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Think it might be FASD?

Ask us, please

We want to provide you with all the information you need to give birth to a healthy child. Our most frequently asked questions and answers are below.

Contact us with further questions, and we’ll have more answers.

What is FASD?

Briefly, FASD or fetal alcohol spectrum disorders is an umbrella term describing the range of birth defects that are caused by prenatal alcohol exposure.  Prenatal alcohol exposure, or drinking alcohol during pregnancy, can cause lifelong mental, behavioral and/or learning disabilities. For a more detailed understanding, click here.

Providing information and education about FASD is an important part of our mission.  We’ve created free, printable PDF fact sheets and strategy guides for you to use and share with others.

FAQs

What are the symptoms of FASD?

Only trained professionals can make an FASD diagnosis. FASD is often misdiagnosed because many of the characteristics look similar to mental health disorders.

Signs to look for that may indicate the need for an FASD assessment include:

  • Hearing or vision problems1, 2
  • Difficulty in school3
  • Poor coordination4
  • Sensitivity to light, touch, or sound5
  • Hyperactive behavior6
  • Difficulty paying attention7
  • Memory issues8
  • Poor social skills9
  • Impulsivity10
  • Poor reasoning and judgment skills11

Click here for a printable fact sheet on FASD.

What causes FASD?

Alcohol. The only known cause of FASD is prenatal alcohol exposure (alcohol use during pregnancy). Alcohol is a teratogen that crosses the placenta and can damage the central nervous system (including the brain) and other organs of the developing embryo/fetus.12

No more than two hours after maternal ingestion, the blood alcohol level of the fetus is the same as or higher than the mother’s.13

Prenatal alcohol exposure is the leading preventable cause of birth defects in the United States.14 Prenatal alcohol exposure can cause a number of birth defects, including:

  • Microcephaly, a condition in which the baby’s head and brain are significantly smaller than expected15, 16
  • Abnormal facial development in the lip, mid-face, and eyes17
  • Structural brain changes18, 19

The effects of prenatal alcohol exposure are lifelong and can include FASD, a brain-based permanent disability that has wide-ranging effects. 20-24 Prenatal alcohol exposure may result in cognitive deficits related to executive function, learning, attention, language, memory, and visual spatial reasoning.25,26

Because there is no known amount of alcohol that can be considered safe during pregnancy, it is advised by all major medical associations, including the Centers for Disease Control27, the American Academy of Pediatrics28, and the U.S. Surgeon General29, that if a person is pregnant or could become pregnant, they should abstain from drinking alcohol.

Click here for a printable fact sheet about how alcohol affects pregnancy.

What's the difference between FASD & Autism?

Fetal alcohol spectrum disorders (FASD) and autism spectrum disorders (ASD) have a number of overlapping characteristics. They are both neurodevelopmental disabilities that can affect brain function, development, behavior, and social interaction.30, 31 Not only do children with FASD often display a number of autistic-like characteristics, but children with high levels of prenatal alcohol exposure are at an increased risk for autism. One study found that as many as 72% of children with Fetal Alcohol Syndrome also met criteria for autism.32 However, there are a number of differences between the two spectrum disorders. Below we have outlined some of the common characteristics associated with both FASD and ASD. We have italicized the similar characteristics shared between the two disorders. Please note that both FASD and ASD are spectrum disorders, meaning that each case is unique and people on either spectrum may display some, all, or none of these characteristics.

Fetal alcohol spectrum disorders (FASD):

  • Affects about 1 in 20 children33
  • One known cause: prenatal alcohol exposure34
  • Lifelong effects 35
  • Outcomes can be improved by early intervention36
  • Sensitivity to light, touch, taste, smells, or sound37
  • Associated with microcephaly (a condition in which the baby’s head and brain are significantly smaller than expected)38
  • Often comfortable initiating conversations and joining social activities39
  • Difficulty with change in routines or transitioning from one task to another 40
  • Deficits with speech and language skills 41
  • Hyperactivity 42
  • Impulsivity 43
  • Short attention span 44
  • May have difficulty in school 45
  • Listed as a medical condition in the ICD-10 (International Statistical Classification of Diseases and Related Health Problems)46
  • Not included in the  American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

