The News Service
David C. Lewis, M.D.
Stop perpetuating the “crack baby” myth
After 16 years of research and more than a decade of following the development of children thought to have been at serious risk, medical experts have not identified a recognizable condition, syndrome or disorder that should merit the label “crack baby.” With no basis in science, the term serves only to stigmatize and slander children and their mothers and should be eliminated from public discourse.
The term “crack baby” is an urban legend masquerading as a medical diagnosis. It is a label that stigmatizes, marginalizes and endangers children and their mothers who are desperately in need of care. Born from the combination of an ongoing crisis in urban health care and draconian zero-tolerance drug policies, the crack-baby myth thrives even though it has no basis in science.
Due to a combination of insufficient data and public fears that followed the crack cocaine epidemic of the mid-1980s, crack was alleged to be harmful to the cognitive and emotional development of children. Sensational news stories warned of the damage that crack would inflict on a generation of children and thus on society in general. A few scientists went beyond the data from incomplete research and contributed to the hype with inaccurate comments.
Now, with the benefit of additional research and better data, we know that those fears and early stories were wrong. But change comes slowly: We persist in mislabeling the children.
After 16 years of research and more than a decade of following the development of children thought to have been at serious risk, experts have not identified a recognizable condition, syndrome or disorder that should merit the label “crack baby.” This is in dramatic contrast to the specific and well-established criteria for a diagnosis of fetal alcohol syndrome. According to what we now know from medical and psychological research, we should eliminate a number of terms from our usage – not only “crack baby,” but “crack-addicted baby,” “ice baby” and “meth baby.” That these terms do not correspond to a proper diagnosis is not simply an academic question; there are serious practical implications for our nation’s health and welfare.
Recently a New Jersey family allegedly starved several of its adopted foster children. The foster parents claimed that the children looked emaciated because they were “crack babies” and therefore could never grow. Thus, the family was able to fend off outside attempts to intervene. Newspaper and television reports added legitimacy to their rationale by describing at least one of the children as a “crack baby.”
If crack cocaine was not responsible for the children’s emaciated condition, what could account for these symptoms?
Research now shows that the fetal and infant health problems previously associated with crack cocaine use are better explained by malnutrition and a lack of pre-natal care. In fact, a comprehensive research review shows no consistent negative association between maternal cocaine exposure and children’s physical growth, developmental test scores, or performance on receptive and expressive language tests. Furthermore, standardized parent and teacher reports of student behavior showed no independent effects from maternal cocaine use.
Thirty of the nation’s top scientists and physicians in the field are now trying to set the record straight. They have united to document the current status of scientific evidence regarding the effects of children’s exposure to drugs during their mothers’ pregnancies. This scientific statement is available for public review at www.jointogether.org/sa/files/pdf/sciencenotstigma.pdf.
Our nation’s prowess in science and medicine is only worthwhile if it can help us dispel myths and provide better care. An obvious positive step in achieving both these goals is to finally eliminate “crack baby” myth from public discourse.
David C. Lewis, M.D., a pioneer in the medical diagnosis and treatment of addiction, is the Donald G. Millar Distinguished Professor of Alcohol and Addiction Studies at Brown University.