Ms Paula Leonard:

On other programmes that have been shown to work, there is an acceptance at a global level that prevention on its own is not adequate to address issues in relation to foetal alcohol spectrum disorders. It is necessary to have a long-term strategy for the provision of supports, services and diagnostics to families who are impacted by prenatal alcohol exposure. That said, there is a role for prevention and many forward steps have been taken in that area. Levels of foetal alcohol spectrum disorder in a population are linked to population level consumption. On the positive side, the Public Health (Alcohol) Act has been introduced and the HSE has established a clinical working group on foetal alcohol spectrum disorder and appointed a clinical lead. This group and the lead specialist have clearly marked out that the areas they will cover are prevention, education and population level messages. That is very welcome and the DFI is happy it is happening. In addition, through the Department of Health, an additional seven drug liaison midwives will be appointed under the national drugs strategy to work with women who have issues with alcohol addiction and support them in moving towards alcohol-free pregnancies.

While much has been done in this area, we have not yet reached a point where the policy and medical areas have one clear message. At an international level, the World Health Organization says that no amount of alcohol intake during pregnancy can be considered safe, there is no safe trimester in which one might drink alcohol, all forms of alcohol pose a similar risk and binge drinking poses a dose-related risk. We should all be concerned that binge drinking is very much the signifier of how people in this country drink.

Population level consumption was going down over a number of years but binge drinking continued to be the norm.

While we would welcome all of the developments I have mentioned, it is important that we do not just view this in the narrow space of prevention. There will always be women who continue to drink during pregnancy. The European Birth Mother Network is a group of mothers with children who have been impacted by foetal alcohol spectrum disorders, FASDs. The network is clear that there is a complex mix of reasons for women drinking during pregnancy, for example, childhood trauma, addiction and knowing people who drank during pregnancy and whose children were okay. Not every alcohol exposed pregnancy will result in a child with an FASD. These are important messages. Another reason for prevention alone being a major challenge is that women may often not know that they are pregnant until they are five, six, seven or eight weeks into their pregnancies and the foetus may be exposed to alcohol during that period.

There are a range of reasons that we must approach this issue in a no stigma, no shame and no blame way and we must understand that it is complex. We need prevention and a clear message from our medical community but we will also need supports and services, which can only follow on from diagnostics. That is why we are asking committee members to use whatever access and influence they have to support the call for the development of clear diagnostic criteria for foetal alcohol syndrome, FAS, and FASD.