Autism spectrum disorders (ASD):

  • Affects about 1 in 59 children47
  • Has no single known cause48
  • Lifelong effects49
  • Outcomes can be improved by early intervention 50
  • Sensitivity to light, touch, taste, smells, or sound 51
  • Associated with macrocephaly (a condition in which the baby’s head is significantly larger than expected)52
  • Often avoid social situations53
  • Difficulty with change in routines or transitioning from one task to another54
  • Increased risk of epilepsy and seizures55
  • Deficits with speech and language skills56
  • Repeat words or phrases over and over (known as echolalia)57
  • Uses repetitive motions (such as flapping hands, rocking body, or spinning in circles)58
  • Hyperactivity 59
  • Impulsivity 60
  • Short attention span61
  • May have difficulty in school 62
  • Listed as a medical condition in the ICD-10 (International Statistical Classification of Diseases and Related Health Problems) 63
  • Included in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5)64

Click here for a printable fact sheet about FASD and Autism.

Is FASD hereditary?

The only known cause of fetal alcohol spectrum disorders (FASD) is alcohol use during pregnancy.65 If a pregnant person does not drink any alcohol throughout their entire pregnancy, their child will not be born with an FASD.

FASD cannot be “passed down” from a parent with an FASD, and it cannot be caused by a partner’s drinking. FASD can be prevented by not drinking any alcohol throughout pregnancy, from conception to birth.66-70

Can a partner cause an FASD?

Your partner’s alcohol use cannot cause your child to be born with an FASD; the only known cause of FASD is prenatal alcohol exposure that occurs when a pregnant person drinks.107-109 However, a partner can be supportive by encouraging the pregnant person not to drink alcohol and by abstaining from alcohol themselves. Enjoy a delicious mocktail together and request alcohol-free drinks when you go to restaurants or social gatherings.

Click here for a fact sheet on the father’s role during pregnancy.

Is there a cure for FASD?

There currently is not a cure for fetal alcohol spectrum disorders (FASD). Because prenatal alcohol exposure can change how the brain develops over the lifetime, the effects are lifelong.71-74 Even drinking at low levels can affect development.75

However, everyone with an FASD has the ability to succeed. Strategies, support, and interventions can help reduce the long-term effects of prenatal alcohol exposure and improve outcomes, behavior, and well-being for people with an FASD.73 Early intervention is especially effective in decreasing the risk of adverse life outcomes.76

How many people have an FASD?

Prenatal alcohol exposure is the leading preventable cause of birth defects in the United States.77 In the United States, up to 1 in 20 children has a fetal alcohol spectrum disorder (FASD).78 This makes FASD more common than spina bifida, anencephaly, and trisomy 18.79 FASD is also more common than autism, which affects 1 in 59 children.80

  • FASD is caused by prenatal alcohol exposure, or alcohol use during pregnancy.81
  • Over 1 in 9 babies are born with prenatal alcohol exposure each year–that’s an estimated 8,000 a year in Minnesota.82, 83
  • Experts estimate that 3,400 of the children born in Minnesota each year will have an FASD.84

Click here for a printable fact sheet about FASD in Minnesota.

How do I know if I or my child has an FASD?

The only way to determine if you have a fetal alcohol spectrum disorder (FASD) is to receive an FASD assessment. Only trained professionals can make an FASD diagnosis. FASD is often misdiagnosed because many of the characteristics look the same as mental health disorders. Take the test to find out if you have signs of an FASD. If you think you might have an FASD and want to learn more about the FASD assessment process, visit our Diagnosis page for more information.

What is an FASD assessment? Where can I get one done?

Proof Alliance and other clinics in Minnesota offer FASD evaluation services.  You can find out more about the process, what is needed, and where to go, by visiting our Diagnosis page.

Is there a safe amount of alcohol to drink during pregnancy?

