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Don't Call Cocaine-Exposed Infants 'Crack Babies', Pediatrician Says

DRUG USE, DRUG ABUSE

April 1993

Cocaine-exposed children should not be called 'crack babies', Daniel Neuspiel, M.D., Associate Professor of Pediatrics at Albert Einstein College of Medicine in New York, said in a recent letter to the New York Times (Daniel Neuspiel, Letters/Editorials, "Let's Not Call Cocaine-Exposed Children 'Crack Babies', New York Times, 3/9/93, A18).

Referring to a February 16, front-page story in the Times titled "For Children Of Cocaine, Fresh Reasons For Hope," Neuspiel notes that the story reports a mixed prognosis for later development of cocaine-exposed children. The article incorrectly generalizes the findings of Ira Chasnoff, M.D. in Chicago to the entire country, writes Neuspiel. Chasnoff has tracked 300 cocaine-exposed children and has found 60 percent with early neurobehavioral deficits. But Neuspiel, citing his own experience with more than 200 cocaine-exposed children, notes that "many other programs have not detected this degree of effects."

Neuspiel writes:

"Although cocaine exposure appears to confer higher risk for problems in behavior and development, most of these children appear to develop normally. Among the minority of these children who demonstrate problems, it is not at all clear whether cocaine was the cause or some other aspect of their prenatal or postnatal environment contributed to their delays.

"Pejorative labeling of these children with terms like 'crack baby' may have negative consequences in conferring a self-fulfilling prophecy of adverse outcomes. In addition, since the identification of early substance abuse exposure is largely limited to the poor, nonwhite newborns in public hospitals, the use of drug exposure information to label these infants may increase their victimization by racial and social bias. These children and families need individual assessment and better services."