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First ever guidelines issued in UK for diagnosing foetal alcohol spectrum disorder

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Healthcare professionals are being urged to read the UK’s first guideline on diagnosing foetal alcohol spectrum disorder (FASD) in order to become better acquainted with how to identify it.

The new guidance, published for health professionals in Scotland, highlighted that a “reliable and accurate” maternal alcohol history was the “best screening tool for identifying risk of FASD”.

“I would urge healthcare professionals to read the guideline”

Patricia Jackson

It stated: “All pregnant and postpartum women should be screened for alcohol use with validated measurement tools by service providers who have received appropriate training in their use.”

It noted that all women should be advised not to drink during pregnancy and women drinking above the low-risk guideline for the general population “should be offered early, brief interventions”.

FASD describes a range of harmful effects to a foetus and baby’s development when alcohol is consumed during pregnancy.

These can result in brain damage and, in its most severe form, physical issues such as a smaller head and poor growth. The detrimental effects are life-long.

The national guidelines have been published by the Scottish Intercollegiate Guidelines Network, which develops clinical guidelines for Scotland and is part of Healthcare improvement Scotland.

The guidance backs a Scottish government policy to improve outcomes and support the well-being of children and young people by offering the “right help at the right time from the right people”.

“Early diagnosis of FASD can make a huge difference in a child’s life”

Catherine Calderwood

An estimated 3.2% of babies born in the UK are affected by FASD, which is three to four times the rate of autism and means up to 172,000 people could be affected by the disorder in Scotland.

A recent study in Glasgow studied the meconium of newborn babies and found that 42% of samples showed evidence of the mother having consumed alcohol during pregnancy, with 15% of those pregnancies exposed to very high levels of alcohol.

Children looked after or adopted are at significantly increased risk of having FASD, with 75% of children referred for adoption having a history of alcohol exposure during pregnancy.

Meanwhile, a Healthcare Improvement Scotland report on the experiences of caregivers looking after individuals with FASD highlighted that a lack of knowledge and understanding among healthcare professionals was a key barrier to formal diagnosis and to receiving meaningful support.

Dr Patricia Jackson, senior fellow of Royal College of Paediatrics and Child Health and co-chair of the Guideline Development Group, said: “FASD remains undiagnosed in the majority of cases.

Catherine Calderwood

Catherine Calderwood

Catherine Calderwood

“Diagnosis is currently dependent on professionals being aware of the condition and confident in carrying out a diagnostic assessment,” said Dr Jackson.

“For people with FASD, early identification and support can mean fewer mental health issues, better educational achievements, and improved life chances, reducing the possibility of later difficulties such as homelessness and involvement with the criminal justice system,” she said.

“I would urge healthcare professionals to read the guideline and become better acquainted with how to make the diagnosis,” she said. “As a result, they can significantly change the lives of people with this disorder.”

Chief medical officer for Scotland Dr Catherine Calderwood, added: “Early diagnosis of FASD can make a huge difference in a child’s life and these guidelines will help raise awareness of the condition among healthcare professionals.”

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