Family management of infants with fetal alcohol syndrome or fetal alcohol spectrum disorders

We studied the effects on family life of medical, social, and/or judiciary decisions taken when 28 infants born between 1995 and 2003 to alcohol-abusing mothers and diagnosed with fetal alcohol syndrome (FAS) or fetal alcohol spectrum disorders (FASD) were discharged from a neonatology hospital unit near Paris. Medical files of these infants and their mothers' obstetrical files (when available) were retrieved from the hospital database; data was then collected and analyzed retrospectively. Post-discharge familial settings were established using questionnaires or telephone interviews with their doctors or the staff of the institutions where they were fostered. The 28 mothers of these FAS/FASD children all came from underprivileged backgrounds, had chronic health problems and/or lived with alcohol abusers. The neonatology team has to decide, at discharge, whether the families can provide a 'good environment' for their babies, if not, they refer them to the courts. In any case, the mother/parents must obey certain rules (such as respecting follow-up appointments for example). These FAS/FASD infants usually came from dysfunctional families, and at hospital discharge, 18% of them were put in care, while the mothers could be given court-approved visiting rights. When the infants lived with their biological families, the mothers' marital situation usually deteriorated within 2 years. The mothers/parents often proved unable to look after their babies properly; this was reported to the courts, and their children put in care. Based on our results, we recommend that the current management of families with FAS/FASD children should be reviewed.