The idea that foetal alcohol syndrome is a working-class condition has been turned on its head, with more research showing that children of middle-class mothers are also being affected by alcohol use in pregnancy.
”Now that we’re getting better at measuring the [foetal alcohol] spectrum, more and more of this is coming out of the woodwork,” says Professor Colleen Adnams, an expert on the subject and lecturer in the University of Cape Town’s department of psychiatry and mental health.
Because the educated middle-class is not considered a high-risk group for foetal alcohol spectrum disorders (FASD) — a range of permanent birth defects caused by exposure to alcohol while in the womb — little research has been done locally in this area. But studies in Europe and the United States have questioned whether FASD is more common than previously estimated. A recent study conducted in Italy found that the incidence of FASD was about five times higher among middle-class schoolchildren than previously thought.
As middle-class women are usually healthy and well nourished, their babies are better protected against the effects of alcohol, so they may not suffer from full-blown FASD. But the effect is still there. ”It’s just less severe,” says Adnams. Although they may not have the distinctive facial features of a child with foetal alcohol syndrome, these children can suffer from developmental, behavioural and learning problems, lower IQs, inattention and hyperactivity.
Adnams says many cases of attention-deficit hyperactivity disorder or behavioural problems in children can be traced back to alcohol and smoking. ”The two are a very bad combination,” she says.
And you don’t have to be falling-down drunk for alcohol to affect your baby. For a pregnant woman ”four or five drinks on one occasion a week is heavy drinking, two drinks or more a day is heavy drinking”, says Professor Dennis Viljoen of the Foundation for Alcohol-related Research.
Professor Kirstie Rendall-Mkosi, an occupational therapist with the University of Pretoria, says many women drink into pregnancy without realising it.
”They may be able to give up using alcohol once they know they’re pregnant, but there’s a good few months when they may not know that they’re pregnant — and they’ve done damage [to their babies] without realising it.”
For Adnams and many of her colleagues the solution is simple. ”If you are sexually active, of child-bearing age and not on family planning you should not be drinking.”
”Why take a chance?” asks Viljoen. ”Your child might appear normal, but he may [have functioned] better without being exposed to alcohol.”