How much can one drink do?

Imagine your favourite playground from your childhood. The sun is warm and you are playing with all your friends - laughing, chatting, having a great time. Ok, now imagine, instead, sitting on the side of this playground watching the other children. No one wants to play with you. You go into the classroom and you can't concentrate, on top of that your teacher keeps shouting at you for your bad grades. You go home and your caregiver shouts at you for not sharing and for bad manners. You are stuck, not because of anything you did, but because you are a victim of Fetal Alcohol Syndrome (FAS). At the quintessential level, your brain is different. Not because of any action you could control. Arguably, not even because of your mother's decision to drink alcohol during pregnancy, but due to a societal loop set into place before this disorder even had a name.

In the Western Cape of South Africa, one of the highest rates of FAS in the world exists. This rate is estimated to be 18-141 time higher than the Western world. Why? Previously, wine farmers could pay their workers (predominantly people of Cape Coloured ancestry) part in wine and part in cash. This was called the "dop" system, after the Afrikaans word for alcoholic beverage. Although this is no longer legal, the collateral damage has been profound, resulting in a societally created cycle of alcoholism and generations of children being born with the adverse effects of prenatal alcohol exposure. In fact, many of the children born with FAS have mothers who have FAS and so such a cycle perpetuates.

The lab I am a student in at the University of Cape Town collaborates with Wayne State University and together they have collected huge amounts of data from a longitudinal study of children born to mothers in Cape Town.  We have children who have been diagnosed with FAS or partial FAS, or have been heavily exposed to alcohol in-utero as well as controls. Why do different brains have a different tolerance for alcohol damage? What structures in the brain are most affected? What makes these children so susceptible to misinterpretation of social nuance and so likely to be socially inept? These are all questions that are being investigated. 

My research has, to date, has looked at the effect of alcohol on certain brain structures important in memory, attention, executive function and crossover of information from one side of the brain to the other. All of them were found to be different by alcohol exposure level during pregnancy. In a nutshell, the more the mother drank and the more frequently she drank, the smaller these structures became. Of course, risk factors and protective factors play a role too, but how much do you want to bet on these? The take home message: Even one drink could have the potential to change a child's life forever.