The signs of fetal alcohol syndrome (FAS) can range from mild to severe, depending on the level of exposure to alcohol. Generally, the more alcohol a woman consumes during pregnancy, the greater the risk of FAS and the more severe the signs in a child.

FAS results in a range of physical, mental and behavioral disabilities, which are present at birth. Some signs are easily identifiable, but others may not become apparent until a child is older.   

Signs associated with physical growth deficiencies as a result of FAS include:

• Low birthweight
• Decreased length
• Failure to thrive

Distinctive facial features are characteristic of children with FAS. These facial features may also be noticed in children unaffected by FAS. These signs include:

• Smooth philtrum (underdeveloped vertical groove between the nose and upper lip)
• Significantly thin upper lip
• Small eye openings
• Flattened cheekbones
• Small lower jaw
• Short, upturned nose

Signs of structural damage due to central nervous system (CNS) abnormalities include:

• Small head circumference at birth
• Underdeveloped brain
• Diminished muscle tone

Signs of functional damage due to CNS abnormalities include:

• Impaired motor skills (e.g., poor eye-hand coordination, difficulty tying shoes)
• Lack of imagination or curiosity
• Poor reasoning and judgment skills
• Decreased IQ
• Speech and language difficulty
• Learning difficulties (e.g., memory, problem solving, learning disabilities)
• Mental retardation

The learning difficulties of FAS may center on a child’s inability to generalize, make inferences, and understand causes and effects. For example, a child with FAS may be told not to play in the street near home – but may fail to understand this could also mean not to play in the street near school, too. Children with FAS may not understand similarities or differences between items, and have difficulty sorting or classifying objects.

Signs of behavioral problems associated with FAS include:

• Hyperactivity
• Difficulty concentrating
• Impulsiveness
• Anxiety
• Difficulty relating to others
• Lack of age-appropriate communication skills
• Social withdrawal
• Teasing and bullying behavior

Birth defects that can occur as a result of fetal alcohol exposure include:

• Heart defects
• Joint, limb and finger abnormalities
• Organ dysfunction (e.g., lung, kidney)
• Hearing problems and vision problems
• Cleft palate