Open Letter to the Media

February 25, 2004

To Whom It May Concern:

As medical and psychological researchers with many years of experience studying addictions

and prenatal exposure to psychoactive substances, we are writing to request that the terms "crack

baby" and "crack addicted baby" be dropped from usage. These terms and similarly stigmatizing

terms, such as "ice babies" and "meth babies," lack scientific validity and should not be used.

Despite the lack of a medical or scientific basis for the use of these pejorative and stigmatizing

labels, they have been repeatedly used in the popular media, in a wide variety of contexts and

across the country. Just a few examples include the Washington Post ("She taught a class of

about eight kids, ages 3 to 6, in Charlottesville when her husband, Rob, was attending business

school at the University of Virginia. Some of the children just had speech delays; others were

crack babies.") Ylan Q. Mui, Including Ashley, Washington Post Magazine (Nov. 9, 2003, at

W22); LA Weekly (California) ("Some widows take up tennis, or volunteer to be museum

docents or to hold crack babies down at County hospital") Michelle Huneven, Atwater Rising

(Sept. 12, 2003 pg. 38); The Arizona Republic ("But the number of removals was rising in the

four months before that, up 13 percent after the 2001 death of a crack baby was made public last

summer.") Karina Bland, CPS Taking More Children; New Effort May Stir Trouble Experts Say

(July 5, 2003 pg. 1A); The Post and Courier (Charleston, SC) ("The defendants had asked the

Supreme Court to again consider the issue of whether the women knew their urine was being

screened for drugs, as part of a 1989 policy designed to stop the crack baby epidemic.") Herb

Frazier, Supreme Court Won't Review MUSC Case; Trial Will Determine Damage Awards for

10 Pregnant Women on Cocaine, (June 17, 2003, pg. 3B); Amarillo Globe-News, Jim McBride,

Women Indicted in ‘Crack Baby’ Case (Feb. 6, 2004, pg. 1A) (italics added throughout).

Throughout almost 20 years of research, none of us has identified a recognizable condition,

syndrome or disorder that should be termed "crack baby." Some of our published research finds

subtle effects of prenatal cocaine exposure in selected developmental domains, while other of our

research publications do not. This is in contrast to Fetal Alcohol Syndrome, which has a narrow

and specific set of criteria for diagnosis.

The term "crack addicted baby" is no less defensible. Addiction is a technical term that refers to

compulsive behavior that continues in spite of adverse consequences. By definition, babies

cannot be "addicted" to crack or anything else. In utero physiologic dependence on opiates (not

addiction), known as Neonatal Narcotic Abstinence Syndrome, is readily diagnosed, but no such

symptoms have been found to occur following prenatal cocaine exposure.

That these concerns are not merely academic is vividly illustrated by the fact that the media’s use

of these terms has led to a situation in which children can be starved and abused and the "crack

baby" label can be used to excuse the results. The New York Times’ coverage of the New Jersey

family that allegedly starved four of their adopted sons provides a compelling and tragic example

of how the stereotype of the "crack baby" is not only scientifically inaccurate, but potentially

dangerous to the children to whom it is applied. On October 28, 2003, Lydia Polgreen, in

"Uneven Care Not Unusual in Families, Experts Say," reported that the family used this label as

an explanation for the children’s apparent lack of growth: "In the Jacksons’ case, the couple told

friends, neighbors and people who went to their church that the four brothers had been born

addicted to crack cocaine and had an eating disorder." Several days later, in another story on the

same children, "Amid Images of Love and Starvation, a More Nuanced Picture Emerges"

(November 2, 2003), Leslie Kaufman and Richard Lezin Jones reported that "if anyone asked

about the little ones, they were told that the children had some fetal alcohol and crack baby

syndromes, and that’s why they would never grow."

While these references are indirect quotes from sources, another New York Times story that used

this term and the many uses of the term by other media outlets validated this usage. In "In Home

That Looked Loving, 4 Boys’ Suffering Was Unseen" (October 28, 2003), the New York Times

reported that "Michael, the youngest, was born a crack baby before being taken in" (italics

added).

We are deeply disappointed that American and international media continues to use a term that

not only lacks any scientific basis but endangers and disenfranchises the children to whom it is

applied.

