It turns out that the placental barrier is pretty awesome.
(http://www.nhs.uk/news/2012/06june/Pages/daily-drinking-preg...)
> “Pregnant women can binge drink safely,” according to a report in today’s Metro. Expectant mothers should be able to “down up to 12 alcoholic beverages a week knowing it will have no ill effect on their offspring before the age of five”, the paper continued. Reports in several other papers were in agreement, with the Daily Mail claiming that a drink a day would not harm the baby’s development and the Daily Express reporting that 12 drinks a week is safe in pregnancy. So should pregnant women heave a sigh of relief and down a large glass of Chardonnay? Unfortunately, no.
(http://www.nhs.uk/news/2013/06June/Pages/Misguided-claims-al...)
> “A glass of wine every day in pregnancy could be good for your baby,” is the entirely incorrect headline in The Daily Telegraph today. Other newspapers reported that drinking while pregnant does ‘no harm’, these claims are also misleading.
(http://www.nhs.uk/news/2012/11November/Pages/Just-one-glass-...)
> has not been made clear in many of the reports, the researchers were also looking at foetal and maternal variations in genes thought to affect the metabolism of alcohol (how long it takes for the body to break down alcohol). Researchers then looked at whether these variations had an impact on the children’s IQ at age eight.
This is UK media, so "one drink" is "one unit", and that means 125 ml of drink of 8% Alcohol by volume. One bottle of wine (750 ml) at 8% has 6 units. Chardonnay is usually about 12.5% ABV, so a bottle has about 9.5 units. One unit of a 12.5ABV chardonnay is going to be 80 ml of wine. This is important because no one ever pours themselves 80 ml of wine.
Well, this is not completely correct - in wine tastings, for example, the recommended pouring usually is about 2 oz which is under 80 ml. Of course, tasting just once is another question that gets us back to the square one...
A wine tasting portion is a sip, that you slurp up and then spit out. No-one (I imagine) thinks of that portion as a real serving size!
I think there's quite a big difference between saying we have no evidence that alcohol consumption during pregnancy is unsafe, and recommending that pregnant women should drink.
It would be great if we could tell expecting mothers: "have two drinks a week, you'll be fine." We don't know, so "don't drink at all" is a reasonable statement.
Now, absence of proof is not proof of absence, but in what other contexts do we tell people: the studies don't show harmful effects at low levels, but you shouldn't do it anyway because the studies haven't proven there aren't harmful effects at low levels? That's not how we generally do things. We only say "no" when we have actual evidence that some activity is harmful.
The reason we do it is not because science demonstrates there is a danger. We do it because we as a society love to control women, their behavior and their bodies, and pregnancy offers a great opportunity to exert that control.
This latter theory is a bit silly.
In fact, we say "no" to all sorts of things regardless of evidence that the activity is harmful. Examples include modafinil, steroids and various other brain and body enhancers. More commonplace examples include salt, fat, carbs, second hand smoke, marijuana, gluten and foods not present in the cave man era.
And if you decided to light up and expose others to harmless secondhand smoke, "they" certainly would freak out.
| We do it because we as a society love to
| control women
In our society, where drinking is an important social rite, not drinking makes you "the other" and we're tremendously eager to force women into that position based on little to no evidence that it actually has any impact on children at low levels. Even the justifications that are possible ("doctors say not to do it at all because women might drink too much") treat women like children instead of adults who are capable of evaluating truthful information from their doctors and reaching reasoned conclusions about their behavior.
IMO, the appropriate response to that is to fix our society's attitudes about drinking as a social rite, not to use it as an excuse for women to risk harm to their children.
That said, if the woman's job is what's going to support the child, that does add an element to the risk-benefit calculation.
Its one step above segregating women into sanitation tents during menstration. A policy completely disproportional to the underlying problem whose intent is social exclusion as much as anything else.
What's the limit of "light drinking"? Nobody knows for sure. If the woman were making a decision about her own risk, that's one thing; but she's making a decision about the risk to her child. That makes a big difference; when you're imposing a risk on someone else, the standard should not be "is there evidence of harm", but "is the risk avoidable". The risk of drinking is avoidable, so it should be avoided.
So you really have to question the motives of a policy that dictates women to engage in a behavior that excludes them socially for an imagined benefit to children.
I question the motives of people who claim drinking is so socially necessary that it's OK to socially exclude people who don't drink, and OK to exert social pressure on women to drink while pregnant even if it might harm their child.
But that's really a red herring, because you're misrepresenting the policy--at least, the policy I've been advocating in this thread. I'm not saying anyone should force women to not drink during pregnancy; I'm just saying that, IMO, whatever imagined benefits there are to drinking are not worth the risk to the child.
> There is no evidence of harm to
> children from light drinking
> during pregnancy
> Even the justifications that are possible
> treat women like children
You don't think "Think of the Children" is part of the "Women need to be controlled" category? This is also where we get the notion that there is a magical mystical maternal mojo.
Women are resources, not players.
> You don't think "Think of the Children" is
> part of the "Women need to be controlled"
> category?
