Prenatal Alcohol Exposure (ND-PAE)

What is Neurobehavioural Disorder Associated With Prenatal Alcohol Exposure (ND-PAE)?

ND-PAE is a disorder that children and youth may have if their mothers drank alcohol while pregnant. It can lead to intellectual disability and problems with learning and memory. Children with ND-PAE may have difficulty controlling their behaviour, and with daily activities.

A mother is more likely to have a baby with ND-PAE if she:  

  • is an older woman who drinks while pregnant
  • has a long history of alcohol use and drinks while pregnant
  • is dieting or overly thin or eats poorly and drinks while pregnant
  • drinks heavily and often while pregnant
  • uses alcohol together with other substances (sleeping pills, painkillers, marijuana, etc.) while pregnant

Alcohol can cause brain damage in an unborn baby. All babies’ brains are sensitive to alcohol and some are affected by very little alcohol. The only way to be surea baby won’t have ND-PAE is for the mother not to drink any alcohol while pregnant.

The only way to develop ND-PAE is if the mother drinks during pregnancy. It is not genetic.  That means it is not transferred from a mother with ND-PAE to an unborn baby, and it is not passed on through breast milk. But alcohol itself can be passed through breast milk, so it is best to avoid alcohol while breastfeeding too.


How do I know if it's Neurodevelopmental Disorder-Prenatal Alcohol Exposure (ND-PAE)?

Children or youth may be diagnosed with ND-PAE if they have:

A.    A mother who drank alcohol during pregnancy


B.    At least one symptom in each of these three groups:

  1. Problems with neurocognitive skills such as:
    • planning, solving problems
    • flexible thinking
    • controlling behaviour
    • learning (adding, subtracting, money)
    • memory
    • visual tasks (drawings or constructions are disorganized; confuses left and right)
    • IQ – intellectual ability
    • understanding consequences
  2. Problems regulating self, for example:
    • controlling emotions
    • controlling behaviours (impulsive)
    • paying attention 
  3. Problems with daily-living skills such as:
    • speaking and using language
    • communicating and getting along with others
    • walking, balance, and coordination of movement
    • learning to use tools and other manual tasks

A child or youth may have some of these traits and not have ND-PAE. But if they have many of these traits, they are more likely to have ND-PAE.

Some children and youth with ND-PAE have a special look such as small eye openings, a short snub nose and no bridge, and no groove beneath the nose. Others with ND-PAE may not have these features. 

What can be done?

We do not know how many people suffer from ND-PAE. Experts think that about2-5% of people in the United States live with this disorder. There is no cure. But it is possible for a child with ND-PAE to grow up and develop many important skills. For example, they may grow up to be loyal, friendly, affectionate, and artistic. And they may work well with animals and plants.

Children and youth with ND-PAE will most likely need life-long help to:

  • finish school
  • get and keep a job
  • manage money
  • get along with other people

Some of this help may come from special services:

  • special education programs
  • training programs
  • tutors

Children and youth with ND-PAE develop at a slower rate than other children. A 12 year old, for example, may behave like a younger child. Some children will develop at a slower rate very early in childhood, but with others, the delays may only become apparent at school age. Children with ND-PAE function best in a structured environment.

For women who may become pregnant

There are many ways to lower your risk of having a baby with ND-PAE:

  • If you’re not using birth control and you’re trying to get pregnant, avoid drinking any alcohol. This way your baby will have no chance of developing ND-PAE.
  • If you have just found out you’re pregnant and have been drinking up until now, do not drink alcohol from now on. If you need help stopping, ask your doctor to help you find resources, a support group, or look at the information listed below.
  • If you know you’re pregnant but are struggling to stop drinking, try your best to cut down on how much and how often you drink. If you need help to do this, talk to your doctor or someone close to you about ways to manage the amount of alcohol you drink.

For Men

A father’s drinking will not cause ND-PAE. Only a mother’s alcohol intake can affect the fetus. But you can help by making it easier for a woman not to drink. This may be by not drinking when you’re around a mother-to-be. Or the two of you could quit drinking completely during the pregnancy and breast feeding stages.

Where to from here?

Talk to your doctor and look for help from a mental health professional by:

​For additional information about options for support and treatment in BC, visit the Finding Help section of our site.


BC Children's Hospital

This is an agency of Provincial Health Services Authority, providing provincial tertiary mental health services to the citizens of British Columbia. Programs include: Adult Tertiary Psychiatry, Geriatric Psychiatry, Forensic Psychiatric Services, Child & Adolescent Mental Health, Women’s Reproductive Mental Health, as well as the Provincial Specialized Eating Disorders Program for children and youth located at the BC Children’s Hospital.

Provincial Health Services Authority

Provincial Health Services Authority (PHSA) is one of six health authorities – the other five health authorities serve geographic regions of BC.

Ministry of Health

British Columbia Ministry of Health

RBC Children's Mental Health Project

RBC Children’s Mental Health Project is RBC's cornerstone “health and wellness” pillar; RBC Children’s Mental Heath Project is a multi-year philanthropic commitment to support community-based and hospital programs that reduce stigma, provide early intervention and increase public awareness about children’s mental health issues.

BC Children's Hospital Foundation

Through a wide range of fundraising events and opportunities, The BC Children's Hospital Foundation is united with its donors by a single, simple passion - to improve the health and the lives of the young people who enter BC Children's Hospital every day.