There is no known safe amount of alcohol during pregnancy.85 Even drinking at low levels can affect fetal development.86 This is because alcohol is a teratogen that crosses the placenta and can damage the central nervous system (including the brain) and other organs of the developing embryo/fetus.87 No more than two hours after maternal ingestion, the blood alcohol level of the fetus is the same as or higher than the mother’s.85

Harmful effects from prenatal alcohol exposure have been well-documented.88-90 This includes physical birth defects and brain-based disabilities.91-96 The risks posed to the fetus increase as maternal alcohol use rises.97 Overall, the scientific community continues to advise that the healthiest and safest choice is to abstain from alcohol during pregnancy – from conception through birth. 98-104

Click here for a printable fact sheet about how much alcohol is safe to drink during pregnancy.

Is it safe to drink alcohol while nursing?

Alcohol in breast milk can impact a baby’s sleep patterns, growth, and development.105 Because of this, the safest choice is not to drink while nursing and to choose an alcohol-free beverage instead. If you do choose to drink alcohol, the American Academy of Pediatrics (AAP) states that it is safer to do so just after you have nursed or expressed milk rather than before.106 The AAP also suggests waiting at least 2 hours per drink before the next nursing or pumping session.  If you or your partner are concerned about alcohol use while nursing, speak to your health care provider.

View sources

1 Stephen JM, Kodituwakku PW, Kodituwakku EL, Romero L, Peters AM, Sharadamma NM, Caprihan A, Coffman BA. Delays in auditory processing identified in preschool children with FASD. Alcoholism, Clinical and Experimental Research. 2012;36(10):1720-1727.

2 Vernescu RM, Adams RJ, Courage ML. Children with fetal alcohol spectrum disorder show an amblyopia-like pattern of vision deficit. Developmental Medicine and Child Neurology. 2012;54(6):557-562.

3 Glass L, Moore EM, Akshoomoff N, Jones KL, Riley EP, Mattson SN. Academic difficulties in children with prenatal alcohol exposure: Presence, profile, and neural correlates. Alcoholism: Clinical and Experimental Research. 2017;41(5):1024-1034.

4 Taggart TC, Simmons RW, Thomas JD, Riley EP. Children with Heavy Prenatal Alcohol Exposure Exhibit Atypical Gait Characteristics. Alcoholism: Clinical & Experimental Research. 2017;41(9):1648-1655.

5 Masotti P, Longstaffe S, Gammon H, Isbister J, Maxwell B, Hanlon-Dearman A. Integrating care for individuals with FASD: results from a multi-stakeholder symposium. BMC Health Services Research. 2015;15(1):1-12.

6 Young S, Absoud M, Blackburn C, Branney P, Colley B, Farrag E, & … Mukherjee R. Guidelines for identification and treatment of individuals with attention deficit/ hyperactivity disorder and associated fetal alcohol spectrum disorders based upon expert consensus. BMC Psychiatry. 2016; 16(1):324.

7 Flak AL, Su S, Bertrand J, Denny CH, Kesmodel US, Cogswell ME. The association of mild, moderate, and binge prenatal alcohol exposure and child neuropsychological outcomes: A Meta-analysis. Alcohol Clin Exp Res. 2014;38(1):214-26.

8 Terasaki LS, Schwarz JM. Impact of Prenatal and Subsequent Adult Alcohol Exposure on Pro-Inflammatory Cytokine Expression in Brain Regions Necessary for Simple Recognition Memory. Brain Sciences (2076-3425). 2017;7(10):1-16.

9 Panczakiewicz AL, Glass L, Coles CD, et al. Neurobehavioral deficits consistent across age and sex in youth with prenatal alcohol exposure. Alcoholism: Clinical and Experimental Research. 2016;40(9):1971-1981.

10 Pei J, Leung WSW, Jampolsky F, Alsbury B. Experiences in the Canadian criminal justice system for individuals with Fetal Alcohol Spectrum Disorders: Doublejeopardy?. Canadian Journal of Criminology & Criminal Justice. 2016;58(1):56-86.

11 Rangmar J, Dahlgren Sandberg A, Aronson M, Fahlke C. Cognitive and executive functions, social cognition and sense of coherence in adults with fetal alcohol syndrome. Nordic Journal of Psychiatry. 2015;69:472-478.

