09/09/09 = International FASD Awareness Day

[AlohaSteven]

No, not the Apocalypse, or even auf Deutsch Nein, nein, ach nein! ("No, no, oh no!).

09/09/09 is International Fetal Alcohol Spectrum Disorders Awareness Day. Here is a good website on the topic; the "links" section is particularly useful: http://www.acfasd.net/

Are there any observances promoting FASD prevention happening in Puna today?

This morning I headed to the Anchorage library to assist in pounding over 1,000 FASD stick figures into the lawn (one for each diagnosed FASD birth in Alaska, as a dramatic photo-op background) and participate in the televised ceremony with a proclamation from Alaska's governor (no, not the notorious ex-governor, the actual governor) being read and so on. There are all sorts of activities and events around the state today drawing attention to this critically important issue. Canadian research has found the majority of prisoners have detectable fetal alcohol spectrum disorder brain damages; I am sure the same is true in the USA.

Effectively addressing FASD in society is not a simple matter because of the interwoven issues of alcohol, sex, parenting and so on --all complicated by issues of education, poverty, shame, access to quality care, and other factors-- yet we neglect FASD at huge cost. A dime spent on effective prevention pays back thousands over the years in savings and revenues -and that is just the economic aspect! How can a price tag be put on a child's capacity to thrive, learn, and bloom ...or the stunting thereof? Whatever it takes to promote abstinence from alcohol consumption during pregnancy (and breastfeeding, afterward) is well worth the effort. Like the bumper sticker on my truck says, Pregnancy + Alcohol = Brain Damage.



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It is not our part to master all the tides of the world but to do what is in us for the succor of those years wherein we are set, uprooting the evil in the fields we know, so that those who live after may have clean earth to till. What weather they shall have is not ours to rule.
J.R.R. Tolkien

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[missydog1]

Thanks for this, Alaska Steven. I didn't hear of anything, but it's certainly an issue here.
I do know that if you live here and FASD is a possible diagnosis, that the only genetic testing is done on Oahu, and it's not necessarily covered by health insurance - and I think it should be!

[MarkP]

Do FASD cause genetic changes? I always assumed not.

[missydog1]

Scratch that. I was asking a doctor about FAS and he mentioned genetic testing, but he also wanted to rule out another syndrome involving missing gene sequences (not inherited). Anyway, he said it would involve a trip to Oahu. Here is what I found on line for FASD diagonosis. In addition to possible documentation of alcohol consumption by mother:

"a diagnosis of FAS requires documentation of three findings: 1) three specific facial abnormalities; 2) growth deficit; and 3) CNS abnormalities"

[AlohaSteven]

Conventional wisdom and the majority of animal studies to date suggest fetal alcohol exposure and damage from alcohol exposure via breastfeeding or bottlefeeding during infancy does not transmit forward to the the next generation. Conventional wisdom in this area is limited, however, by the relative recency of studies in this area and by paradigm limitations. Alcohol as a teratogen only first began to become broadly recognized by medical science in the 1970s, quite recently as such things go; moreover, sometimes a limitation of scientists' studies is they are designed such that they cannot recognize results other than those they were devised to detect. So, conventional wisdom holds FASD is an environmental issue, not genetic per se, and as such is completely preventable in the first instance. "None for nine" (and during breastfeeding and bottle-feeding subsequently) and there genuinely is zero risk of primary order fetal alcohol spectrum disorders. No alcohol exposure, no FASD. This much is absolutely 100% true, for sure, as regards primary effects.

That said, my reading and experience of recent research into epigenetics, animal model studies, and early exposures relating to adult onset of various diseases --perhaps even multigenerational effects-- suggests to me the book is not yet closed on this issue. My guess (and it is just that: a guess) is a link is indeed possible between exposure in one generation and deleterious effects showing up in another generation ...or even perhaps in several generations from that point forward. Perhaps even likely. If so, then this does makes the problem of FASD "genetic" as well as environmental, though not a genetic disease in the usual conventional senses of the term. Also, if this effect exists at all then it is probably relatively subtle compared to the outright teratogenic impact on the fetus &/or infant originally exposed (...if anyone wants examples of what I am talking about, then please say so -I hesitate to jabber on and on if this is perhaps already too much information).

