image by Olivia House Photography - found on Pinterest
I talk most about the impact of prenatal alcohol exposure (PAE) to the brain because that is what impacts my son’s daily life the most. But alcohol exposure in utero can adversely impact any part of a developing fetus. The impact is, as always, dose dependent, meaning the more alcohol the larger the potential impact. What feels that impact, i.e. what part of the developing child is affected, depends in a large part on the timing of consumption and what is developing at that time. Many people focus on the first trimester as the most critical time because the development of the fetus is most dramatic then but the truth is parts of a baby are developing the whole 9 months and while the most severe damage (including fetal death / miscarriage) is most likely in the first 3 months – some pretty rotten stuff can happen from alcohol exposure at any time during the pregnancy.
One of the potential issues people seem unaware of is how PAE can affect the heart. People with prenatal exposure are at risk for defects to the tricuspid and mitral valves leaving them either malformed, missing, or dangerously thinned (which then allows blood to flow backward into the atria); ventricular septal defects, commonly known as a “hole in the heart” between the left and right ventricles; and enlargement of the left ventricle, the primary pumping chamber in the heart. Any of these issues, when serious enough, could cause the need for surgical correction. All of them if present, even in a milder form, make the heart work harder and age faster than normal, leading to the increased risk of heart disease in general in the future. the first sign of these sort of problems is usually a heart murmur found during an infant exam.
Development of the heart begins during the third week of pregnancy when most women are not even aware that they are pregnant. Alcohol interferes with the migration and specialization of the cells forming the structure of the heart. It’s worth noting that one study by Case Western University showed that a single binge drinking episode timed at the beginning point of the heart’s development was sufficient to produce dangerous impacts to the heart. Genetic background is of course an important factor in moderating alcohol's effects on the developing fetus.
It is common for babies exposed in the womb to have a heart murmur that fades away by one year of age. Unfortunately because PAE has been found to reduce the ability of the heart to contract at the tissue level the risk of developing heart problems does not fade even if the murmur does. Most parents, upon hearing that a heart murmur has “resolved” would consider that any danger of cardiac issues had past. Little Man had such a murmur. Its long since gone. While I don’t talk about it often it is something that stays in my mind. Because of his prenatal alcohol exposure his cardiac function is something we will have to worry over – and perhaps monitor - his whole life.
I've been thinking about this more recently because I have been having some concerns about my own heart health. Which, of course as any personal health issue does, leads me into worry about who will take care of my son someday (hopefully a long, long time from now) when I am not here to. Today, I refuse to travel down that rabbit hole of fear though. Instead, I'm going to remember what Little Man said to me the other day about hearts and family and love.
"Love is when you feel warm and safe because you have your family in your heart."
Yes baby. Yes it is.