12 Fitzpatrick JP, Pestell CF. Neuropsychological Aspects of Prevention and Intervention for Fetal Alcohol Spectrum Disorders in Australia. Journal of Pediatric Neuropsychology. 2017;3(1):38-52.

13 Burd L, Blair J, Dropps K. Prenatal alcohol exposure, blood alcohol concentrations and alcohol elimination rates for the mother, fetus and newborn. Journal of Perinatology. 2012;32(9):652-659.

14 Williams JF, Smith VC. Fetal Alcohol Spectrum Disorders. Pediatrics. 2015;136(5):e1395-406.

15 Feldman HS, et al. Prenatal Alcohol Exposure Patterns and Alcohol-Related Birth Defects and Growth Deficiencies: A Prospective Study. Alcohol Clin Exp Res. 2012;36(4):670-676.

16 Treit S, Zhou D, Chudley AE, et al. Relationships between Head Circumference, Brain Volume and Cognition in Children with Prenatal Alcohol Exposure. PLoS ONE. 2016;11(2):1-15.

17 Sawada Feldman H, Lyons Jones K, Lindsay S, et al. Prenatal Alcohol Exposure Patterns and Alcohol-Related Birth Defects and Growth Deficiencies: A Prospective Study. Alcoholism: Clinical & Experimental Research. 2012;36(4):670-676.

18 Muralidharan P, Sarmah S, Feng C. Zhou, Marrs JA. Fetal Alcohol Spectrum Disorder (FASD) Associated Neural Defects: Complex Mechanisms and Potential Therapeutic Targets. Brain Sciences (2076-3425). 2013;3(2):964-991.

19 Lewis SM, Vydrová RR, Leuthold AC, Georgopoulos AP. Cortical miscommunication after prenatal exposure to alcohol. Experimental Brain Research. 2016;234(11):3347-3353.

20 Noor S, Milligan ED. Lifelong Impacts of Moderate Prenatal Alcohol Exposure on Neuroimmune Function. Frontiers in Immunology. 2018.

21 Burd L, Blair J, Dropps K. Prenatal alcohol exposure, blood alcohol concentrations and alcohol elimination rates for the mother, fetus and newborn. Journal of Perinatology. 2012;32(9):652-659.

22 Rodríguez JJ., Smith VC. Prenatal Opioid and Alcohol Exposure: Understanding Neonatal Abstinence Syndrome and Fetal Alcohol Spectrum Disorders to Safeguard Maternal and Child Outcomes. Zero to Three. 2018;38(5):23-28.

23 Rutman D. Becoming FASD Informed: Strengthening Practice and Programs Working with Women with FASD. Substance Abuse: Research & Treatment. 2016;10:13-20.

24 Girault V, et al. Prenatal Alcohol Exposure Impairs Autophagy in Neonatal Brain Cortical Microvessels. Cell Death & Disease. 2017; 8(e2610).

25 Subramoney S, Eastman E, Adnams C, Stein DJ, Donald KA. The Early Developmental Outcomes of Prenatal Alcohol Exposure: A Review. Frontiers in Neurology. 2018; 9(1108).

26 Gross AC, Deling LA, Wozniak JR, Boys CJ. Objective measures of executive functioning are highly discrepant with parent-report in fetal alcohol spectrum disorders. Child Neuropsychology. 2015;21(4): 531-538.

27 Centers for Disease Control and Prevention. Fetal Alcohol Spectrum Disorders (FASDs). https://www.cdc.gov/ncbddd/fasd/alcohol-use.html

28 American Academy of Pediatrics. AAP Says No Amount of Alcohol Should Be Considered Safe During Pregnancy. https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/AAP-Says-No-Amount-of-Alcohol-Should-be-Considered-Safe-During-Pregnancy.aspx

29 Centers for Disease Control and Prevention. Notice to Readers: Surgeon General’s Advisory on Alcohol Use in Pregnancy. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5409a6.htm

30 Redei EE, Zoeller RT. Fetal alcohol spectrum disorders and autism spectrum disorders share common molecular vulnerabilities. https://www.eurekalert.org/pub_releases/2013-06/ace-fas060613.php

31 Geib EF. Neurodevelopmental disorders: an overview of autism spectrum disorder and fetal alcohol spectrum disorder. https://www.ihs.gov/telebehavioral/includes/themes/newihstheme/display_objects/documents/slides/nationalchildandadolescent/childneurodevfasd091217.pdf

32 Mukherjee RAS, Layton M, Yacoub E, Turk J. Autism and autistic traits in people exposed to heavy prenatal alcohol: Data from a clinical series of 21 individuals and nested case control study. Advances in Mental Health and Intellectual Disabilities. 2011;5(1):42-49.

