Adoption

speaking of alcohol exposure

i was reading through the responses to Orange1414's post about alcohol exposure, which i found to be incredibly helpful. some of you made mention about alcohol being the worst drug to be exposed to prenatally and someone commented about a seminar where she learned that drinking early on in the pregnancy is the strongest risk factor for FAS. 

but then i hear about all these women who are pregnant and are always saying things about how the baby and the mom don't share a blood supply in the beginning, so not to worry about getting smashed before finding out you're pregnant.

 i guess i'm just getting confused.

my husband and i are filling out our profile key, saying what we are and aren't comfortable with dug/alcohol wise.  intially we were thinking we were basically not comfortable with any drug exposure and we were okay with light alcohol exposure, through all trimesters. but, now that i'm hearing these things, i'm beginning to wonder if we really would be comfortable with any alocohol exposure.  everything just seems so risky....

Re: speaking of alcohol exposure

  • It's really hard to fill out that part of the profile. DH and I referred to it as the spreadsheet of doom because for days while we worked on it we had to contemplate all sorts of terrible things that might have happened to our future child. And, even though we felt confident in our decisions (drug exposure ok, but no more than light alcohol), that confidence was shaken when our social worker asked us about a situation that was outside of our specifications (heavy alcohol).

    I would encourage you to do more research, talk to your agency, take some online classes through Adoption Learning Partners and do your best to decide what you think you can handle. And, as I did yesterday, you can always lean on this board. Good luck!

    Trying to grow our family with both fertility treatments and adoption since March 2009 
    IUIs#1-4 = BFN, IVF#1 = c/p, IVF#2 = OHSS, FET#1=BFP
    BabyFruit Ticker
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  • Yes--everything is risky. But you really aren't ever given guarantees when it comes to adoption unless you are positive that the BM is honest with you. 

    Our daughter's BM told us and the agency that she had not had drugs and alcohol during pregnancy but we found out after DD was born that that was not the case and we ended up with a sick baby in the NICU going through withdrawls. 

    I don't mean to alarm you--but this is the reality of adoption.  Unless you know an E-mom and are very close, it is only her word that you have to go on as far as her health is concerned.  

    All that being said, even knowing what we know now, we would do it all again in a heartbeat without a second of hesitation.  DD is the joy of our lives--everything happens for a reason and the right baby finds the right mom and dad. 

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  • Everything is a risk in adoption. Heck, everything is a risk in life.

    You really have to just decide what you're comfortable with, and what you may be willing to take on. We were the rare birds who were OK with social drinking. You could say I'm old school in the whole vein of "My mom smoked, drank, and took diet pills while pg with me and I'm fine." That and our SW emphasized that a lot of moms in general drink before they're pg, so finding someone who hadn't touched a drop was going to be difficult at best.

    I actually think it's more accurate to say it's the least understood. You can generally predict what the short term (and often long-term) effects of crack, or heroin, are going to be on a developing child. Alcohol? It can depend on so many factors: how much and how often, binge drinking vs an occasional glass of wine, maternal metabolism, timing, etc. I'm saying all this with the caveat that we did very little research on it and just went with our gut. All the links people posted may change my mind, but that's where I am now.

    At some point you'll just have to make a decision and roll with it. And you can always change your profile key if you want to make it more or less strict.

  • yeah... we will make a decision and see how it goes... change things as we go along and as we see fit.

    thanks for you all your input!

  • imagemiss071311:

    some of you made mention about alcohol being the worst drug to be exposed to prenatally and someone commented about a seminar where she learned that drinking early on in the pregnancy is the strongest risk factor for FAS. 

     

    The above is a true, medical belief.  I say "belief" because their is one other type of substance that might come close to the damage that can be caused by alcohol, and those are methamphetamines.  Their wide-spread abuse is too new, however, for reliable studies to show what type of (and how severe) damage typically they cause to fetuses.

    In 1997, one of the leading FASD reseachers, Ann Streissguth, wrote, "Prenatal exposure to alcohol is the leading prevenatabe cause of mental retardation in western civilization.  But most persons with FASD have an IQ in the normal range."

    In the Institute of Medicine's report to Congress stated, "Alcohol causes more neurological damage to the developing baby than any other substance."

    imagemiss071311: 

    but then i hear about all these women who are pregnant and are always saying things about how the baby and the mom don't share a blood supply in the beginning, so not to worry about getting smashed before finding out you're pregnant.

      

    The concept that it's okay early in the pregnancy (before you know you are pregnant) and even in moderation throughout does seem to have become the prevailing sentiment among American pregnant women, and is backed by some ob/gyns and other doctors.  I believe it is a backlash against the idea that pregnant women should never drink, and is fueled by the fact that it is common for pregnant women in other cultures to drink.

