I think my niece has FAS

[Mena1]

I think my niece ( DH's sisters daughter) has FAS. Her mum drank heavily while pregnant ( with all pregnancies) , and i strongly believe she has FAS. While SIL was pregnant i tried speaking to her about FAS but it went in one ear out the other. her standard response was " its my F&cking body I can do what I like". So I decided to keep my mouth shut. Of course I only said something as the LO cant speak for themselves. Now at the age of 7 she is showing signs, she's put on less than 2kgs in two years and her bmi is that of a two year old.

She has seen the gp and gone for blood tests (suggested by her teacher) and is now going to see a pediatrician as the blood work came back clear. (according to SIL whom I dont trust and think is lying.)

Should I do anything? I love this LG so much as if she were my own.

I'm not sure you can do anything.

She is going to see a pediatircian, who will be able to tell she has FAS.

" its my F&cking body I can do what I like". I hear this argument about women a lot on MN.

You right, I cant do anything, I feel utterly helpless.

Poor girl is 17 kilograms and height is 1.15metres and shes 7, shes not even on the percentile.

SIL lies to dr's about her drinking during pregnancy I wonder if they will pick up on it. SIL has never even seen a HV with any of her babies.

Dont get me started on the line, I rage when i hear it. if that how they feel maybe hey should be having unprotected sex in the first place.

Maybe controversial but if she was my SIL, i'd report her. If she isn't willing to care for them when they are actually inside her then how can she care for them when they are in the real world?
Have you checked for physical signs of a child with FAS? Thin upper lip, small head circumfrence, flat face etc.? It does sound that she has the slow development of a child that has FAS. Look into Fetal Alcohol Effects (FAE) as well as FAS too and Alcohol-Related Neurodevelopmental Disorder (ARND).
I wish you all well.

I wish i could report her, if i did they would know its me and it would cause so much trouble i dont know if its best to just be quiet. MIL took SIL's side when i confronted her about drinking while pregnant and said she drank and theres nothing wrong with her kids . FIL says thats rubbish! she always makes excuses for SIL and claims shes this fantastic mum when shes not. IE this weekened she is going away for the weekend with her new man and leaving the kids with MIL. This man moved in after two weeks . since her split 1year ago with husband she has had 8 lovers and all met the kids. Mum of the year isnt she? Getting of topic here, I could write a book about my in laws.

I've read doens of books on FAE and FAS and i truly believ her kids have it but I cant tell her that. It would just cause drama that i cant be arsed to deal with.

I've checked my Red Book. She appears to be on about the 9th centile for both height and weight. That is not in itself any cause for concern.

I am assuming there are other symptoms which you do not want to post about publicly. But as she has been recently seen by the GP, and has a paed referral, then any underlying conditions should be picked up.

I checked the red book as well! typical mums isnt it?

She has really bad language skills, she says got instead of have and can be very rude (for a better word) , her concentration skills is non existent and the facial indicators are there. my FIL actually said "she looks like a skinned rabbit" (horrible I know.) Since she was born I have wondered about her. I dont think i'm looking for things but i couldnt say.

her mum said the gp said she isnt on the percentile.

Didnt want to just put the post and run but I really feel for you and the poor child. I understand when you say it could cause tension reporting her which could be worse!
What has your partner said?

Is saying "got" instead of "have" an indicator of learning difficulties then?

Edith - a 7 year old at 115cm and 17kg is under the 1st centile for BMI.

DH thinks she is irresponsible and reckless but couldnt say anything even to MIL.

I'm not sure if its a definite indicator but her younger sibling speaks better than she does and even after correcting her constantly she still says "got". of course her mum doesnt correct her neither does MIL , its everyone else.

What a horrible situation - many sympathies. The difficulty about FAS/FAE is that it can manifest in different ways according to when the damage was done (distinctive facial features only figure where heavy drinking happened at the point facial features are formed, and there are many children with FAS who do NOT have these features). It can be hard to diagnose, and often parents have to fight to get a diagnosis or appropriate help - so just seeing the GP may not do the trick (especially with a mother in denial).

But what can you do? Lord, I don't know.

Rita - I had a check in the red book and saw 1st as well thought i might not have done it properly.

Need a paed to formally diagnose fas.that's not your remit
Do report any suspected neglect,to duty sw local authority sw dept can do so anonymously too

Rita:I've just double checked the Red Book - definitely 9th centile for 7.0 years.

