13.03.2023 - Approximately 60 people, ranging from pediatricians and midwives to psychologists and adoption caseworkers, participated in Fokus FAS in person in Gothenburg on February 9-10. Almost as many people followed the conference online. FAS-föreningen took the opportunity to speak with some of the participants.
Camilla Midborn is a midwife at the Haga Maternal and Child Health Care Team in Gothenburg, which provides support to pregnant women at risk or with harmful use of alcohol or drugs.
Why are you participating in Fokus FAS?
We at the Haga Maternal and Child Health Care Team work with this target group and this is the first time there is a conference like this. It is valuable to gain knowledge and be able to spread it to colleagues at other midwifery clinics.
What is the most important thing you take away from here?
Figures like 1 child in 100 may experience developmental problems due to being exposed to alcohol during pregnancy are concerning. 85% of all women drink alcohol in Sweden and are often told they are pregnant in week 5. This means that many fetuses are exposed. It was also interesting to hear about the Norwegian guidelines. There, both the mother and father should abstain from alcohol from when they plan to conceive.
How will you be able to use the content of the conference in your work?
I meet women who have drunk alcohol during pregnancy. Most can abstain, but not all. It is important that they receive information about how alcohol affects them, so that they can make an informed decision about whether or not to continue the pregnancy.
Margareta Albåge is a pediatric neurologist at Sachsska Children's and Youth Hospital in Stockholm.
Why is this conference needed?
To gather knowledge, what we know, and also to start a joint effort on how we should proceed, both locally where we work and in Sweden as a whole. We need to continue the work on how we medically diagnose the children, so that we have the same type of diagnostic system in all investigation teams throughout the country.
What is the most important thing you take away from here?
Partly some facts about the effects of alcohol that I didn't really know, partly how the team in Norway works and sets up their diagnostic system.
Should Sweden have a competence center like the one in Norway?
Not one, but several that are linked to the pediatric clinics.
Lukas Granberg, a psychologist at the National Board of Institutional Care and working at Rebeckahemmet on Färingsö, which receives girls with psychosocial problems, criminality, and substance abuse.
Why are you participating in Fokus FAS?
Last fall we had a few assessment cases where I became aware that it could be FAS-related. I felt that I needed more knowledge, that I knew too little and therefore contacted the FAS Association. Of course, it is difficult to estimate how common FAS is with us, but I think there may be quite a few who are not correctly diagnosed. We carry out extensive assessments and make treatment-specific recommendations to those who take over from us in the care chain. The young people with us often have significant needs for adjustments, and then it is good if we can reduce the risk of misunderstandings.
What is the most important thing you will take away from here?
That it is not as complicated to assess as I had imagined. The diagnostic method we have gone through here, the 4-digit diagnostic code, is not as difficult to implement as I thought. It does not require expensive technology, which is of great importance for public operations like ours, and it was not difficult to learn the method.
Will you use the method in your work?
Yes, our intention is to implement the method with us, but it is not something we can just start with right away. Planning is required. We need to anchor the work method and purchase technology. But it is doable, and I think that is the case in many different public operations.
Esperanza Hidalgo Núñez is a BT doctor in Kristianstad and a junior doctor at the pediatric emergency department in Malmö.
Why are you participating in Fokus FAS?
I want to become a pediatrician and did not know much about FAS before. It was mentioned during my education, but not much more than that. This is a good opportunity to learn more.
What is the most important thing you take away from here?
How important it is for the family to get a diagnosis. As a doctor, it's easy to focus on what can be treated, and sometimes we forget that a diagnosis can mean so much. Not least for families to get help, support, and other things that can make their lives easier.
You have studied your medical education in Spain. How does Spain differ from Sweden?
FAS was mentioned during my education, but I don't really know much. For example, I don't know how and if pregnant women drink in Spain, but I think it's similar to Sweden. We are probably quite similar culturally, both with pregnancies and the view on alcohol.
Beata Skanse, a pediatric neurologist at the Central Hospital in Kristianstad and also in the Region Skåne Child Protection Team.
Why are you participating in Fokus FAS?
Because I have encountered children with FAS for more than 30 years and have noted that we do not talk about it as much today. I want to gain more knowledge to bring with me when I educate in primary and pediatric care. My ambition is that we should identify all children with difficulties. No one should fall through the cracks. We should be able to think preventively and also have the courage to have difficult conversations.
What is the most important thing you are taking away from here?
Partly the contact with the FAS association, partly the fact that we are actually starting to talk about FAS in Sweden again. At the clinic where I work, it has felt unfamiliar. Most people are not familiar with FAS and FASD. But when a conference like this is organized and receives funding from the National Board of Health and Welfare, it gives status to the subject.
Did we talk more about FAS 30 years ago?
Yes, we did. At that time, when I did maternity examinations, it could happen that we did extra checks regarding vision, hearing, and other things related to FAS. But many of the doctors who have only worked in the last 20 years do not know about this.
Why did it change?
My personal opinion is that we are so afraid of stigmatizing and that there is a fear of difficult conversations. It is no coincidence that only adoptive and foster parents are present at the conference, talking about their children. There is no feeling of guilt. In addition, I think that it has affected that the mother today is the one who takes care of the child at the maternity ward, and then they are followed up at the child health center. Neither we pediatricians nor the staff at the maternity ward see the children as much as we did before.
This article was written and photos were taken by Camilla Adolfsson for FAS Portalen.
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