industry to be held accountable that our social drug of choice (alcohol) has caused brain damage in 1 in 20 U.S. children (CDC, 2015).
For more information about Neurodevelopmental Disorder associated with Prenatal Alcohol Exposure, check out my book at www.prenatalalcoholexposure.com.