Study: Cocaine Exposure Doesn’t Doom Babies to Bad Behavior

Published May 22nd, 2000 - 02:00 GMT

For much of the 70s and 80s, countless media stories told us that babies exposed to cocaine in the womb would turn into a generation of antisocial zombies. But new research, published by, Sunday, shows that cocaine exposure itself doesn't doom children to the kinds of behavioral problems later in life that many experts predicted. 

These children are no more likely to have significant behavioral problems in their first 3 years than youngsters whose mothers did not use cocaine during pregnancy, researchers said this week at the joint meeting of the Pediatric Academic Societies and the American Academy of Pediatrics in Boston.  

"We didn't find any support at all for the terrible things people had predicted would happen to these cocaine-exposed children, like very small, screaming, sick babies that turned into children who had many behavioral problems," said Fonda Davis Eyler, a developmental psychologist and professor of pediatrics at the University of Florida's (UF) College of Medicine in Gainesville. She is one of two primary UF scientists involved in the study, which is supported by a $3 million National Institute on Drug Abuse grant.  

"We're not negating that people were seeing children exposed to cocaine who had serious problems," Eyler said.  

"What we're saying is that their problems do not appear to be driven by prenatal cocaine exposure and instead could be related to other things that are going on with them.,” he said.  

As easy access to cocaine swelled in the 1980s, so did dire predictions that children exposed to the toxic drug in the womb would be brain damaged and irredeemable, despite little scientific evidence proving it. Each year, 45,000 infants are born who were exposed to cocaine in utero, according to the National Institute on Drug Abuse.  

"We need to be very careful before we start labeling children as cocaine babies, said Dr. David Burchfield, professor of pediatrics and medical director of the neonatal intensive care unit at Shands Children's Hospital in Gainesville, Florida. "Saddling them with that kind of negative label is totally counterproductive. This study is important not just because it was so well designed, but because it shows that these kids can be as productive as their peers."  

Burchfield adds that, in general, most of these babies are indistinguishable from any other baby.  

"It is very difficult to do these kinds of human studies, because there are so many things that fold into what becomes human behavior, and exposure in utero is just one tiny part of what a person becomes," he says.  

Other researchers agree.  

"We need to say right up front that cocaine, methamphetamine, heroin and all other illicit drugs are very bad things to use when pregnant," said Jean Schroedel, PhD, associate professor in the department of politics and policy at Claremont Graduate University in Claremont, California. "But the basic bottom line here is that the early media stories on crack babies were way overblown, extrapolated from small, non-typical samples. The prevalence of crack use was massively overstated."  

The UF findings are part of an ongoing study of how prenatal cocaine exposure affects children's physical and developmental growth. The results dovetail with earlier data showing a group of cocaine-exposed babies had no consistent pattern of abnormalities nor more significant problems at birth than those who had not been exposed.  

General behavior and temperament also did not differ significantly between cocaine-exposed children and their drug-free counterparts. But both groups, who were largely from poor, uneducated families, showed more behavioral problems than the national average, the study found. The researchers speculate that poverty and the children's home environment could be to blame.  

According to, the study also showed that traits seen in infants may help predict which children will be prone to behavioral problems down the road.  

"Just because there are no differences in behavior doesn't mean there might not be differences in other areas, such as language development or problem-solving abilities," said co-researcher Dr. Marylou Behnke, a neonatologist and professor of pediatric.  

“We're delighted these kids haven't shown any major differences, but they're still pretty young.”  

The UF researchers evaluated more than 300 children from infancy to age 3. Half were exposed prenatally to cocaine, primarily crack. The children's mothers, who ranged from 18 to 43 years old when the study began, had similar racial and socioeconomic backgrounds. The women, who gave detailed drug histories, were tested randomly for cocaine use.  

The study is one of the few to examine women who used rural public health clinics for prenatal care, while others have largely tracked women from drug treatment centers in urban areas.  

Parents and primary caregivers answered hundreds of questions on three standardized tests that assessed the behavior and temperament of their children at five specific ages. The questions included whether the child daydreamed, was disobedient, got into more trouble than others the same age, failed to finish things, was destructive, had problems eating, fought constantly, pouted or sulked or was easily frustrated.  

Overall, researchers discovered the questionnaires did not uncover significant differences in behavior or temperament between the two groups. Interestingly, the study did show the children's behavior at birth and 1 month was related to later temperament, conduct and learning problems, impulsiveness and hyperactivity.  

"Our worry is that when you give children such negative labels, that if they don't do well, people will say they can't do better, and they won't be pushed or nurtured or helped, and other causes of the problems will be overlooked," Eyler said. "People will assume the cause of the problems is the cocaine exposure and that there's nothing we can do about it " – 


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