This assignment will discuss and critically analyse maternal welfare, observing the effects of alcohol on the growing fetus. Firstly, the issue will be to identify ways in which consumption of alcohol affects pre and postnatal conception. Barnes and Bradley (1990) assert consumption of alcohol during pregnancy may have serious consequences for the fetus. Furthermore, the importance of current health initiatives relating to fetal alcohol syndrome will be addressed, including preventable measures. In addition, throughout the assignment, one will abbreviate Fetal Alcohol Syndrome/Effects to FAS/E

Barnes and Bradley (1990) emphasise alcohol travels through the blood stream to affect the sperm, egg and fetus. Professor Kaufman 1988 (in Barnes and Bradley 1991,p.98) suggests “no alcohol in the preconception preparation stage for both partners”, and during pregnancy for the women. Similarly, Stroebe (2000) stipulate women should not drink alcohol for the duration of pregnancy because of the risk of birth defects termed fetal alcohol syndrome. Moreover, Beattie 1981 (in Booth and Williams 1985, p75) highlight social and constant heavy drinking especially in the first trimester of pregnancy can damage the normal growth of the fetus. In support of this Zieman (2004) assert drinking during the first trimester is the most serious, and babies exposed to alcohol at this most crucial time often have small brains and physical problems, what's more these babies can develop severe learning difficulties. Zieman (2004) additionally suggest alcohol crosses the placenta to the baby, where it accumulates in the amniotic fluid surrounding the baby before the birth and cause for the mother problems such as miscarriage, stillbirth, and premature birth. In support of this, Stroebe (2000) stress the most familiar effects seen are an increase in spontaneous abortions, commonly known as miscarriages. Additionally, Stroebe (2000) goes on to say babies can also be born at low birth weight, birth length, and with a small head circumference resulting from prenatal alcohol exposure.

It is obvious that maternal and fetal healths are closely related to each other. Poor maternal health pre-existing maternal diseases and other general risk factors strongly influence the outcome of the pregnancy (Dietz and Brandrup-Likanow, 1993). Some of the other effects caused by maternal drinking range from an increase in the number of stillbirths, decreased apgar scores at birth, an increase in the number of birth defects, increased developmental delays, decreased I.Q. scores, to Fetal Alcohol Syndrome and an increased death rate. To support this Dietz and Brandrup-Likanow, (1993), state that low birth weight is a major contributing factor to infant and child mortality, due to mothers who have failed to achieve the optimum growth and development due to under nutrition, recurrent illness and chronic diseases in adulthood are more likely to give birth to low birth weight children.

There is evidence to suggest that if a woman drinks two or more standard drinks each day the baby can be affected and grow slowly. If a woman drinks, six or more standard drinks each day the baby may have slow physical growth, poor coordination, movement and intellectual disability (fetal alcohol syndrome). According to Hall, (2003) substance misuse is present in approximately 20% of families and frequency is said to grow with falling prices and increasing consumption of alcohol. In addition, Hall (2003) evokes in today’s society it is said that 1 million children live with an alcoholic parent, this can put the child at risk of violence or neglect. Subsequently, substance abuse can be both biological and social. Furthermore, in pregnancy it has been linked to cognitive and interactional difficulties, more severe problem such as small head size low birth weight (Goswami, 2000). This in turn could bring about long-term effects of drug misuse on family social circumstances the parents ability to care for the child.

Babies of women who are heavily dependent on alcohol can suffer withdrawal after birth. The symptoms can include tremors, irritability, fits and bloated abdomen. Similarly, Zieman (2004) evokes that the effects of FAS/FAE last throughout life. A baby with FAS/FAE may be irritable, nervous, and very sensitive to sound and light, the child may cry often. Furthermore, Mitchell and Brown (1991) state that it is imperative to have quality of life as a structure within early childhood services relates to recognition that the nature of environment can considerably increase or decrease the problems associated with young children. Additionally, Curtis and O’Hagan, (2003) suggest the problems change as the child grows up these can lead to aggressive behaviour, depression, psychosis, and substance abuse that commonly begin in their teenage years.

Nevertheless, Steele and Josephs 1990 (in Stroebe, 2000, p.111) assert consumption of alcohol decreases cognitive ability and thereby limits the amount of information to which one can concentrate. Similarly, Goswami (2000) states that processes of cognitive development are learning, perception, and attention. What is more, the cognitive system cannot display memory without consecutively displaying learning, and learning and memory in infants and neonates would be impossible if they lacked ample perceptual skills and ample concentration mechanisms (Goswami, 2000).

