The National Institute for Health and Care Excellence has published new standards for the diagnosis and assessment of fetal alcohol spectrum disorder.
Fetal alcohol spectrum disorder can occur when a mother drinks alcohol during pregnancy and the baby showcases mental and physical problems. It occurs when the alcohol in the mother’s blood passes to her baby through the placenta. Characteristics of this disorder include hyperactivity, speech problems and problems with movement.
The new standards, published on the 16th of March 2022, address how health and care services can improve the diagnosis, assessment, and prevention of fetal alcohol spectrum disorder. It also covers support during pregnancy to prevent this condition.
Support for avoiding alcohol in pregnancy
The quality standards focus on how to support expecting women in avoiding alcohol consumption during their pregnancy. It outlined two components to achieve this:
- Ensuring midwives and other healthcare professionals that carry out antenatal appointments are aware of the risks of drinking alcohol in pregnancy, including fetal alcohol spectrum disorder.
- Evidence of local arrangements to ensure that antenatal appointments include discussions of risks of drinking alcohol in pregnancy.
Emphasis on the importance of clear advice for pregnant women to not drink alcohol is necessary to reiterate the implications it can have on babies. The standards also note that pregnant women should be asked about their alcohol use through pregnancy, and this must be recorded in maternity records. This is essential to encourage tailored support and interventions, especially if the woman expresses she would like to cut down or stop drinking. Women wanting to discuss their alcohol use should be asked about the quantity, frequency, and pattern of drinking.
“Helping women to drink less or no alcohol during their pregnancy will reduce the number of children and young people affected by FASD,” commented Dr Paul Chrisp, director of NICE’s Centre for guidelines.
Support children with fetal alcohol spectrum disorder
The guidance defines ways in which children should be supported with their fetal alcohol spectrum disorder. It states that children and young people should be referred to a healthcare professional with specialist training if they present characteristics of the condition.
NICE also asks for evidence that local arrangements to increase awareness of fetal alcohol spectrum disorder among healthcare professionals and further evidence is needed to show whether local services with healthcare professionals have additional training in fetal alcohol spectrum disorder.
Furthermore, children and young people with confirmed prenatal alcohol exposure or all three facial features associated with fetal alcohol spectrum disorder should have a neurodevelopmental assessment if there are clinical concerns. This will be measured by the number of healthcare professionals in the local area with expertise in neurodevelopmental assessments and fetal alcohol spectrum disorder.
The standards also state that children and young people with a diagnosis of fetal alcohol spectrum disorder have a management plan to address their needs. This plan should be individualised, setting out intervention and support needs that were identified during the assessment and diagnosis of the disorder. The plan should point towards support and resources for the child and their family.
Dr Paul Chrisp, director of NICE’s centre for guidelines, said: “We know children and young people with FASD often have a poorer quality of life and must overcome some incredibly difficult challenges in their daily lives.
“This quality standard aims to improve the diagnosis and care offered to children and young people with FASD as well as ensuring that women are given consistent advice about their alcohol consumption during pregnancy.
“FASD is a series of preventable mental and physical birth defects associated with alcohol use during pregnancy. Helping women to drink less or no alcohol during their pregnancy will reduce the number of children and young people affected by FASD.
“Data on the number of children and young people in the UK with FASD are limited, with no single reliable source. It’s important that we have clearly defined areas for improvement in place to reflect national priorities, promote best practice and help all those involved in delivering services to provide the very highest levels of care.”
