Management of the Neonate
whose Mother has been Using or Abusing Alcohol During Pregnancy
Alcohol is a teratogen. There is no known safe amount of alcohol, or time
to drink alcohol, in pregnancy. If a mother identifies herself or is
identified during pregnancy as posing a risk to the fetus, the the
management should be as follows.
These infants are at risk of Fetal Alcohol Spectrum Disorder.
This includesFetal Alcohol Effect,Fetal Alcohol Syndrome and
Alcohol Related Neurodevelopmental Disorders.
Fetal Alcohol Spectrum Disorder is difficult to diagnose in the newborn period.
They are also at risk of withdrawal
particularly if the mothers are drinking alcohol during labour and delivery.
The prevalence is thought to be 1%, although no local data exists and it
is thought to be underestimated.
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
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 Mariam Buksh are the specialists who primarily evaluate
these infants in the newborn period.
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
and for referral of mother to a
detoxification programme if 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
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