This document discusses the need to expand the definition of fetal alcohol spectrum disorder (FASD) to include preconceptual alcohol exposure from both parents. Currently, the definition of FASD only considers prenatal alcohol exposure from the mother during pregnancy. However, recent research suggests paternal preconception alcohol use and other environmental toxins can also impact fetal development and increase vulnerability to stress and alcohol drinking behaviors later in life through epigenetic mechanisms. The document lists several relevant research papers that studied the effects of preconceptual exposures from both parents on offspring development, behavior, and health outcomes. There is a call to raise more awareness about how preconception lifestyle factors can influence fetal and child development.