33 May et al. Prevalence of Fetal Alcohol Spectrum Disorders in 4 US Communities, JAMA. 2018;319 (5):474-482.

34 Burd L, Blair J, Dropps K. Prenatal alcohol exposure, blood alcohol concentrations and alcohol elimination rates for the mother, fetus and newborn. Journal of Perinatology. 2012;32(9):652-659.

35 Noor S, Milligan ED. Lifelong Impacts of Moderate Prenatal Alcohol Exposure on Neuroimmune Function. Frontiers in Immunology. 2018.

36 Peadon E, Rhys-Jones B, Bower C, Elliott EJ. Systematic Review of Interventions for Children with Fetal Alcohol Spectrum Disorders. BMC Pediatrics. 2009;9(35).

37 Masotti P, Longstaffe S, Gammon H, Isbister J, Maxwell B, Hanlon-Dearman A. Integrating care for individuals with FASD: results from a multi-stakeholder symposium. BMC Health Services Research. 2015;15(1):1-12.

38 Treit S, Zhou D, Chudley AE, et al. Relationships between Head Circumference, Brain Volume and Cognition in Children with Prenatal Alcohol Exposure. PLoS ONE. 2016;11(2):1-15.

39 Stevens SA, Nash K, Koren G, Rovet J. Autism characteristics in children with fetal alcohol spectrum disorders. Child Neuropsychology. 2013;19(6):579-587.

40 Millar JA, Thompson J, Schwab D, et al. Educating students with FASD: linking policy, research and practice. Journal of Research in Special Educational Needs. 2017;17(1):3-17.

41 Subramoney S, Eastman E, Adnams C, Stein DJ, Donald KA. The Early Developmental Outcomes of Prenatal Alcohol Exposure: A Review. Frontiers in Neurology. 2018; 9(1108).

42 Peadon E, Elliott EJ. Distinguishing between attention-deficit hyperactivity and fetal alcohol spectrum disorders in children: clinical guidelines. Neuropsychiatr Dis Treat. 2010;6:509–515.

43 Pei J, Leung WSW, Jampolsky F,  Alsbury B. Experiences in the Canadian criminal justice system for individuals with Fetal Alcohol Spectrum Disorders: Double jeopardy?. Canadian Journal of Criminology & Criminal Justice. 2016;58(1):56-86.

44 Gross AC, Deling LA, Wozniak JR, Boys CJ. Objective measures of executive functioning are highly discrepant with parent-report in fetal alcohol spectrum disorders. Child Neuropsychology. 2015;21(4): 531-538.

45 Glass L, Moore EM, Akshoomoff N, Jones KL, Riley EP, Mattson SN. Academic difficulties in children with prenatal alcohol exposure: Presence, profile, and neural correlates. Alcoholism: Clinical and Experimental Research. 2017;41(5):1024-1034.

46 American Academy of Pediatrics. Fetal alcohol syndrome. https://www.aap.org/en-us/professional-resources/practice-transformation/getting-paid/Coding-at-the-AAP/Pages/Fetal-Alcohol-Syndrome.aspx

47 Centers for Disease Control and Prevention. Data and statistics on autism spectrum disorder. https://www.cdc.gov/ncbddd/autism/data.html

48 Mayo Clinic. Autism spectrum disorder. https://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/symptoms-causes/syc-20352928

49 Autism Society. Autism through the lifespan. http://www.autism-society.org/living-with-autism/autism-through-the-lifespan/

50 National Autistic Society. Sensory differences. https://www.autism.org.uk/about/behaviour/sensory-world.aspx

51 Christensen D, Bilder D, Zahorodny W, et al. Prevalence and Characteristics of Autism Spectrum Disorder Among 4-Year-Old Children in the Autism and Developmental Disabilities Monitoring Network. Journal of Developmental and Behavioral Pediatrics. 2016;37:1-8.