Centiles are measured against whole population, eg data from measuring children in schools. I wonder if the scale has been revalorised since that book was issued?

It's not a key point though. She is in proportion, and it's no dofferent from posters who have children up in the high 90s who remain unconcerned about weight, and especially not of she has always been on that trajectory.

The paed will be checking for a range of conditions against her full symptoms. She is being seen by the right people. OP, all you can do now is await their conclusions and then you will know what (if anything) there is.

Concerns about adequate parenting are somewhat separate (though may be picked up in this process). If you remain concerned that there are issues which are not being addressed, then you will have to find a way to make a report (perhaps ring NSPCC for advice on to whom and how). I don't think you would be able to live with the possible consequences otherwise.

The height/weight charts in my red book only go up to age 4, so I can't check. However, her BMI puts her below the 1st percentile which is underweight - a child with a BMI in the 90s would also be of concern.

Rita

Height/ weight no indication ds3 is nearly 7 he is 105cm and 15kg and no I did not drink etc

He is just very very tiny oh and gorgeours

The other stuff well if true then that's a separate issue

Oh dd is 9 122cm and 19kg so not much bigger and she is still on chart and nothing up with her she is bright/ sporty little girl

To balance out ds2 is 6foot and 44kg at 14 .(has crohns] Build is not a good indicator

I've now worked it out on an on line calculator (which incidentally confirms that centiles I gave above). Her BMI is 12.9 which is just under 3rd centile. In children 1-4 centile is classed by NHS as underweight. The healthy weight category range for this age and height starts at 18kg.

This is all rather a red herring though, as small stature and low weight (which presumably is one of the things being medically checked) is not a specific symptom of anything (and indeed - as noted by posters above) may not be unhealthy at all.

The key thing for OP though, is whether the wider symptomology (which she does not wish to make public) will be found to indicate a particular condition (whether FAS/FAE, or anything else).

And then the crux - whether she is being looked after properly. The possibility of a diagnosis seems to have prompted the posting now, btu it seems the real issue is a longstanding one of sub-optimal care. OP has to decide whether she is going to permit it to continue (by staying silent) or report and take the consequences. That's a difficult choice, and one I wouldn't want to have to make.

OP: roughly when is the paed appointment? As I noted above, if there is a diagnosis, depending on what it is, more advice and support for the family might be forthcoming. If that happens, and she responds well, perhaps your concerns will be alleviated.

Not sure focussing on what might have caused the issues helps. If it was because of alcohol that doesn't really matter now other than in terms of accessing the right help and understanding, whats done is done and can't be undone. My third son has autism and some members of my extended (thankfully not my immediate family) were interested in the blame game - who had autistic traits, where it might have come from. None of that talk was remotely helpful to me or my child. You need to deal with the here and now. Children with FOS present very similarly to those with learning difficulties or autism except often with physical signs.The school should be on top of this - is she getting support at school eg speech therapy, 1:1, behaviour support? Maybe you could get your DH to ask his sister if she is getting right support? Do you know who the GP or paed is? You could write a letter to the GP or paed. They can't reply for confidentiality reasons but at least you might be putting the idea of FOS on the radar and if it comes from a Dr she is not likely to suspect you. My mum has written to my Dad's GP before now when he had a medical problem she knew he wouldn't disclose! It can be an effective way of getting a GP or paed to ask the questions. But if she has obvious physical signs the paed should pick it up as soon as she walks through the door.

If she has FAS, then she has it, and there is not really anything you can do about it. However, you are right to be concerned if you feel she is being neglected. Do you think her small stature and low weight is the result of her not being fed properly - or are you quite a small family? I would follow Edith's advice if you are concerned for her welfare. Though I don't really understand the 'got' thing.

I think Agnes has the right idea. If you know who her GP is, you can write to them and tell them your concerns or even make an appointment to discuss it with them and anything else you are worried about. They won't tell you anything in return but can document it all. More than likely they will be able to look up mums notes and see if there is anything in her notes that indicate that she drinks/drank heavily and pass this on to the paediatrician.

If you have any social concerns then you need to speak up about those too. If she is still drinking heavily it is a huge risk factor for abuse, not to mention the string of men she brings into the family. The GP may not be able to do anything about them now but if there are ever any issues or questions in the future, it is all useful background evidence to have noted.