Likewise, DeCasper and Fifer 1980 (in Goswami, 2000, p1) claim that babies begins storing memories while they are still in the womb. This suggests that drinking will impact on a child’s memory. What is more, drinking by parents can be a cause of significant confusion for children and families. It can bring a lot of short-term suffering during upbringing, and across a broad array of areas. In support of this Tunnard, (1997) accentuates the levels of behavioural problems, school-related problems and emotional difficulties are elevated than in other children, as well as those whose parents have other mental or physical health problems.

As discussed earlier FAS/FAE can have affects on the child’s development concerning their language aptitude through the transmission of alcohol during pregnancy. Similarly, Oates and Grayson, (2004), state children with FAS/FAE often build up language skills at a slower rate than usual. They may not use the semantics or syntax expected for their age. Furthermore, children repeatedly recognize the word however cannot retrieve it from memory. Moreover, Oates and Grayson, (2004), evoke may use a wrong word from the same general category. For example, they might call a sheep a goat. Likewise, examples of undeveloped syntax consist of using the incorrect pronoun or verb form, using plurals incorrectly, omitting prepositions, as well as other mistakes that younger children might make (Oates and Grayson, 2004). Additionally, Browne (1996), accentuates children with FAS/FAE may have impaired communication and have difficulty producing sounds (e.g., “s,” “th” and “r”). They may possibly lack a more general speech problem that makes it hard for them to speak intelligibly. Moreover, peers may pay no attention to or make fun of a child with language problems, and this can aggravate problems with the development of social skills. Similarly, Abbott and Langston (2005) imply to reinforce a child’s sense of individuality whilst also nurturing a sense of group belonging emerges from the respect to facilitate every child is a part of a family and a society, somewhat than an isolated person. Moreover, Abbott and Langston (2005) communication problems are often identified prior to a child starting school, but more subtle problems with language expression may not turn out to be clear until the child is faced with the challenges in the classroom. Furthermore, Browne, (1996) stipulates our primary and most recognizable language forms are connected with our closest early relationships; they are closely bound up by means of the models used by individuals who are close to us. Each individual’s use of language represents their experience and the culture and values of their immediate society. Similarly, Clay 1998 (in Riley, 2003, p61) quotes:

“Language is a gateway to new concepts, a means for sorting out confusions, a way to interact with people, or to get help, a way to test out what one knows. It is the source of much pleasure for the child and the adult. It is a pervasive, persuasive, perpetual fountain of learning – and there is no equipment that will give children the interactive experiences that will power their progress.”

Conversely, children who have been living in disadvantaged state of affairs often display poor language skills. Furthermore, Hall, (2003) stipulates children with FAS/FAE can display forms of demanding behaviour that would not be considered as part of a child’s normal developmental understanding. Additionally, Curtis and O’Hagan (2003) highlight these sorts of behaviours should be where the vigilant of adults notice there is a far deeper primary problem and the child is trying to find ways of dealing with these problems. Examples when a child is deliberately cruel, inflicting pain on other children stealing of just refusing to miss with other children. To support this, Curtis and O’Hagan (2003) stipulate that children with fetal alcohol syndrome may be less approachable to the normal methods for dealing with that behaviour, due to their disability, this in turn results in low self esteem and they may not have learnt the social rules of behaviour. Additionally, Abbott and Langston (2005) accentuate all of these children should receive attention via a key worker, which they can build a relationship with them to form a secure base to work