It is not just alcohol exposure during pregnancy and perinatal development, either. Smoking, other drug use, and various compounds present in some cosmetics, soft plastics, and lotions may be (or definitely are) suspect in this regard (again, examples are available). Various pesticides, herbicides, fungicides, and so on may also eventually be identified as having influences not only in the offspring directly affected but also in subsequent generations from that same line. I think we are just starting to begin to understand this aspect of subtle teratogenic influence. Organically-grown foods during pregnancy and while breastfeeding are probably worth the extra cost.

Bottom line: staying clean and sober if of reproductive age and actively having sex is highly recommended, especially if effective contraception is not uniformly in use. The problematic alcohol and other drug exposures in many FASD-affected births often happen during the first weeks of pregnancy, before the mother-to-be realizes she is pregnant. We know for a fact exposure to alcohol, cigarette smoke, and other environmental insults causes huge damage to the developing fetus &/or newborn. This is solidly established as fact. We are unsure to what degree and in what forms that damage transmits forward to the next generation when the impaired baby grows to adulthood and reproduces.

Here is a link to UW's Diagnostic Code. Depending on when during the nine months of pregnancy (and during breastfeeding or bottlefeeding subsequently) the alcohol exposure(s) occur, how massive the dose(s), the condition of the mother's liver, and some other factors the outcome from one case to the next can look very different. This variability in FASD outcomes is part of why it took so long to pin down alcohol as a teratogen.
http://depts.washington.edu/fasdpn/



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It is not our part to master all the tides of the world but to do what is in us for the succor of those years wherein we are set, uprooting the evil in the fields we know, so that those who live after may have clean earth to till. What weather they shall have is not ours to rule.
J.R.R. Tolkien

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[missydog1]

When we talk about genetic defects we naturally think of inheritance, but there are developmental defects that occur, which are not genetically inherited; however genes sequences are damaged or missing, and this affects the child. The specific condition we were told might be in play was Williams Syndrome, with or without FASD. Williams is a genetic condition but is not known to be inherited, and might be associated with alcohol use, and it also has a set of facial characteristics that are typical.

Sorry for confusing the issue.

[AlohaSteven]

Please do not be sorry at all, KathyH, as imho this question and discussion did not confuse the issue at all.

An astonishingly large percentage of the population is unclear about the straightforward formula "Pregnancy + Alcohol = Brain Damage" (as well as eye problems, heart defects, cleft palate, et cetera) in producing primary order effects of FASD, let alone being aware of the possibility for damage transmitting forward to the next generation or successive generations.

Any discussion of FASD raising awareness of the issues involved is a plus.

Angst and ranting about budgets, economic shortfalls, and so on so commonly encountered recently strikes me as ironic when the single measure of effectively preventing FASD births --just by itself-- would have such huge impact rippling all across society. Quite profitably so, too.

Each diagnosed FASD birth costs the taxpayer from $1.5 million to over $3 million in direct expenses (medical care, special education needs, etc) ...and this is just the diagnosed cases (which are only a tiny minority of all existing alcohol-exposed impairments, just the tip of a huge iceberg). Children with FASD and the FASD-impaired adolescents and adults they become do not rise to the professional level they could have if undamaged by alcohol exposure; they never serve the community in ways they might have and do not pay in the tax revenues they could have if unexposed. Instead, they occupy lower-level positions and often place a strain on social services from welfare systems to medical care to law enforcement. Somewhere between 40% and 60% of the prison population (depending on the population studied) is probably incarcerated in significant part because of FASD. The expense for this incarceration alone (apart from the economic costs of the crimes which landed them behind bars) is staggering.

When politicians are serious about improving the economy then we will see them meaningfully address FASD prevention.


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It is not our part to master all the tides of the world but to do what is in us for the succor of those years wherein we are set, uprooting the evil in the fields we know, so that those who live after may have clean earth to till. What weather they shall have is not ours to rule.
J.R.R. Tolkien

)'( )'( )'( )'( )'( )'( )'( )'( )'( )'( )'( )'( )'( )'( )'( )'( )'( )'( )'( )'( )'( )'( )'( )'( )'( )'( )'( )'( )'( )'( )'( )'( )'( )'( )'(