Ever wonder what became of crack babies? In the 1980s,
media coverage in Canada and the US horrified the public
with stories of cocaine and crack cocaine's toxic effects
on children in the womb. Addicted newborns, brain-damaged
neonates and disturbed toddlers were all said to be part
of an 'epidemic' caused by the rising incidence of drug
use during pregnancy. But Canadian and US researchers
claim that the hysteria over crack babies was more a product
of the media than of scientific data.
Cocaine addiction increased in
the 80s and, in Canada, "There was a huge concern that
we would see another thalidomide [incident] with birth
defects and neurodevelopmental impairment," recalls
Dr Gideon Koren, Professor of Pediatrics at the University
of Toronto and Director of Motherisk — a program
that counsels women on drug safety and other pregnancy
related issues. "In Toronto, we did a study 12 years
ago measuring hair levels of cocaine in babies and found
that 6% of women used cocaine in their last three months
of pregnancy. This translates into 5,000 exposed babies
a year in the Greater Toronto area," he says. However,
further research by Dr Koren — now, a staunch critic
of the crack baby myth — found no link between
birth defects and in utero exposure to cocaine.
AMERICANS
ON CRACK
University of Florida researchers Dr Fonda Eyler, PhD,
a developmental psychologist, and Dr Marylou Behnke,
MD, a neonatologist, were appalled at the number of
uncontrolled case studies they found. "People were seeing
children with problems, then asking about drug use,
finding a few who had been exposed to cocaine and making
the assumption that there was a cause and effect relationship,"
says Dr Eyler.
During a presentation at the annual
meeting of the Society for Research in Child Development
in Atlanta this April, Dr Eyler finally put the crack
baby myth soundly to sleep. Since 1993, she and Dr Behnke
have been following 154 children exposed to cocaine
in utero and 154 unexposed kids who were matched
on race, parity, socio-economic status and prenatal
care.
"We did extensive physical and
neurologic exams at birth and found no group differences,"
says Dr Eyler. There were no developmental or cognitive
differences found in these kids at age three either.
These results can be found in the April 12 issue of
the Journal of Pediatric Psychology. At the meeting,
the researchers presented a preliminary analysis of
the kids at ages five to seven which also failed to
detect any major differences in overall development
or IQ.
PRODUCT
OF POVERTY
"Our research has shown that you can't look at the exposure
of one child and predict where that child will be. We
have children with a lot of exposure in gifted classes,
and children with no exposure not doing well. It could
be that the groups are both at risk just because of
their poverty," Dr Eyler surmises. She stresses that
attention should be focused on treating each child individually
and on the home environment, rather than on prior cocaine
exposure. Another obvious intervention would be to offer
these mothers treatment for their addiction. In fact,
all the study participants were offered treatment but
few accepted — not surprising since Florida strongly
favours prosecution over drug treatment and may remove
children permanently from mothers going into rehab.
The study itself had to receive special dispensation
from the US federal government in order to resist state
subpoenas of the medical records of the drug-using participants.
For U of T's Dr Koren, the primary
danger of the crack baby myth is the stigma faced by
children with prenatal exposure to cocaine. As a pediatrician,
he takes exposure as an indication that the family may
need help. "Because the environment isn't optimal, it's
important to monitor the child more often to identify
areas of lack of challenge. The earlier you intervene,
the better the outcome. Call it secondary prevention."
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