The World Health Organisation (2005) suggests that there is really no safe level of alcohol consumption during pregnancy and that no alcohol at all is the safest approach. Furthermore, The Children Act 1988 (in Cohen, 1990) requires authorities to provide a range of services for children ‘in need’ which safeguard and promote their welfare and promote their upbringing by their families. In addition, Standing Conference on Drug abuse and local Government Drugs Forum 1997 (in DoH, 2005) that in pregnancy, the aim should be to encourage early engagement in adequate antenatal care and with a local alcohol treatment service that can advise on treatment during and after pregnancy. It is clearly important to maximise the intake of alcohol-misusing parent’s engagement in antenatal care and appropriate substance misuse treatment during pregnancy. In support of this the DoH, (2005) advise alcohol detoxification during pregnancy is best conducted with obstetric supervision, to work with multi-agencies such as Sure Start Initiative. Moreover, Abbott and Langston, (2005) advocate with its overall aim of improving the health and well being of families and children under four especially those who are disadvantaged, that children have greater opportunity to flourish when they go to school. Another support that families can use is that of the Health Visitor they work exclusively in the community, and can be approached either directly or via the family doctor. In support of this Bruce and Meggitt (2003) state health visitors work with children up to the age of 5 years; this includes all children with disabilities, also they carry out a wide range of developmental checks. Furthermore, DoH (2005) accentuates the need to regularly review and co-ordinate care for the mother and suitable antenatal care plan is required with all appropriate agencies working together. Additionally, areas that have services specialised in managing pregnant misusers are more effective in engaging women and probably have better outcomes. Similarly, Hall (2003) evokes that recent health initiatives provide and support parents on prevention and detection of particular developmental problems and disorders, which can incorporate a more holistic view that aims to improve children’s chances of success by family support.

There are many disorders within child health and early detection will not improve the quality of life for the child and family in the sense of significantly altering the severity of the disability (FAS/FAE) (Hall, 2003). Nevertheless, appropriate involvement allow the child and family to cope with disability more efficiently by reducing parental irritation and inclusion and helping the child to make the most of effective use of whichever functions and abilities that are preserved (Hall, 2003). The Department of Health (1994) introduced new Child Growth Standards, which allows all children to have their length and weigh regularly measured at birth and throughout childhood. Furthermore, this would be carried out by the Health Visitor who offers child health programmes and screen for problems (Bruce and Meggitt, 2003). According to Fry, (1994) this is a good indicator of child health variation from the average it is a significant indicator to disease or distress in the child. This screening will in turn help to identify fetal alcohol effects in later life. Furthermore, Every Child Matters (2005) accentuates that some children will always require extra help due to them having disadvantages that they may face. Moreover, the Every Child Matters Document (2005) is there to make sure that all children receive services at the first onset of any problems, and to prevent any children slipping through the net. It has been suggested that FAS/FAE of prenatal growth and growth in the months directly after birth are linked with differences in health in later life, these incidence of hypertension and coronary heart disease. For a child who may have communication problems the school can consult with the speech/language specialist to determine how best to assist the child at home and school (Hall, 2004).
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Another preventative measure now is the Government has ordered a review of its guidelines on drinking alcohol during pregnancy following claims that even small amount of alcohol may possibly be damaging to unborn babies. (Peter, 2005). As, Dr Adshead, Deputy Chief Medical Officer 2005 (in Peter, 2005) pronounce that the Government has commissioned a new research project to look into the effects of low to moderate drinking of alcohol during pregnancy and that consuming any alcohol during pregnancy is unsafe. Furthermore, it is vital public health messages be based on sound evidence and retain the credibility and confidence of health professionals (Peter, 2005). Similarly Dr Mukherjee 2005 (in Peter, 2005) a specialist in FASD argues that the Government's guidelines are not clear: stipulating to women that one to two units of alcohol, once or twice a week, is safe during pregnancy is too general and ambiguous. What is more Dr Mukherjee 2005 (in Peter, 2005) argues the United Kingdom should be following the same advice as those of the American and Canadian Governments that abstinence is best. Furthermore, Dr Mukherjee 2005 (in Peter, 2005) evokes the only guaranteed safe message is if you can avoid it then don't drink. To conclude, the health status of a human being at whichever point in their lifetime is determined by the associations of numerous influences, for the most part arising from their biology, their social and economic circumstances, their own psychology and behaviour, and the occasion of ‘random’ actions. A number of these influences were active only for a short time in that individual’s earlier developments, but they have left permanent damage to the child. The condition of Foetal Alcohol Spectrum Disorder and its effects is just not widely known to people in this country so it is important that awareness is raised. There currently is no way to predict which babies will be damaged by alcohol; the safest course is not to drink at all during pregnancy this will optimise your chances of a healthy baby. Furthermore, all women who drink should stop as soon as they think they are pregnant. By developing learning environments that respond to the unique challenges of a child with FAS/E, one can provide an important link in the chain of support needed to assist these children to succeed in the school and in the community.

Reference
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Booth, D. and Williams, M. (1985) Antenatal Education Guidelines for Teacher 3rd Ed London: Churchill Livingston
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