A question for the researchers out there~

I attended a training today on Fetal Alcohol Spectrum Disorder(FASD).I expected this to give me more materials to use in prenatal classes, but it left me with questions on lactation management instead.

Among the challenges listed during the presentation was the difficulty of diagnosis at birth if some of the more severe characteristics and typical physical facial features are not present ( eyes, ears, etc).

Listed among the FASD physical abnormalities are an initial diagnosis of FTT, 98% are under normal weight with the deficiency occurring postnatal. 80% will develop speech impediments later on due to many issues including a 20% rate of swallow/suck abnormality. 95% have facial anomalies, but some of these are subtle such as a short or barely -there frenulum.

So my question to the group is, based on this data, and the suggestion that FASD is on the rise, what percentage of the slow-to gain, disorganized and orally challenged babies might be, in fact, dealing with FASD ? 
This question certainly was in the back of my head recalling some of the babies I have seen over the years with very mysterious sets of similar circumstances that seemed otherwise unexplainable.

Has anyone looked at this correlation and written about lactation evaluation relating to catching previously undiagnosed FASD babies? Among the topics NOT discussed; how to integrate alcohol related questions into a pregnancy history with compassion? How would a suspicion of FASD affect lactation management?



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Mirine R. Dye, B.S., CLE
MPH graduate student
Florida Keys  

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