    However, I can tell you unequivocally that the doctors, researchers, and others who specialize in FASD strongly urge not drinking at any point during a pregnancy, or even if a woman is trying to (or may otherwise) become pregnant.  They have mounted an entire public education campaigned aimed at teenage girls/women, urging them not to drink if they are sexually active, because they may unexpectedly become pregnant and damage the fetus.

    The presentation I posted about below and (I believe) the book Fred mentioned, The Mystery of Risk, both by Ira J. Chasnoff, explain exactly how alcohol affects a baby's development (most often the brain, but can affect any portion of development) and why exposure at any time, especially extreme exposure, can result in developmental/health issues.

    imagemiss071311:

    my husband and i are filling out our profile key, saying what we are and aren't comfortable with dug/alcohol wise.

    Ugh!  The dreaded "situation" form.  We all agonize over it.  Just know that you can change your preferences at any time, and it is perfectly okay to not feel comfortable taking on more than you want or believe you can.  If you say you are not comfortable with a certain situation, but a particular case comes along and you'd like to be considered, you can request that.  Similarly, if you say you are open to a certain level of exposure/risk, and it comes down to a specific case, you can always change your mind or just say you are not comfortable with the specifics.  The form is designed to make the agency's job of narrowing profiles down for expectant mothers easier, and to make prospective adoptive parents think about what they are comfortable and capable of taking on--that's all.  So give it due thought and really work these things over with your husband so you know where your lines are drawn when you are called, but don't let it stress you out too much right now.

  • One more thing:  this really isn't politically correct and remains a very hot topic, but there are some scientists studying whether it's true that some races/backgrounds/groups have a higher likelihood of becoming alcoholics.  This is relevant because the thinking is that fetuses of these races/backgrounds/groups may be more susceptible to damage from prenatal exposure to alcohol.

    M is at least part Aymaran, which is a native people of Peru.  We do wonder if this increased his mother's chances of being an alcoholic and his outcome of having the symptoms he presents.

  • I just went to a Prenatal Drug Exposure intensive workshop on Tuesday night so this is all fresh in my mind. The #1 concern is alcohol exposure because it does the greatest damage in the first trimester when most women do not know they are pregnant or are in denial that they are pregnant. The exposure is greatest because the drug can cross the placenta to the baby and at that time, the baby's central nervous system and brain are developing.

    They consider even one to two binge drinking sessions (that's 6 or more drinks in a sitting) to be dangerous and reason to have concern for Fetal Alcohol Syndrome. However, having said all that, there are of course still women who drink throughout pregnancy and the children do not exhibit signs of FAS.

    Some FAS is easily noticed upon birth (the change to facial features being the primary indicator). Other children will not exhibit FAS until later in life when facial features start to develop more. Mental retardation is also of great concern when a fetus is exposed to alcohol and they believe to be on the of the biggest contributors to mental retardation in our history.

    I know it's not easy to make these personal decisions but I really loved what one of the panelist and doctors said at the workshop I went to, that adoption is the "biggest natural intervention" we can perform in our society. That providing these children with a loving and caring home, that has access to resources to help their development is really the primary indicator (and primary way to effect) long term outcome.

     And just for kicks...did you know that pot is the most studied drug with expectant moms and it is the only drug that has shown no long term or short term effects on the fetus?

    Additional information on drug exposure, most all drugs they have studied (meth, cocaine, barbituates, etc) have shown no long term effects. The effects are primarily pre-natal (i.e. cocaine can cause death in the womb) or short term effects (i.e. withdrawal upon birth or high risk for premature birth). The primary indicator that has a direct cause and effect is the environment the child is placed in. That is not to say you can't just brush it all off and not be realistic about it, but as one person said at the workshop, these children need a healthy place to grow up. Many times they will come from an unhealthy environment  and the exposure that is most critical to their development is the exposure they have after birth.

    They encourage us to open our minds and hearts. Not to be in denial but to really think, "If my child grows up with a problem, will I blame the birth mother for having exposed the child to drugs? How do I know drugs were the cause of my child's problem and not genetics?" They encourage us to be informed, to work our process to make our decisions, but to examine how we feel about these things and what we think of birth mothers who expose the fetus to drugs.

    Also...did you know that there was a big concern in the 80s and 90s about "crack babies." But all the research has shown that the biggest problem with crack babies was the stigma attached to them, not their actual exposure to the drug.

    Just some food for thought. I'm not saying it will work for you but I was very appreciative that I took the time to go to the workshop which was led by a highly respected pediatric Dr that works with a population that has a very high use of drugs.

