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"I think the way the Irish are drinking too," Boyle said. "If someone does not go out or drink an evening, everyone thinks," Oh, what's wrong? "
On the outside of Lady Tavern, Paula Kennedy noted the ignorance of previous generations about the effects of alcohol on the fetus, adding that her mother had not changed her habits during the pregnancy.
"My sister was very sick and I was born premature," said Kennedy, 36. "Without a medical report, I would say it was because she smoked and drank with us that it happened.
Doctors also contribute to the confusion. A survey of Irish pediatricians revealed that one-third of them were unaware of the existence of FASD and 17.3% felt that light alcohol consumption in the third quarter was safe.
Dr. Kieran O'Malley, a Belfast-based psychiatrist who has written extensively about these disorders, said that some doctors across the Irish border simply did not believe that FASD exists.
"That's why I treat it as the last taboo. I think alcohol is so intertwined in our society that it's hard to know where to start, "he said.
O 'Malley said that "the level of transgenerational alcoholic brain damage is staggering" in Ireland, adding that "nobody knows it".
Public Health Specialist O'Mahony agreed that "conflicting advice is everywhere."
FASD does not necessarily hurt the poor harder, O'Mahony said. Richer women who can afford to buy wine or expensive spirits with a dinner at home may also have a child with FASD. And it does not necessarily require drinking at levels considered problematic. "Alcohol and alcohol damage do not discriminate by socio-economic group," she said.
Part of the confusion, O'Mahony said, comes from the lack of research showing exactly how many drinks it takes to damage a fetus.
A study on overall FASD rates published last year in The Lancet found that for 67 women who had been drinking during pregnancy, at least one child was born with the most severe form of this disorder – the syndrome. fetal alcohol – born with symptoms on the spectrum.
Body type, nutrition, other health problems and even genetics can affect how the body metabolizes alcohol and, hence, how it affects the fetus. The high risk of having irreversible effects in a child is the reason why many medical authorities, including the Centers for Disease Control and Prevention (CDC), recommend not to consume alcohol during pregnancy .
The Irish National Statistics Office indicated that the annual consumption in 2016 was 3.03 gallons of pure alcohol per capita. If it is estimated that 20% of the population does not drink at all, this makes the average consumption rise to more than 3.7 liters per year. In comparison, per capita consumption in the United States in 2016 was 2.59 gallons.
Misdiagnosed?
David Gerry understands the challenges of FASD. He raised two children in foster care with FASD and co-founded FASD Alliance Ireland, a support group for parents.
What sets FASD apart from other cognitive disorders is the impact on the brain's ability to understand the causes and effects. Children and adults with FASD are struggling to draw the consequences of the consequences of prenatal exposure to alcohol.
Gerry said that her adopted daughter was smart and that she was a very attractive speaker in her childhood, but her logic was different and she did not have the adaptive skills needed to handle abstract concepts like money.
One of the reasons Gerry is targeting educators in his awareness of FASD is the impact of lack of adequate support at school.
Last month, he organized a workshop for the Education Training Council for Donegal County. Many of the assistants with special needs attending the workshop said that they could think of the children in their school who probably have the disorder but who have other diagnoses such as ADHD.
Educators stated that understanding the condition would allow them to adapt the way they treat children they suspect of having FASD by giving them clearer instructions, dividing them into smaller steps and understanding that the consequences are not effective.
"It's easier to fix the environment than to fix the child," said Gerry, because brain damage caused by prenatal alcohol exposure can not be reversed.
"No need to cry over spilled milk"
O'Mahony's proposed pregnancy screening test this year aims to reduce the likelihood of FASD – or at least the most severe forms of the disease – and has been supported by the Irish medical organization.
The test would be performed on a urine sample provided by a pregnant woman to her doctor, which is already part of the routine examinations. O'Mahony explained that he would not look for alcohol, which leaves the body shortly after consumption, but a metabolite that lasts up to five days after drinking.
The test would be voluntary. A pilot project, which officials hope to launch next year, would determine whether women are receptive to the idea and ensure that the results are accurate.
According to a 2016 study in Canada, people with Fetal Alcohol Syndrome have a life expectancy of only 34 years. The main cause of death is suicide. They are also overrepresented in prisons, and research in Canada has estimated that youth with FASD are 19 times more likely to be incarcerated than those who do not.
For children and adults already living with the disorder, Gerry said that one of their biggest challenges is not knowing that they have FASD.
The diagnosis of FASD can be difficult because the symptoms overlap with other disorders, and it takes a team of five specialists working with a patient to determine a result. There is no diagnostic service dedicated to FASD in Ireland and there is only one clinic in England that offers this service.
Gerry said that for his children, the diagnosis of FASD made all the difference and allowed them to get the proper support.
"When a person has a diagnosis, they can understand how it is different and, as they grow up, they can defend themselves," he said. "It's no different than a child with cerebral palsy in a wheelchair – you have to build a ramp."
But O'Mahony thinks that prevention – as opposed to diagnostic services – is the best place to invest.
"When a child is born with Fetal Alcohol Syndrome or Fetal Alcohol Spectrum Disorder, the horse has run away. There is no need to close the door at this stage." we must not cry over spilled milk, "she said.
Some signs indicate that Irish culture around alcohol is changing. The federal government has debated a draconian alcohol bill that addresses a number of health-related issues, including the link to cancers and accidents, by offering warnings about tags.
Proponents of the bill, which includes a minimum unit price similar to that approved by Scotland last year, hope it will become law later this year.
The debate around the bill also raised the issue of alcohol consumption among the public.
"They are starting to realize that drinking is not just a hangover," said Siobhan Creaton, head of public affairs at the Royal College of Physicians of Ireland.
September 9 is International FASD Awareness Day, which was launched by Canadian and American parents in 1999 to shed light on this disorder.
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