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Module 4: FASD Signs and Symptoms

Signs and Symptoms: Infants and Toddlers

Alcohol-exposed infants are often irritable and do not respond to holding and rocking. Many have a poor sucking reflex, which can interfere with nursing and feeding. This may lead to failure to thrive. Some women may drink alcohol to stimulate milk production, but it is a myth that alcohol improves breast milk. In fact, alcohol can be transmitted through breast milk. Therefore, women who have problems abstaining from alcohol use should not nurse their babies.

Mother and baby

Infants with an FASD may also have low muscle tone or be floppy. They may have poor spatial awareness, resulting in a failure to cross the midline (e.g., reaching for something to the left with one's right hand). Many fail to meet normal developmental milestones for sitting, crawling, and walking.3  Prenatal alcohol exposure can also impair attention regulation. This deficit may affect cognitive development and related behaviors.4

Specific signs seen in infants include:

  • Jitteriness
  • Tremors
  • Problems with sleeping and eating
  • Delayed development such as walking and talking
  • Poor adjustment to the environment
  • Hypersensitivity to noise, light, taste, and touch
  • Hearing and vision difficulties
  • Lack of stranger anxiety
  • Bonding problems
Sleeping baby swaddled in blankets

Caregivers have reported success with swaddling. Native American programs and some hospitals are promoting cradle boards and swinging the infant in a hammock or a device that mimics this motion.

Speech and language difficulties are also common in children with an FASD. Children with prenatal alcohol exposure may talk late and have trouble understanding others. They may not follow directions. Complex speech development is often slow, and the child may have much less detailed language than peers.

Problems with word meaning and sentence structure show up early. Many children have trouble finding the right words to say what they want. They also may be able to repeat what has been said but may not understand it. That is they understand the words but not their meaning. Thus, children with an FASD may not follow the specific directions given.

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