Medicine

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Pregnancy + Alcohol = Problems

Even Moderate Drinking Can Cause Foetal Damage

Some babies smell like powder, some like cheap wine. A pregnant woman who drinks heavily can hide her bottles, but in the delivery room she can't hold back the seriously underdeveloped child who often arrives steeped in pungent amniotic fluid that's really an 80proof marinade.

The set of physical and mental deficiencies that doctors call Foetal Alcohol Syndrome (FAS) has been a recognised pitfall of pregnancy since Old Testament times, when Samson's mother was warned by an angel to avoid wine while carrying her unborn child. Now comes the bad news that pregnant women who drink even moderately during pregnancy may be harming their unborn children. Consuming large amounts of alcohol can result in mental retardation, curvature of the spine and facial abnormalities in the foetus; a moderate to small amount of imbibing may produce a child who has emotional problems, insomnia and a chronic inability to cope in school and on the job. This less severe form of FAS, known as Foetal Alcohol Effect (FAE), apparently can be brought on at certain critical stages of development by a single "Hooray I'm pregnant" glass of champagne.

Research in this area has just begun in earnest, but drinking during pregnancy ranks as one of the major causes of mental retardation in America. Last year, one to three in every 1,000 newborns were diagnosed as having fullblown FAS, and Dr. Kenneth Lyons Jones, a leading researcher in the field, estimates that 10 percent of babies born to "moderate drinkers" may have alcoholrelated problems. A recent study, by University of Washington psychologist Ann Streissguth, found that women who averaged one or two drinks a day during the first two months of pregnancy had children with slow reaction times and short attention spans.

The key to understanding the problem, says Michael Dorris, a Dartmouth anthropology professor who has written about the experience of raising an FAS child in a new book called ‘The Broken Cord' (300 pages, Harper & Row), is to realise that any alcohol a mother consumes passes into the bloodstream of the foetus, which promptly gets drunk. "The operative question," he says, "is, if you wouldn't give your kid a bottle of gin the day after birth, why give it one the day before?"

Dorris isn't an alarmist or crusader just the adoptive father of a now 21yearold man who has trouble tying his shoes. ‘The Broken Cord' is the moving story of his son Adam's slow progress through life and the writer's own success in building a family around his troubled child. Since 1981 Dorris has been married to novelist Louise Erdrich, with whom he has three biological and two other adopted children. But he was a bachelor, living on his own, when he adopted Adam, a 3yearold Sioux Indian boy, in 1971. Dorris, himself half Native American, had been warned that Adam was undersize and slow, had been the victim of neglect by alcoholic parents and had "failed to thrive". But Dorris felt sure that he could nurture the boy back to normalcy.

There is no way, though, to undo the damage done in uterine to any FAS or FAE child. Adam, a beautiful but strange child, from the start combined a minimal vocabulary with a huge capacity for affection. He was extremely skinny, thoroughly uninterested in toilet training and, eventually, given to epileptic seizures. Doctors and psychologists around Dartmouth couldn't put a label on the problem, but when Dorris showed a photograph of Adam to a family counsellor who worked with Native Americans, the man took one look at the boy's small head, flat nose and droopy eyes and said, "FAS, huh?" It's not surprising that Dorris would begin learning about the affliction on an Indian reservation. For reasons that may involve genes, peer pressure and poverty, Native Americans have an alcoholism rate about five times greater than the population as a whole, and, according to some estimates, a quarter of the children born on reservations show signs of Foetal Alcohol Effect. The situation there is even bleaker than it first seems, says Dorris, because girls born with the "poor judgement" that characterises FAE victims, "just can't understand the message about staying sober while pregnant." In order to break the cycle that causes the number of FAE people to increase exponentially, some reservations (which are not wholly bound by the restraints of the U.S. Constitution) have begun locking up pregnant women who refuse to stop drinking a move that Dorris and his wife, who is also half Indian, strongly support.

Breast milk: If the problem is less severe off the reservation, it's not because it is being handled with greater intelligence. Many doctors who were trained years ago and have not kept up with the research are still telling women it's OK to have a drink or two each night. And some outdated La Leche League literature still in circulation encourages nursing women to drink beer to encourage the flow of breast milk even though the alcohol it contains can damage an infant's development. Despite all that, Dorris remains optimistic. Not much can be done for Adam, who has been able to live away from home and hold down a series of dishwasher jobs with only limited success. Yet the writer notes that, unlike AIDS and other serious disorders, FAS and FAE are, in theory, totally preventable through education. Beginning in November, in fact, Federal law will require all alcoholic beverages to carry warnings about birth defects and other hazards of drinking.

One thing Dorris has learned, though, is that many people have their own very private relationship with alcohol into which they resent any intrusion. In ‘The Broken Cord' he tells how, when he overheard a pregnant woman order a martini at an airport restaurant, he asked her to reconsider. She told him to mind his own business, and then, when the drink arrived, smiled sarcastically in his direction and said, "Cheers".

by Charles Leerhsen

with Elizabeth Schaefer

Source: ‘Newsweek', August 21, 1989