The editorial " 'Stronger brains' start developing at birth" (Dec. 26) describes an excellent recent forum on the importance of stimulation and enrichment in the first three years of life. And yet, I'm sure that the medical providers involved in the conference are aware that brain development also is happening long before birth. It begins during the earliest stages of fetal growth and continues throughout gestation and beyond.

During pregnancy, the complex structure of the fetal brain can be altered by many factors — including the crucial one of exposure to toxins. During the past 50 years, many studies have shown that alcohol, one of the most harmful toxins, can cause permanent damage to the fetal brain.

Specific changes include deficits in cognition, learning, planning and judgment, requiring special care, often lifelong and at great expense to society. This damage, along with abnormalities of the heart, face and bones, is called Fetal Alcohol Spectrum Disorder (FASD) and it is common in our state. Effects can range from quite mild to devastating.

The editorial quoted forum keynote speaker George Halvorson saying that a child's vocabulary at kindergarten predicts who will be in prison at age 18. A common factor in poor vocabulary or other early learning problems can be alcohol exposure before birth. If the problem is diagnosed correctly at an early age, specific interventions can make a difference, though the damage is permanent.

It is not difficult to imagine that individuals who lack judgment and planning skills, along with poor verbal ability, are likely to enter the legal system. In fact, persons who have been diagnosed with FASD are overrepresented in our prison populations. Many others may not have been identified.

As a pediatrician with 40 years of experience, I cheer the heightened awareness of the crucial importance of education at the earliest possible opportunity for our precious young children. As a board member of the Minnesota Organization on Fetal Alcohol Syndrome, I want to educate the public about the preventable brain injury of FASD that can limit the potential of Minnesota's children even before birth.

Please join us to spread the word that FASD and its expensive, life-altering, heartbreaking problems can be prevented 100 percent of the time by avoiding the consumption of alcohol during pregnancy.

Mary Meland, of Minneapolis, is a retired pediatrician and a board member of the Minnesota Organization on Fetal Alcohol Syndrome (