# Early signs of FASD on a home visit

Canonical: https://pinnacleblooms.org/ask/what-early-signs-of-fetal-alcohol-spectrum-disorder-should-a-frontline-health-worker-look-for-during-a-home-visit
Publisher: Pinnacle Blooms Network / Bharath Healthcare Laboratories Private Limited

On a home visit, look for clusters rather than one sign: low birth weight or growth faltering, poor feeding and weak suck, small head size, subtle facial features (smooth philtrum, thin upper lip), irritability or poor sleep, and developmental delays — alongside any history of alcohol use in pregnancy, asked sensitively. Route clusters to the PHC medical officer; FASD is confirmed only by clinical assessment.

*During a home visit, you are often the first to notice that a baby is growing slowly or feeding poorly — and a gentle, non-judgemental eye can open the door to early help.*

## In short
Fetal Alcohol Spectrum Disorder (FASD) follows alcohol exposure in pregnancy and shows as a pattern — poor growth, subtle facial features, and developmental or behavioural differences — rather than one single sign. On a home visit, look for clusters across growth, feeding, milestones and the mother's history, and route any concern to the PHC medical officer for a developmental check. FASD is never confirmed in the home; it needs qualified clinical assessment.

## Signs to look for on a home visit
**Growth and feeding**
- Low birth weight, or weight and length tracking below the expected curve despite feeding
- Poor feeding, weak suck, or a baby who tires quickly at the breast
- Small head size relative to the body

**Subtle facial pattern (note gently, do not over-read)**
- A smooth area between nose and upper lip (flat philtrum), a thin upper lip, small eye openings

**Behaviour and development**
- Irritability, poor sleep, or a baby who is hard to settle
- Delays in smiling, head control, sitting, babble or first words
- As the child grows — restlessness, difficulty with attention, learning or following routines

**History (ask with warmth, never blame)**
- Any alcohol use during the pregnancy — frame it as routine maternal health, recorded sensitively

## When to refer
No single feature confirms FASD. Refer to the PHC medical officer when growth faltering, feeding difficulty or developmental delay cluster together, especially with a history of antenatal alcohol exposure. Early routing means early support — do not adopt a "wait and see" stance when several signs appear together.

## The Pinnacle way
A clinical [AbilityScore®](/ask/what-is-the-abilityscore-and-how-is-it-calculated) and any diagnosis of [FASD](/fetal-alcohol-spectrum-disorder) are formed only at a Pinnacle Blooms Network centre under qualified clinician care — never from a home screen. Your observation, paired with [early intervention therapy](/early-intervention-therapy), turns a worried visit into timely help. Backed by 25 million+ therapy sessions and 700+ therapists across 70+ centres.

## Trusted sources
Aligned with WHO ICD-11 (LD2F.00), CDC FASD guidance, and the American Academy of Pediatrics on early developmental screening and surveillance.

**Next step —** to refer a family or set up a PHC referral pathway, reach the Pinnacle clinical team on WhatsApp: +91 91001 81181.

This is general information, not a diagnosis — individual assessment and diagnosis require an appropriately qualified healthcare professional.

## Sources
- WHO ICD-11 — Fetal Alcohol Spectrum Disorder (LD2F.00): https://icd.who.int/
- CDC — Fetal Alcohol Spectrum Disorders guidance: https://www.cdc.gov/
- American Academy of Pediatrics — developmental surveillance: https://www.aap.org/