The National Institute for Health and Care Excellence (NICE) has published its first quality standard aimed at improving the diagnosis and assessment of fetal alcohol spectrum disorder (FASD).
The document sets out how health and care services can improve the diagnosis, assessment, and prevention of FASD, highlighting five key areas for improvement, including that pregnant woman are given advice throughout their pregnancy not to drink alcohol.
‘Midwives and other healthcare professionals should give women clear and consistent advice on avoiding alcohol throughout pregnancy, and explain the benefits of this, including preventing FASD and reducing the risks of low birth weight, preterm birth and the baby being small for gestational age,’ the quality standard stated.
‘There is no known safe level of alcohol consumption during pregnancy and the UK Chief Medical Officer’s low-risk drinking guidelines state that the safest approach is to avoid alcohol altogether to minimise risks for the baby.’
Another key area of the quality standard states that women are asked about their alcohol use throughout their pregnancy, and this is recorded.
A draft statement had recommended that a mother’s alcohol consumption should also be included on the child’s medical records, but this has been changed following consultation.
Physical, behavioural, and neurodevelopmental difficulties associated with FASD included abnormalities in how the brain worked, which could manifest as problems with learning, attention, memory or language, difficulty with abstract concepts, poor problem-solving skills and confused social skills, the quality standard said.
Physical effects included a smaller head circumference, damage to the structure of the brain, heart or kidney problems, vision or hearing impairment and characteristic facial features including short palpebral fissures, smooth philtrum and thin upper lip.
The other three key statements included in the quality standard are:
· Children and young people with probable prenatal alcohol exposure and significant physical, developmental, or behavioural difficulties are referred for assessment.
· Children and young people with confirmed prenatal alcohol exposure or all three facial features associated with prenatal alcohol exposure have a neurodevelopmental assessment if there are clinical concerns.
· Children and young people with a diagnosis of FASD have a management plan to address their needs.
Dr Paul Chrisp, director of NICE’s centre for guidelines, said children and young people with FASD often had a poorer quality of life and had to overcome 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,’ he said.
‘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 were limited, he said, with no single reliable source.