Sunday, September 28, 2003

Official says pregnancy
is no time for alcohol

A specialist says that the only
safe amount to consume is none

A pregnant woman who drinks alcohol can damage her child's brain and no amount is safe to drink, says a national specialist on fetal alcohol.

"There is no way to say a certain amount might be safe, so the only safe amount to drink is none," emphasizes Dan Dubovsky, with the Substance Abuse and Mental Health Services Administration's Fetal Alcohol Syndrome Center for Excellence in Rockville, Md.

He will speak at a series of meetings with pediatricians, health, human services and justice system professionals tomorrow through Friday on Oahu, Maui, Kauai and the Big Island.

The public, policymakers and people concerned with developmental disabilities are invited to a presentation from 3 to 5 p.m. tomorrow in the State Capitol auditorium. The topic: "Improving the Quality of Life for Individuals Who Struggle with School, Work and/or Relationships: Exploring the Reasons and Responses."

Fetal Alcohol Spectrum Disorder (FASD) is a developmental disability caused by prenatal alcohol exposure.

Some people have difficulties throughout life because of unrecognized prenatal alcohol damage, Dubovsky said in a telephone interview from Maryland.

"We know it (fetal alcohol damage) exists and it's totally preventable but we're pretty much ignoring it as an issue," said Nancy Partika, executive director of the Healthy Mothers Healthy Babies Coalition of Hawaii, which is sponsoring the information series with the state Health Department's Maternal and Child Health Branch and other organizations.

Partika said there are almost no statistics on Fetal Alcohol Spectrum Disorder. Only 85 cases have been reported to Hawaii's birth defects registry since 1986, she said, "and it is probably the most common developmental disability, if the state was prepared to diagnose it."

Many special-needs kids covered by the Felix consent decree, people in prisons and foster homes and the homeless population may be affected by fetal alcohol, Partika said.

"How many children and adults are out there with FASD who are not diagnosed and haven't been helped?" she asked.

The effects can last a lifetime and there is no cure, but people with fetal alcohol exposure can do well with intervention, Dubovsky said.

For instance, he said his son had fetal alcohol disorder and used to say, "My brain doesn't work." Dubovsky said he told his son, "Your brain works but it works differently than other people's. We need to help your brain work as best as we can."

Dr. Jeffrey Okamoto, developmental behavioral pediatrician at KapiolanI Medical Center for Women and Children, said children are referred to his clinic with suspected mental retardation, autism, hyperactivity and inattention.

"Fetal alcohol kind of covers the gamut," he said.

Okamoto, pediatrics professor at the University of Hawaii John A. Burns School of Medicine, said children who have severe Fetal Alcohol Spectrum Disorders often have characteristic facial features. They often include small heads and a smooth or indistinct philtrum, the area between the upper lip and the nose, he said.

But some kids exposed to prenatal alcohol might not have distinctive facial features, he said, "and we can't tell if they have developmental problems."

He said diagnosis of suspected FASD cases is difficult because some mothers will deny that they ever drank during pregnancy and others will say they only drank a small amount.

"It is kind of a delicate issue. How do you call a child 'Fetal Alcohol Syndrome' if a mother denies drinking?"

According to studies, about 75 percent of people with the disorder have mild to moderate developmental delay or mental retardation. But most people with FAS don't have mental retardation, Dubovsky said.

They may be poorly coordinated, hyperactive, impulsive and easily distracted, have language problems and impaired social skills, he said.

Often, kids and adolescents with fetal alcohol exposure appear to be defiant but they can't follow multiple directions and don't know what to do, he said. "They're not really oppositional. They just need one direction at a time ... If we break it down, they can often be much more successful."

Some children in regular education classes have behavioral problems and "no one has really identified that (fetal alcohol) as the reason," Okamoto said.

He said there aren't enough resources to address the problems of fetal alcohol exposure, but the earlier affected people are identified, the earlier they can get help.

Besides hurting the fetus, drinking alcohol during pregnancy can cause miscarriages and premature births, Okamoto pointed out.

He said a preventative health campaign is needed to reduce Fetal Alcohol Spectrum Disorders and "take care of problematic kids who have not been identified but are in schools."

"There is a lot of shame and blame" about fetal alcohol disorders, Dubovsky said, stressing that the problem must be discussed "so there's not a question of blame. Women don't set out to harm children."


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