Management of the Neonate whose Mother has been Using or Abusing Alcohol During Pregnancy

1. These infants are at risk of Fetal Alcohol Syndrome or Fetal Alcohol Effect.
   Fetal Alcohol Syndrome is difficult to diagnose in the newborn period.
2. They are also at risk of withdrawal particularly if the mothers are drinking alcohol during labour and delivery.
3. There is also the risk of respiratory depression in these circumstances.

• Paediatric attendance is recommended at delivery. The initial assessment should include careful head, length and body weight measurements and any dysmorphic features should be noted. The baby would normally be able to go to the postnatal ward with the mother.
• Urine toxicology is recommended (there may be polydrug abuse).
• Consider using a drug withdrawal nursing chart as for narcotic withdrawal.
• Paediatric Consultant review should be arranged non-urgently.
  • Drs Simon Rowley and Carl Kuschel are the specialists who primarily evaluate these infants in the newborn period.

Follow Up Arrangements

These may need to be in conjunction with Social Services if already involved.  Social work evaluation is usually required to look at child protection issues.  Referral of mother to a detoxification programme may be appropriate.

• Paediatric Clinic at four months of age and at one year.
• Parents should be made aware of potential late effects of alcohol, e.g. attention difficulties and where to seek help if concerned.

More protracted follow up although desirable, is probably not practical.

If neurodevelopmental problems are evident, then appropriate referral to Child Development Services should be made.

If you cannot see an index above, please press the "Refresh" button of your browser.