Lori Gertz was vilified last year when critics accused her of heartlessly sending her 7-year-old adoptive daughter Ellie 1,700 miles from their home in Long Grove, Ill., to be raised by strangers.
Ellie's violent outbursts began from infancy and progressed. At one point she threatened to kill her little sister and pulled her eight-month pregnant mother down a set of stairs.
The Gertz family -- Lori, a marketing specialist, and Craig, a lawyer -- sought help from every available social service agency, spending hundreds of thousands of dollars and consulting 39 doctors until they learned she had fetal alcohol syndrome disorder (FASD).
The insidious disorder includes an array of neurological deficits that can cause poor judgment, inability to bond and aggression.
By the age of 6 she had seen four psychiatric hospitalizations and made numerous suicide attempts. Specialists worried that Ellie, who could be at once charming and malicious, might one day fatally hurt her siblings, then 5 and 11.
Worried for the safety of her family and hopeful that Ellie might improve under the care of a couple from Washington state who had experience with FASD, Gertz made an excruciating choice -- to relinquish the daughter she said she still loves.
Now, as the alcohol-laden holidays approach, Gertz is speaking out: Don't drink during pregnancy, ever, and be "ultra-cautious" during childbearing years, she cautions.
"The legacy of FASD never wanes," she said.
According to the Centers for Disease Control and Prevention, about 125,000 women a year have serious alcohol problems throughout pregnancy.
Ellie's story, publicized nationally last September, has no happy ending.
After a 15-month honeymoon with her new family, Ellie again displayed meltdowns so aggressive that both families became embroiled in unfounded accusations of child abuse. Now they struggle to co-parent a child whose brain has been permanently damaged by her biological mother's drinking.
"This Mama couldn't kiss it better, and then her guardian Mama couldn't kiss it better," Gertz, now 48, told ABCNews.com "The thesis for all of this is prevention -- so stories like this don't need to be told."
"The pattern of her self-destructive nature didn't change with the shift in caregivers, which is an integral part of our ongoing story, because so many people skewered me for being this horrific person at the root of Ellie's problems," she said. "And everyone wanted her to recover with her new family."
That family did not want to share their side of the story with ABCNews.com for fear that they would compromise Ellie's anonymity and slow progress.
FASD affects about 40,000 newborns a year -- about one percent of all live births in the United States, according to the National Organization on Fetal Alcohol Syndrome (NOFAS). Two million adults are also affected by FASD.
Alcohol, like the carbon monoxide from cigarettes, passes easily through the placenta into the blood of a developing fetus, putting the child at risk. Because the fetus cannot break down the alcohol the way an adult can, its blood alcohol levels remain high for a longer period of time.
A fetus is most vulnerable in the first trimester and the extent of damage is determined by both the timing and pattern of alcohol use. The severity of the disorder can range from full-blown fetal alcohol syndrome, with facial deformities and growth deficiencies, to a spectrum of neurological disorders like Ellie's.