Foetal Alcohol Syndrome

Tracey Crouch Excerpts

Tuesday 14th October 2014 Westminster Hall

[Tracey Crouch (Chatham and Aylesford) (Con)]

It is a pleasure to serve under your chairmanship, Mr Turner. I congratulate the hon. Member for Sefton Central (Bill Esterson) on bringing forward an incredibly important debate at a pivotal time, when political parties are considering alcohol-related issues and how they might form part of our election manifestos. The problems are important to many people out there.

I cannot yet speak from my own experience, but I imagine that there can be no more exciting time for a family than when they are bringing a child into the world. There is all the expectation and preparation throughout pregnancy; there are the classes that future mums and dads go to, with varying degrees of enthusiasm; there is the need to make the home baby-proof for the arrival of the newest member of the family; and there is an endless amount of information read and digested in preparation for becoming parents. That is all part of the nervy but exciting process that millions of parents go through each year. They take every precaution that they can to ensure that they give their child the best and healthiest possible start in life. Why, then, is there an ongoing problem with children being born with foetal alcohol syndrome disorder?

FASD refers to several diagnoses of permanent brain damage and can vary in severity from case to case. It could affect up to one in every 100 babies in England. One thing that does not vary from case to case is the fundamental cause: pre-natal exposure to alcohol, or the alcohol intake of women during pregnancy. We need to be careful, as the hon. Gentleman said, that we do not demonise or frighten women who may have drunk before they realised that they were pregnant, but that is not a reason for us not to discuss the issue.

The prevalence of FASD is particularly concerning because the link between pre-natal exposure to alcohol and FASD is quite clear. Expectant mothers can prevent it by taking precautions when it comes to drinking alcohol, as of course many do. No expectant mother in possession of all the facts would wilfully jeopardise the health of their unborn child by not taking precautions, so why is FASD still a problem? I would respectfully say that one thing missing from the hon. Gentleman’s speech was the point that there is a generational issue here. Many people with children of child-bearing age will say to their young daughters, “I smoked and drank throughout my pregnancy and you turned out fine,” but there is a difference in consumption. My parents did indeed drink and smoke while pregnant with me, and I turned out fine, or so I would argue; my parents might disagree. Their level of alcohol consumption was different from the level that women are consuming these days.

FASD is at root poorly understood, and little has been done by way of meaningful study into it. Our understanding of the true scale of the problem is limited, and it is feared, with some justification, that those diagnosed with FASD are just the tip of the iceberg. Nobody knows just how bad the situation is, and how bad the rate of misdiagnosis is among children who display similar symptoms, such as those associated with autism. The misdiagnosis of a child’s symptoms can have a severe impact on their development, and that really needs to be addressed. Even with this relatively limited understanding, knowledge of what to do about FASD and awareness of the dangers of drinking alcohol during pregnancy are patchy. There is so much conflicting information out there for expectant mothers, and so much uncertainty about what might be safe to drink and when. Some sources say not to drink at all. Some say that one glass of wine a week is fine. Some say that one glass of wine a day is fine. The messages are inconsistent, which is a major problem. That is not good enough, and while there is uncertainty in our understanding and in the messaging around FASD, nothing will change.

The all-party parliamentary group on alcohol misuse, which I chair, often discusses the lack of co-ordination in tackling alcohol-related harms. Whatever the topic, one of the key solutions to which we always return is raising awareness and education, which can succeed only if we know the facts. When it comes to policy, we talk of nothing being a silver bullet; in this instance, except in extreme cases, investing in a full-scale, holistic campaign to raise awareness of FASD, based on a full and proper study, is as close as we will get.

As often appears to be the case with alcohol and health policy, the Government could and perhaps should look to Canada for ideas and guidance on how to tackle FASD. In Canada, there is already much greater understanding of and emphasis on the risks associated with drinking while pregnant. As the hon. Gentleman said, warning statements are visible in pubs and clubs, and containers carry an explicit message about the dangers of drinking alcohol when pregnant.

The all-party group published a manifesto in August that set out key commitments that we would like all three political parties to adopt in their 2015 manifestos. One such measure was to support further health warnings on all alcohol labels. That commitment was considered rather controversial; as chair of the group, I got quite a lot of criticism for suggesting that alcohol bottles should carry better health warnings, as if that somehow infringed people’s civil liberties. In fact, having better information on alcohol labels enhances people’s liberties, because it gives them the right information.

[Kelvin Hopkins]

The hon. Lady makes an important point. Does she not suspect, as I do, some influence from the drinks industry, which is trying to calm fears that alcohol causes problems for babies?

[Tracey Crouch]

I will not criticise the drinks industry fully, because it is trying to improve its labelling. It is strongly committed to having better labels on its products. The problem is the inconsistency in labelling, not least depending on whether the product was imported or produced here in the United Kingdom. Before the APG manifesto announcement, I looked at the wine bottles in my house; there were, for example, differences between French bottles of wine, which had a warning label and an image of a pregnant lady, and Chilean bottles of wine, which had nothing on them.

As the hon. Member for Sefton Central mentioned, other countries have labels that include the Surgeon General’s advice. We do not have anything as specific as a consistent message on all our alcohol products. While one might appear on some bottles of wine, there is no such warning on bottles of beer, given the assumption—untrue, as we know—that women do not drink beer or lager products. We need to learn a lesson from Canada, which has much better labelling, which is focused on pregnant women in particular and better targeted.

The APG manifesto also stated that we would like commitments to introducing mandatory training on FASD for all social workers, midwives and health care professionals. Interestingly, 23% of midwives are not aware of the guidelines on alcohol and only 59% were comfortable asking about alcohol consumption. People are nervous about asking pregnant women what their alcohol consumption is, in case that somehow offends them or perhaps concerns them unnecessarily, but we have to get to grips with asking the difficult questions, so that the right advice can be given to pregnant women.

If we are to understand FASD better and to reduce its prevalence, those who come into contact with pregnant women who might be drinking alcohol play a crucial role in making brief but important interventions to give good, accurate and consistent information. Ensuring that those people are trained sufficiently and are confident enough to make those interventions would be another welcome and logical step in preventing FASD, or at least in enabling us to spot the signs and give an accurate diagnosis.

I am conscious that the debate is on FASD, but I wish to touch on the wider problem of alcohol misuse. Without doubt, more needs to be done to tackle binge drinking and alcohol-related harm in the UK. It is not difficult to assume that, in a country where alcohol is consumed in large quantities, that might have some influence on the prevalence of FASD. If we can get our approach right to tackling alcohol misuse more generally from the start, especially with young women who binge drink, we could see a drop in the number of FASD cases.

I was surprised to learn that 18% of women still binge drink while pregnant. Binge drinking is defined as drinking six units or more in one session, which is two large glasses of wine. Until we have a thorough understanding of how little alcohol it takes to put unborn children at risk, we will not make adequate progress. Although some people will disagree with some of the policy measures proposed in the alcohol misuse group’s manifesto, the entire package of measures sought to address alcohol misuse as a whole. That is relevant to the debate, and I hope that the Government will consider that.

In conclusion, FASD is preventable and its prevalence should be reduced. As I mentioned earlier, save in some extreme cases, I do not believe that any women would jeopardise the health of their unborn child if they knew all the facts. It is therefore essential that we establish the facts and invest in resources now to raise awareness throughout our society. I am interested to hear what the Minister has to say on where we are on developing a coherent strategy to tackle FASD, because it being poorly understood is not a reason to delay action. Let us put in the resources, get the issue understood and deliver meaningful measures, such as those outlined thus far today.

[Several hon. Members]

rose—