52 Klein S, Sharifi-Hannauer P, Martinez-Agosto JA. Macrocephaly as a clinical indicator of genetic subtypes in autism. Autism Res. 2013;6(1):51–56. doi:10.1002/aur.1266

53 Aksoy F aksoy. fnd@gmail. co. Severity Levels of Autism, Social Interaction Behaviours and School Adjustment of Pre-School Children with Autism Spectrum Disorder. International Journal of Early Childhood Special Education. 2018;10(1):1-10.

54 Indiana Resource Center for Autism. Transition time: Helping individuals on the autism spectrm move successfully from one activity to another. https://www.iidc.indiana.edu/pages/transition-time-helping-individuals-on-the-autism-spectrum-move-successfully-from-one-activity-to-another

55 Besag FMC. Epilepsy in patients with autism: Links, risks and treatment challenges. Neuropsychiatric Disease and Treatment. 2018;14:1-10.

56 Yau SH, Brock J, McArthur G. The relationship between spoken language and speech and nonspeech processing in children with autism: a magnetic event-related field study. Developmental Science. 2016;19(5):834-852.

57 Grossi D, Marcone R, Cinquegrana T, Gallucci M. On the differential nature of induced and incidental echolalia in autism. Journal of Intellectual Disability Research. 2013;57(10):903-912.

58 Wolff JJ, Botteron KN, Dager SR, et al. Longitudinal patterns of repetitive behavior in toddlers with autism. Journal of Child Psychology and Psychiatry. 2014;55:945-953.

59 Karalunas SL, Hawkey E, Gustafsson H, et al. Overlapping and Distinct Cognitive Impairments in Attention-Deficit/Hyperactivity and Autism Spectrum Disorder without Intellectual Disability. Journal of abnormal child psychology. 2018;46(8):1705-1716.

60 Tureck K, Matson JL, Cervantes P, Turygin N. Autism severity as a predictor of inattention and impulsivity in toddlers. Developmental Neurorehabilitation. 2015;18(5):285-289.

61 Centers for Disease Control and Prevention. Signs and symptoms of autism spectrum disorders. https://www.cdc.gov/ncbddd/autism/signs.html

62 Hedges SH, Kirby AV, Sreckovic MA, et al. “Falling through the Cracks”: Challenges for High School Students with Autism Spectrum Disorder. The High School Journal. 2014;98:64-82.

63 National Collaborating Centre for Women’s and Children’s Health (UK). Autism: Recognition, Referral and Diagnosis of Children and Young People on the Autism Spectrum. London: RCOG Press; 2011 Sep. (NICE Clinical Guidelines, No. 128.) Appendix I, Diagnostic criteria. Available from: https://www.ncbi.nlm.nih.gov/books/NBK92974/

64 Centers for Disease Control and Prevention. Autism spectrum disorder (ASD): Diagnostic criteria. https://www.cdc.gov/ncbddd/autism/hcp-dsm.html

65 Fitzpatrick JP, Pestell CF. Neuropsychological Aspects of Prevention and Intervention for Fetal Alcohol Spectrum Disorders in Australia. Journal of Pediatric Neuropsychology. 2017;3(1):38-52.

66 Centers for Disease Control and Prevention. Fetal Alcohol Spectrum Disorders (FASDs). https://www.cdc.gov/ncbddd/fasd/alcohol-use.html

67 American Academy of Pediatrics. AAP Says No Amount of Alcohol Should Be Considered Safe During Pregnancy. https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/AAP-Says-No-Amount-of-Alcohol-Should-be-Considered-Safe-During-Pregnancy.aspx

68 Centers for Disease Control and Prevention. Notice to Readers: Surgeon General’s Advisory on Alcohol Use in Pregnancy. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5409a6.htm

69 National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism. Fetal Alcohol Exposure. https://www.niaaa.nih.gov/alcohol-health/fetal-alcohol-exposure

70 World Health Organization. Counting the Costs of Drinking Alcohol During Pregnancy. https://www.who.int/bulletin/volumes/95/5/17-030517/en/

71 Noor S, Milligan ED. Lifelong Impacts of Moderate Prenatal Alcohol Exposure on Neuroimmune Function. Frontiers in Immunology. 2018.