We would be happy to furnish an extensive bibliography if requested or to send representatives

to meet with the staff or editorial boards of your paper, journal, or station and to give you more

detailed technical information. Please feel free to contact David C. Lewis, M.D., 404-444-1818,

David_Lewis@brown.edu, Professor of Medicine and Community Health,

Brown University, who has agreed to coordinate such requests on our behalf and who can

provide you with contact information for the researchers listed below in alphabetical order.

Sincerely,

Robert E. Arendt, PhD

Research Director

The Buckeye Ranch

Emmalee S. Bandstra, M.D.

Professor of Pediatrics and Obstetrics and Gynecology

Director, Perinatal Chemical Addiction Research and Education (CARE) Program

Departments of Pediatrics, Division of Neonatology

University of Miami School of Medicine

Marjorie Beeghly, Ph.D

Assistant Professor of Pediatrics, Harvard Medical School

Senior Research Associate, Children’s Hospital, Boston

Child Development Unit

Children’s Hospital

Marylou Behnke, M.D.

Professor, Department of Pediatrics

Co-Director, Developmental Evaluation and Intervention Program

University of Florida, College of Medicine

Maureen Black, Ph.D

Professor, Department of Pediatrics, University of Maryland School of Medicine

Elizabeth R. Brown, M.D.

Director of Neonatology

Boston University School of Medicine/Boston Medical Center

Ira J. Chasnoff, M.D.

Children’s Research Triangle

Wendy Chavkin, M.D., MPH

Professor of Clinical Public Health and Obstetrics and Gynecology

Mailman School of Public Health and College of Physicians and Surgeons

Columbia University

Claire D. Coles, Ph.D

Director, Fetal Alcohol and Drug Exposure Center, Marcus Institute

Professor, Department of Psychiatry and Behavioral Sciences

Emory University School of Medicine

Nancy Day, Ph.D

Professor of Psychiatry and Epidemiology

Western Psychiatric Institute and Clinic

Virginia Delaney-Black, M.D., MPH

Professor of Pediatrics

Wayne State University

Assistant Director, Children’s Research Center of Michigan

Children’s Hospital of Michigan

Chris Derauf, M.D.

Assistant Professor of Pediatrics

University of Hawaii John A. Burns School of Medicine

Fonda Davis Eyler, Ph.D

Professor, Department of Pediatrics

Co-Director, Developmental Evaluation and Intervention Program

University of Florida, College of Medicine

Deborah A. Frank, M.D.

Professor of Pediatrics

Boston University School of Medicine

Boston Medicine Center

Peter Fried, Ph.D

Department of Psychology

Carleton University

Judith M. Gardner, Ph.D

Bernard Z. Karmel, Ph.D.

NYS Institute for Basic Research in Developmental Disabilities

Hallam Hurt, M.D.

Associate Professor of Pediatrics

Neonatology, Department of Pediatrics

University of Pennsylvania School of Medicine

Children’s Hospital of Philadelphia

Joseph L. Jacobson, Ph.D

Professor and Chair, Department of Psychology

Wayne State University

Linda Mayes, M.D.

Arnold Gesell Professor of Child Psychiatry, Pediatrics, and Psychology

Yale Child Study Center

Connie E. Morrow, Ph.D

Research Associate

Professor of Pediatrics and Psychology

Associate Director, Perinatal Chemical Addiction Research and Education (CARE) Program

Prasanna Nair, M.D., MPH

Professor, Department of Pediatrics

University of Maryland School of Medicine

Daniel R. Neuspiel, M.D., MPH

Associate Professor of Pediatrics and of Population Health

Albert Einstein College of Medicine

Associate Chairman of Pediatrics, Beth Israel Medical Center

Gale A. Richardson, Ph.D

Associate Professor of Psychiatry and Epidemiology

University of Pittsburgh School of Medicine

Western Psychiatric Institute and Clinic

Lynn T. Singer, Ph.D

Interim Provost and University Vice-President

Case Western University

Barry Zuckerman, M.D.

Professor and Chairman

Department of Pediatrics

Boston University School of Medicine

Boston Medical Center