Today sees the launch of a new campaign to get people to reconsider their drinking and ask themselves difficult questions.
As the Herald reported yesterday, midweek-drinking mothers, professional couples and shift workers are among those being urged to ask questions they may not like to answer about whether the long term pattern of their drinking is really healthy.
But there is another area where Scotland needs to force itself to answer hard questions, according to experts. This time mothers-to-be are the primary focus as medical chiefs look at more assumptions about what is normal, and why.
Foetal Alcohol Spectrum Disorder (FASD) is a serious and damaging congenital condition affecting children who have been damaged by parental drinking while still in the womb. It used to be thought that only very heavy drinking produced the severe symptoms. As a result, it has had a lower profile than it ever should have done.
The facial deformities affecting children with classic FASD are notoriously alleged by some experts to be recorded in Hogarth's 1751 print Gin Lane.
But FASD, characterised by babies with a low birthweight, small head, learning disabilities and unusual facial features including a thin upper lip – is rare, affecting barely 0.1% of all births. The rub is in that word "spectrum. Conservative estimates suggest many more, 1% or 600 live births a year, have some level of foetal alcohol damage.
So while Scottish children on the spectrum may mostly been affected less severely, experts believe the numbers affected by FASD are still substantial. According to an online education resource for medical professionals launched by NHS Health Education Scotland at the end of last month, at least 9350 under-18s in Scotland have been adversely affected. With 90% of cases showing no visible signs, there is a real concern that many go undiagnosed.
Symptoms such as learning difficulties, delayed development, hyperactivity and attention problems can be attributed to other causes, yet cause children lifelong problems.
Speaking about the new learning package, Sir Harry Burns, Scotland's chief medical officer, said: "Health professionals have often been reluctant to talk about this issue, but the consequences of FASD are very significant and very damaging."
With better understanding among health workers, he says, more cases can be diagnosed and treatments or other assistance offered.
Charities such as Children in Scotland are also pushing for more recognition of the condition, based on an understanding that the only guaranteed protection is not to drink at all during pregnancy.
It's another unwelcome message and seems to be another lecture aimed at mothers-to-be. Experts say this is only partially the case. Men too can help change the culture. Our national acceptance of drinking which would be seen elsewhere as heavy or reckless, is under scrutiny again.
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