72 Burd L, Blair J, Dropps K. Prenatal alcohol exposure, blood alcohol concentrations and alcohol elimination rates for the mother, fetus and newborn. Journal of Perinatology. 2012;32(9):652-659.

73 Rodríguez JJ., Smith VC. Prenatal Opioid and Alcohol Exposure: Understanding Neonatal Abstinence Syndrome and Fetal Alcohol Spectrum Disorders to Safeguard Maternal and Child Outcomes. Zero to Three. 2018;38(5):23-28.

74 Treit et al. Longitudinal MRI reveals altered trajectory of brain development during childhood and adolescence in fetal alcohol spectrum disorders, Journal of Neuroscience. 2013;33(24):10098-109.

75 Terasaki LS, Schwarz JM. Impact of Prenatal and Subsequent Adult Alcohol Exposure on Pro-Inflammatory Cytokine Expression in Brain Regions Necessary for Simple Recognition Memory. Brain Sciences (2076-3425). 2017;7(10):1-16

76 Peadon E, Rhys-Jones B, Bower C, Elliott EJ. Systematic Review of Interventions for Children with Fetal Alcohol Spectrum Disorders. BMC Pediatrics. 2009;9(35).

77 Williams JF, Smith VC. Fetal Alcohol Spectrum Disorders. Pediatrics. 2015;136(5):e1395-406.

78 May et al. Prevalence of Fetal Alcohol Spectrum Disorders in 4 US Communities. JAMA. 2018;319(5):474-482.

79 Popova S, Lange S, Probst C, Gmel G, and Rehm J. Estimation of National, Regional, and Global Prevalence of Alcohol Use During Pregnancy and Fetal Alcohol Syndrome: A Systematic Review and Meta-analysis. The Lancet Global Health. 2017;5(3), e290-e299.

80 Centers for Disease Control and Prevention. Data & statistics on autism spectrum disorder. https://www.cdc.gov/ncbddd/autism/data.html

81 Fitzpatrick JP, Pestell CF. Neuropsychological Aspects of Prevention and Intervention for Fetal Alcohol Spectrum Disorders in Australia. Journal of Pediatric Neuropsychology. 2017;3(1):38-52.

82 Denny CH, et al. Consumption of alcohol beverages and binge drinking among pregnant women aged 18-44 years — United States, 2015-2017. Morbidity and Mortality Weekly Report (MMWR). 2019;68(16):365-368.

83 2015 Annual MN Births, Minnesota State Demographic Center X percentage of people ages 15-44 who report alcohol use during pregnancy, SAMHSA. (69,835 births*10%)

84 2015 Annual MN Births, Minnesota State Demographic Center X percentage of children estimated to have an FASD, May et al. JAMA study.(69,835 births*5%)

85 Burd L, Blair J, Dropps K. Prenatal alcohol exposure, blood alcohol concentrations and alcohol elimination rates for the mother, fetus and newborn. Journal of Perinatology. 2012;32(9):652-659.

86 Terasaki LS, Schwarz JM. Impact of Prenatal and Subsequent Adult Alcohol Exposure on Pro-Inflammatory Cytokine Expression in Brain Regions Necessary for Simple Recognition Memory. Brain Sciences (2076-3425). 2017;7(10):1-16.

87 Fitzpatrick JP, Pestell CF. Neuropsychological Aspects of Prevention and Intervention for Fetal Alcohol Spectrum Disorders in Australia. Journal of Pediatric Neuropsychology. 2017;3(1):38-52.

88 Treit et al. Longitudinal MRI reveals altered trajectory of brain development during childhood and adolescence in fetal alcohol spectrum disorders, Journal of Neuroscience. 2013;33(24):10098-109.

