Welcome to day 8 of our 99 day journey of all things FASD. Today’s fact is a surprise to some people – that the physical features visible in those with what is referred to as Fetal Alcohol Syndrome or FAS (still a diagnostic term in many countries) will occur only if alcohol is consumed within a 2 – 3 day period of pregnancy. (I’ve heard days 19, 20 and 21). See 2018 update below which shows alcohol consumption on Day 19, 20, 21 can cause smooth philtrum and thin upper lip and on day 32, 33, 34, 35 can cause small palpebral fissures.
What does this mean? It means many people born without the visible features often go undiagnosed, misdiagnosed and/or are misunderstood because they have no visible characteristics. Different countries are updating their guidelines for diagnosis and the terms they use.
Most do use the term FASD to encompass the group of conditions that occur in a person without the facial characteristics. However visible characteristics, facial features or no visible characteristics, FASD is FASD. Visible features do not define the severity of how a person will be affected.
In fact, people without facial characteristics have a more difficult time because outwardly they look “typical” so expectations are that they can perform “typically”. FASD is more than the “face”: it is a whole body disorder (more on that later in our journey).
The following quote is from Pregnancy Birth and Beyond an Australian website:
Much of the research that has been conducted has been in North America by researchers such as Professors Sterling Clarren, Susan Astley and Ab Chudley. Sterling Clarren’s primate and mouse research on alcohol and pregnancy found that the lip and philtrum anomaly of (full) FAS occurred in a very small window of time which would be on the 19th to 20th day after conception in the human – the period called gastrulation. Since the diagnosis of FAS depends on having the full set of facial features then it is likely that only exposures that include the 19th or 20th day will attract the diagnosis of FAS. However, a child can still have a serious brain injury.
2018 Update: This was shared by the FASD Network of Saskatchewan (Canada) on their Facebook page:
We constantly get asked what people with FASD ‘look like.’ While there are characteristic facial features, an individual will only develop them if alcohol is consumed during certain days of the pregnancy so the majority of individuals with FASD live with an invisible disability. In fact, 90% of individuals with FASD do not have the physical features.
The above information I was told by the Network was shared by Dr. Mansfield Mela.
Most times this information is presented there is no source. It likely stems from what is known about developmental stages. My efforts to find a citable source are ongoing. If you know of one that can be added to this post, please leave a comment!
Visit tomorrow for the 9th day in the 99 Days to FASDay journey!
More facts, tips, quotes, research and interesting information is on the way.