One in four adopted children are either diagnosed with or suspected to have a range of conditions caused by drinking in pregnancy, according to a recent survey of nearly 5,000 adopters in the UK. Among the adopters surveyed by the charity Adoption UK, 8% of children had a diagnosis, and a further 17% were suspected by their parents to have foetal alcohol spectrum disorder (FASD), the neurodevelopmental condition characterised by difficulty with impulse control, as well as behavioural and learning difficulties. Maria Catterick, the director of the FASD Network UK, said the statistics were unsurprising given that alcohol, drugs and domestic abuse are major reasons why children are placed into the care system. The overall incidence of FASD in the UK is unclear with wide-ranging estimates, although some researchers suggest it is in the 3-5% range. In contrast, autism spectrum disorder affects around 1.1% of the population, according to the National Autistic Society. “In my view, 3-5% is a lower bound for the prevalence of FASD in the UK,” said Dr Luisa Zuccolo, from the University of Bristol, who is researching the effects of prenatal alcohol exposure. “There is far too much uncertainty on the actual extent of this problem, but it is bigger than other neurodevelopmental outcomes which receive more ‘publicity’ such as autism spectrum disorders.” The survey showed 55% of families polled had waited two years or longer for an FASD diagnosis, and 78% felt healthcare professionals lacked basic knowledge about the condition. The report comes at a time when guidelines are being considered by National Institute for Health and Care Excellence (Nice) to record pregnant women’s alcohol consumption on their child’s medical records in England. Pregnancy charities have been critical of Nice’s plan on the basis that it falls foul of data protection regulations, while proponents argue that the child’s right to diagnosis and support is crucial. In Scotland, this policy has been implemented and “nobody’s kicked up a fuss”, added Catterick. “I have hundreds of families [in England] who will never get a diagnosis and the help the child needs because there is no incidence of alcohol consumption written down,” she said. “I’m not saying that we should compromise women’s rights … but I also believe in the right of the child to have the best start in life.” While drinking more than 1-2 alcohol units a day has been linked to lower birth weight and premature births, research on the effects of lower levels of drinking in pregnancy are difficult to interpret. A 2016 report by the UK chief medical officer indicated that the risks are probably low, but concluded it is safest to avoid consuming alcohol when pregnant. Nice says there is no known safe level of alcohol consumption during pregnancy.