(a) Foetal alcoholic syndrome: face, note the short palpebral fissures, flat nasal bridge and small nose, strikingly featureless philtrum and poorly formed upper lip. (b) Severe malnutrition and growth restriction in foetal alcoholic syndrome. Initially all treatments failed to establish adequate nutrition and growth, including insertion of a gastrostomy and total parenteral nutrition, due to persistent severe vomiting. After 6 months of age, a fundoplication was performed, and gradually enteral nutrition could be reestablished. The child has caught up weight and growth into the percentiles but is still dependent on gastrostomy feeding at present (4 years and 10 months of age).