89 Hendrickson et al. Cortical gyrification is abnormal in children with prenatal alcohol exposure, NeuroImage: Clinical. 2017;15:391-400.

90 Popova S, et al. Comorbidity of Fetal Alcohol Spectrum Disorder: A Systematic Review and Meta-Analysis. The Lancet, 2016;387(10022):5-11.

91 Feldman HS, et al. Prenatal Alcohol Exposure Patterns and Alcohol-Related Birth Defects and Growth Deficiencies: A Prospective Study. Alcohol Clin Exp Res. 2012;36(4):670-676.

92 Treit S, Zhou D, Chudley AE, et al. Relationships between Head Circumference, Brain Volume and Cognition in Children with Prenatal Alcohol Exposure. PLoS ONE. 2016;11(2):1-15.

93 Sawada Feldman H, Lyons Jones K, Lindsay S, et al. Prenatal Alcohol Exposure Patterns and Alcohol-Related Birth Defects and Growth Deficiencies: A Prospective Study. Alcoholism: Clinical & Experimental Research. 2012;36(4):670-676.

94 Muralidharan P, Sarmah S, Feng C. Zhou, Marrs JA. Fetal Alcohol Spectrum Disorder (FASD) Associated Neural Defects: Complex Mechanisms and Potential Therapeutic Targets. Brain Sciences (2076-3425). 2013;3(2):964-991.

95 Lewis SM, Vydrová RR, Leuthold AC, Georgopoulos AP. Cortical miscommunication after prenatal exposure to alcohol. Experimental Brain Research. 2016;234(11):3347-3353.

96 Girault V, et al. Prenatal Alcohol Exposure Impairs Autophagy in Neonatal Brain Cortical Microvessels. Cell Death & Disease. 2017; 8(e2610).

97 May PA et al. Maternal alcohol consumption producing fetal alcohol spectrum disorders (FASD): quantity, frequency, and timing of drinking. Drug and Alcohol Dependence. 2013; 133(2): 502-512.

98 Williams JF, Smith VC. Fetal Alcohol Spectrum Disorders. Pediatrics. 2015;136(5):e1395-406.

99 O’Leary CM, Bower C. Guidelines for pregnancy: What’s an acceptable risk, and how is the evidence (finally) shaping up? Drug & Alcohol Review. 2012;31(2):170-183.

100 Centers for Disease Control and Prevention. Fetal Alcohol Spectrum Disorders (FASDs). https://www.cdc.gov/ncbddd/fasd/alcohol-use.html

101 American Academy of Pediatrics. AAP Says No Amount of Alcohol Should Be Considered Safe During Pregnancy. https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/AAP-Says-No-Amount-of-Alcohol-Should-be-Considered-Safe-During-Pregnancy.aspx

102 Centers for Disease Control and Prevention. Notice to Readers: Surgeon General’s Advisory on Alcohol Use in Pregnancy. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5409a6.htm

103 National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism. Fetal Alcohol Exposure. https://www.niaaa.nih.gov/alcohol-health/fetal-alcohol-exposure

104 World Health Organization. Counting the Costs of Drinking Alcohol During Pregnancy. https://www.who.int/bulletin/volumes/95/5/17-030517/en/

105 Centers for Disease Control and Prevention. Breastfeeding: Alcohol. https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/vaccinations-medications-drugs/alcohol.html

106 American Academy of Pediatrics. Frequently Asked Questions. https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/fetal-alcohol-spectrum-disorders-toolkit/Pages/Frequently-Asked-Questions.aspx#ques24

107 Noor S, Milligan ED. Lifelong Impacts of Moderate Prenatal Alcohol Exposure on Neuroimmune Function. Frontiers in Immunology. 2018.

108 Fitzpatrick JP, Pestell CF. Neuropsychological Aspects of Prevention and Intervention for Fetal Alcohol Spectrum Disorders in Australia. Journal of Pediatric Neuropsychology. 2017;3(1):38-52.

109 Burd L, Blair J, Dropps K. Prenatal alcohol exposure, blood alcohol concentrations and alcohol elimination rates for the mother, fetus and newborn. Journal of Perinatology. 2012;32(9):652-659.