Foetal alcohol syndrome (FAS) is the leading cause of preventable intellectual disability in the world, according to the World Health Organization,1 and the true prevalence is almost certainly underestimated. As long as alcohol is present in our everyday lives, FAS will continue to challenge families, communities and countries.
In this issue of Acta Paediatrica , Dr Feldmann suggests that a historical study of children living in a 1930s German wine‐producing community showed widespread FAS.2 We believe that FAS and foetal alcohol spectrum disorder (FASD) have been around for as long as alcohol has been available, and not at all restricted to times and places where alcohol has been used as reward or payment for work.
Pulque, a fermented agave juice with 4%‐7% alcohol, can be traced back thousands of years to native Meso America. Ancient Aztecs ritualised Pulque and strictly limited its use, but it was still widely used when water was scarce. By the 1500s, Pulque had become so popular that it was temporarily prohibited to quell the devastating health and social problems it wrought on native Mexicans. It is still extensively consumed in poorer rural communities and pregnant women are encouraged to drink it due to its nutrient content and beliefs about its lactogenic effects. It has been suggested that heavy and early Pulque use in pregnancy adversely effects offspring growth and development.3
The College of Physicians suggested that excessive gin drinking in early 18th century, London, after distilling restrictions were lifted, caused ‘weak, feeble and distempered’ children.4 In 1889 and 1895, the French Psychiatrist Maurice Legrain linked alcohol to intrauterine and neurological problems and grave mental issues. More than 40% of inmates in his asylum were diagnosed ‘hereditary insane’, due to their parents’ alcoholism.4 In the early 1900s, emerging research showed hereditary effects, direct teratogenic effects on the foetus, including structural dysmorphia, and other physical defects in animal models.4
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