Deputy David Stanton: Foetal alcohol syndrome is the biggest cause of non-genetic mental disability in the western world. It is 100% preventable and is caused only when a mother drinks during pregnancy. In addition to foetal alcohol syndrome, there is a range of other alcohol related problems such as alcohol related birth defects and neurological disorders. Maternal risk factors for children developing any of these are advanced maternal age, low socioeconomic status, frequent binge drinking, family and friends with drinking problems and poor social and psychological indicators. Symptoms are babies who are small, underweight, and have poor muscle control and different facial characteristics. Other symptoms are permanent brain damage, speech impediments, hyperactivity, heart and eye disorders, genetic deformities and behavioural problems such as autism, aggressiveness and impaired social skills. Prevalence rates in the US have been estimated to be between 0.5 and two per 1,000 births, but other estimates of mild foetal alcohol syndrome have been much higher, at almost one in every 100 births.

I questioned the Minister for Health and Children on this recently and was told that the incidence in Ireland is unknown but that the Health Service Executive is developing proposals for a research project to be carried out in a large maternity hospital to evaluate the prevalence of alcohol in pregnancy. Can the Minister of State tell me where this will happen and when this study will begin? We should take account of the research carried out in the US, other countries in Europe and the UK where lifestyles, culture and attitudes to alcohol are similar to here. It would be safe to assume the estimates for Germany and, perhaps, the UK would apply here as we have cultures where alcohol is consumed in large amounts and is heavily connected to special occasions and social life.

Last week the Minister agreed that symptoms can range from mild attention deficit problems to lifelong problems such as neurological, cognitive and behavioural problems, growth retardation and developmental delay. I am concerned about this when one sees the rise in issues such as these in our schools with children with hyperactivity and other problems. There is possibly a link. The Minister advised at the time that the promotion of healthy behaviour in alcohol intake is a national priority, but we need to do more. We must advise and inform people much more than we have been doing about the dangers of this alcohol syndrome.

I am pleased to note that the Health (Miscellaneous Provisions) Bill will provide for a mandatory labelling of alcohol to advise of risk of drinking during pregnancy. Such labelling is in place in a number of countries such as Canada and will go some way to raising without delay the necessary awareness in this country of the dangers to children. Other awareness raising measures will be included. It is clear from international research that more people need to be aware of the dangers of drinking even a small amount of alcohol when pregnant to stop the needless suffering of many children affected by foetal alcohol syndrome. I urge the Minister of State to develop as a matter of urgency a national policy on the issue and begin initiatives to improve awareness of the risk and dangers as soon as possible. I look forward to the Minister of State’s response to this very important matter which is not known to many people. The awareness levels in this country are very low.

Deputy Áine Brady:   I thank the Deputy for raising this matter on the Adjournment which I am taking on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney. Pre-natal exposure to alcohol can produce a range of effects known as foetal alcohol spectrum disorders, FASD. Depending on factors such as the amount of alcohol consumed during pregnancy, the stage of pregnancy at exposure and the duration of alcohol exposure, FASD can range from mild attention deficit problems to full foetal alcohol syndrome with its lifelong problems such as neurological, cognitive and behavioural problems, growth retardation and developmental delay. FASD is often difficult to diagnose and can be diagnosed as another disorder with clinically similar features. Thus, in many countries, FASD in particular is under-diagnosed.

To establish the levels of alcohol, smoking, and illicit drug use during pregnancy, a research team reviewed maternal records spanning 1988 to 2005 held by the Coombe Women’s Hospital. The study revealed that there has been a change in drinking behaviour in women presenting for antenatal care over the past two decades. In the main, alcohol consumption has increased. The study revealed that one in ten women report drinking more than six units of alcohol per week in pregnancy and two thirds of all pregnant women under 18 years old reported drinking alcohol during pregnancy. The promotion of healthy behaviour in one’s alcohol intake is a national priority, not least among women who are planning or embarking upon pregnancy.

To create greater awareness of the risks associated with alcohol consumption, the Health Service Executive has published a booklet entitled Women and Alcohol. This includes advice for women to avoid alcohol in pregnancy.

The Department is devising legislation to provide for mandatory labelling of alcohol containers advising of the risk of consuming alcohol during pregnancy. The legislation is part of a miscellaneous public health Bill being prepared.

The Health Service Executive is developing proposals for a new research project in a large maternity hospital which aims to evaluate the prevalence of alcohol exposure in pregnancy, the patterns of behaviour, such as social drinking, binge drinking and sustained heavy drinking, and the factors that influence whether a woman drinks alcohol before conception and during each trimester of pregnancy. The research project aims to follow a cohort of women who drink alcohol during pregnancy to evaluate the impact on the infant’s condition at birth and subsequent development.

The diagnosis and management of foetal alcohol syndrome is a clinical issue requiring contact with general practitioners and specialists as appropriate. The Health Service Executive also provides a range of child and adolescent services at local and community level to support children and families. If appropriate in particular cases, a child under five may have an assessment which covers the full range of a child’s health and education needs.

The Government is committed to ensuring all pupils, including those with special educational needs, can have access to an education appropriate to their needs, preferably in school settings through the primary and post-primary school network. This facilitates access to individualised education programmes, fully qualified professional teachers, special needs assistants and the appropriate school curriculum. The Department of Education and Science provides for the education of children with special educational needs through a number of support mechanisms depending on the child’s assessed special educational need.

I am concerned about the harm caused by alcohol misuse in Ireland. FASDs are one of the many consequences of our alcohol culture and especially our binge drinking culture. As my responsibilities as Minister of State include health promotion, I intend to identify and seek implementation of the necessary policy measures and actions required to reduce the overall level of alcohol related harm in society.

Vol. 683 No. 3
Tuesday, 26 May 2009