On Friday, September 9 a service was held at Hastings Hospital to commemorate Foetal Alcohol Spectrum Disorder (FASD) Awareness Day.

Quite a large crowd was treated to Kim Milne's moving description of what it is like to raise a child with FASD. Russell Wills, paediatrician and former Children's Commissioner, gave a speech containing very important information that we all need to know.

He has permitted me to reproduce most of it here. He began by saying that when he first started in Hawkes Bay Hospital 16 years ago, FASD was relatively uncommon.

This has gradually changed and today numbers have increased to the extent that there are now three paediatricians and a child development team for whom FASD is a primary focus .

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What is it?

FASD is brain and heart damage caused by drinking alcohol in pregnancy. Early childhood and new entrant teachers, parents, and whanau refer FASD children for assessment because of their behaviour.

These children demonstrate hyperactivity, very brief concentration spans, problems playing, language delay, and their learning quickly falls behind peers.

They are often aggressive and do not learn from consequences so they repeat the same behaviours despite very good behaviour management.

As time goes by and the gap widens they develop feelings of failure, impulsivity and start to act out more.

They are unable to manage their emotions or think about consequences. As adults they leave school without qualifications, 75 per cent develop mental illness, most remain unemployed and a high percentage have criminal convictions and are incarcerated.

What causes it?

Foetal development in the womb is miraculous. The point at which the foetus is most vulnerable to insult is the first eight weeks when toxins like alcohol cause the most damage, especially to the developing brain and heart.

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This is the period before the woman knows she is pregnant. Alcohol is the most damaging compound we know of, more damaging than cocaine, heroin, marijuana and cigarettes because it interrupts cell development.

In New Zealand half of pregnancies are exposed to alcohol and 10 per cent are at high risk. We do not know how many babies are foetal alcohol affected, but in the US it is estimated to be 1 per cent .

Alcohol use in New Zealand is three times that of the USA so rates would be higher. 1 per cent of 57,000 deliveries in New Zealand gives 570, perhaps as high as 1710 affected each year. The implications of this are enormous. Brian Easton has recently estimated the cost to the country just in terms of lost productivity to be $49 million - $200 million.

How do we prevent it?

FASD is 100 per cent preventable. Very few things in medicine are. It is prevented by not drinking at all in pregnancy.

This is not simple. Women who drink heavily during pregnancy are much more likely to be in a violent relationship, to have had a traumatic childhood, to have depression, to be alone, and poorly supported.

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Simply telling her not to drink will not work. She may need help for addictions, mental illness and violence. Agencies need to be involved throughout her pregnancy.

However, this is only part of the solution.

While alcohol is so cheap, while it is marketed aggressively to young women as if it was just another commodity, while alcohol is available in every corner store and our culture normalises alcohol consumption in excess, we will continue to see huge numbers of children with FASD.

We will continue to see thousands of young lives wasted, children whose brains are permanently damaged by alcohol.

We can change this. We will continue to improve our support for women to be alcohol-free in pregnancy. We can ALL also send the strongest possible message to government and big alcohol.

Your product is too cheap. Aggressively marketing alcohol to young women means they drink more. This must lead to more alcohol-affected babies.

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This is not right in a civilised society. There are too many places to buy alcohol. It should be less accessible.

And finally, we ALL need to examine our relationship with alcohol. A culture that normalises heavy drinking is not a healthy one.

Our children deserve better.

■Fran Lowe, PhD, is from Alcohol Action Hawke's Bay