     

    TTC since April 2010, age 40, 3 miscarriages in total IVF w/PGD June 2012 - failed cycle with a genetically perfect embryo, unexplained infertility January 2013 - On to adoption!!!
  • imagecaliblondieus:

    I'm not saying it will work for you but I was very appreciative that I took the time to go to the workshop which was led by a highly respected pediatric Dr that works with a population that has a very high use of drugs. 

    I'm glad you specified this, because I was going to ask who held the workshop.  My reason for asking was because it sounds like they had an ulterior motive in convincing attendees that if they adopted a prenatally exposed baby, it would likely not be as difficult as they might fear.  Your pointing out that this doctor works with a population that has a high use of drugs explains that perhaps in his experience, many prenatally exposed babies do okay...but alcohol exposure is not the same as exposure to other drugs, as you pointed out early in your post.

    I don't think it does anyone a service to minimize the very real risks of adopting a baby or child exposed to alcohol prenatally.  It can be very rewarding, and that's something that prospective adoptive parents should really consider...in view of the very real challenges that it may also bring with it.  Every case is different, but it can be very difficult to raise a child with FASD and commit to possibly having to remain as a guardian through adulthood, and that's something that we should never gloss over.  Some prospective adoptive parents are willing to take on that risk, but it should be something they enter into knowingly, and not be surprised with later down the line. 

    imagecaliblondieus:

    The primary indicator that has a direct cause and effect is the environment the child is placed in. That is not to say you can't just brush it all off and not be realistic about it, but as one person said at the workshop, these children need a healthy place to grow up. Many times they will come from an unhealthy environment  and the exposure that is most critical to their development is the exposure they have after birth.

    Yes, this is true.  If a child has access to good medical care and therapies, amazing strides can be made, and the child/adult can reach his/her full potential.  For example, M would have eventually died as a result of his heart condition if we hadn't fixed it, and he's making amazing strides due to his intensive tutoring and small-group education.

    BUT, you can't cure brain damage, which is how FASD most often presents. The brains of alcohol-exposed fetuses suffer literal, physical damage because they do not grow the way they are supposed to, and that's incurable.  Therapies and treatments can help cope with symptoms and give these children the best outcome, but the child will always have FASD and often (90%) struggle throughout life with with its symptoms.

  • imagePinkie78:

    I believe the placenta does not form until 6 weeks and that is when the mom and baby share nutrients so alcohol up until that point should not be so bad.

    from what I was told and read, the worst time for alcohol exposure is the middle to end of the first trimester (around weeks 9 to 13).   

    I'm sorry, but according to FASD researchers, this simply is not true.  Simply having confirmed high alcohol blood levels (100 mg/dL or greater) at least weekly in early pregnancy is enough for a child to be considered at "high risk" for FASD.  According to a CDC study, low amounts of alcohol consumed during early pregnancy substantially increases the risk of miscarriage, which may explain why some studies have found that children who were only exposed in early pregnancy do not typically have a lower IQ (it's possible that the babies which were affected were never carried to term).

    Here are more quotes: 

    "We do not know what, if any, amount of alcohol is safe. ... Therefore, it's in the child's best interest for a pregnant woman to simply not drink alcohol."

    --U.S. Surgeon General Richard H. Carmona, February 21, 2005 

    "But while FAS facial features have come to be associated with the most severe cases of the condition, researchers now believe that these simply mark significant alcohol exposure only early in pregnancy."

    "With other toxic exposures during pregnancy, exposure later in pregnancy often causes less serious damage than exposure early on-but this does not seem to be the case with alcohol, because critical periods for brain development occur throughout pregnancy, not just at the start." 

    --George Mason University fact sheet

     "Don't drink alcohol if you're trying to get pregnant, because your baby's brain, heart and blood vessels begin to develop in the early weeks of pregnancy, before you may know you're pregnant. If you haven't already stopped drinking, stop as soon as you know you're pregnant or if you even think you might be pregnant. It's never too late to stop drinking during your pregnancy, but the sooner you stop, the better it is for your baby."

    "Consider giving up alcohol during your childbearing years if you're sexually active and you're having unprotected sex. Many pregnancies are unplanned, and damage can occur in the earliest weeks of pregnancy." 

    --Mayo Clinic 

    "Any pregnant woman is at risk of having a child with an FASD if she drinks alcohol during her pregnancy. Alcohol can harm an embryo or  fetus at any time, even before a woman knows she is pregnant. Women who drink and don?t use contraception and women who have an alcohol dependence or other alcohol use disorder are at an increased risk for having a child with an FASD." 

    --National Organization on Fetal Alcohol Syndrome fact sheet 

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