- Preventing child pornography
- Preventing child abuse
- Preventing children from hearing 'bad words'
- Stopping children from gaining access to violent video games
I fail to see how any of these is about 'controlling women.' I don't see how being generally concerned with the well-being of children (even if it's misguided) has anything to do with controlling women[1].
> This is also where we get the notion that there is a
> magical mystical maternal mojo.
[1] I realize that some people's solutions to Think of the Children problems might involve 'controlling women,' but I fail to see how the entire "Think of the Children" category is a sub-category of "Women Need to be Controlled."
Because you're looking at it in terms of public policy and law making (which is appropriate; "Think of the Children" is precisely such a public face). How do these scenarios play out in a domestic environment?
> How do we get this from "Think of the Children" + "Women Need to be Controlled?"
Because fathers are not expected to have such a strong connection to their children. The chain of command is "Man -> Mother -> Child". A woman's first and foremost responsibility, in this way of thinking, is the well-being of the child. Only when she can't handle it does she appeal to the man. The obedience of the child derives directly from the obedience of its mother.
Thus, the man's job in parenting is to provide from afar. He does not sully his hands by dealing with silly emotional issues; he brings bread home and punishes any misbehavior that isn't dealt with by the mother.
In this model of the world, the mother is useful only as an intermediary to handle messy things like diaper-changing and doctor visits and crying. She is the hammer that pounds down the nail. This particular role and objectification must be justified. That justification is that there is a Super Special Bond of Specialness that makes her uniquely qualified so that no one else could usurp her place.
Honestly, there is so much cultural detritus to point out as context that, if I made dealing with sexism my life's work, I could probably put together a book or two on the subject.
Also, simple rules are easy to state and simple to follow. The words "never" and "always" are very clear and leave no room for misinterpretation.
However, if any of my speculation is correct, and public health messages are tuned to account for their real world affect, than perhaps there is a risk that they will loose credibility.
Erm...in health and safety related contexts. At least in countries that care about those things. When it comes to someone's life isn't that hard to assume that if something is considered it could even be dangerous or not enough is known to advise staying away from it, rather than way and find out until experiments have shown otherwise.
Seems like a no brainier to me. To put it another way, if you are a parent, do you want your child or wife to participate in a study where she told to go ahead and drink 15 glasses of wine while pregnant so 20 year from then they can publish a paper on it.
To put it yet another way, each person has only one life and if they are told it is ok to consume a substance because there is not evidence it is harmful but then oops it turns out it is, they don't get a do over. It is not like buying a car someone saying, wash it with this new acid substance and it rusts and has to be replaced. You can replace a car, you can't replace your body.
Moreover. It is considered unlikely that alcohol will help in the pregnancy case. It seems at best it won't have any effect and at worst it will have a detrimental effect. Again, seems like a pretty good reason for the advice to stay away from it for 9 months.
> We do it because we as a society love to control women, their behavior and their bodies, and pregnancy offers a great opportunity to exert that control.
See now I don't know if you are serious or sarcastic. That is a pretty ridiculous argument. Sure go ahead and tell your wife, friends and family to drink so they can liberate themselves from the shackles of the Western Anglo-Saxon While Male Dominated Society
A specific 'health and safety' context where this exact issue comes up is actually with ionizing radiation (such as from nuclear reactors).
Humans (like most animals) actually have a remarkable ability to overcome low levels of radiation damage, by means such as genetic repair, programmed apotosis (essentially ASSERT()s in your own genetic code), and even roving patrols by your immune system that catch pre-cancerous cells.
The problem is that it is difficult to determine whether there is a real low-dose threshold, below which people do not suffer appreciable increase in health risk from radiation. Also, whether that threshold depends on the person, depends on prior exposure, depends on type of dose received, a combination of the above, etc.
The evidence leans heavily to there being a threshold much higher than the levels of radiation we'd ever encounter in day-to-day life (and possibly even there being a beneficial effect to low levels of radiation).
But our radiation health physicists (and UN health organizations) have tended to take a very conservative view and simply recommend that people minimize radiation exposure, at least until there is enough evidence to make very clear what a safe threshold level is.
Exactly. The rule is not "put on your seatbelt except when you don't plan to exceed 10mph and there are no obvious nearby hazards, or if the windows are open and you're near a body of water," the rule is "always wear a seat belt."
If American society would tolerate it, surely we'd have anti-drunk driving laws that allowed no higher BAC than naturally occurs due to metabolism.
In contexts where the effects aren't suffered by the person making the choice, but by someone else that's at their mercy--in this case, the child. Making decisions about one's own risk is very different from making decisions about someone else's; the latter involves a much greater responsibility to avoid possible harm.
So you're basically saying that it's OK to roll the dice with a child, since after all it's only a 20-sided die? That a mother's temporary gratification is more important than a 5% chance of your child suffering damage?
>"The government advises that people should not regularly drink more than the daily unit guidelines of [...] and 2-3 units of alcohol for women (equivalent to a 13% ABV 175 ml glass of wine). ‘Regularly’ means drinking every day or most days of the week."
[175ml is about ¾ cup (USA) and the units above are about equivalent to a single pint of 4% beer]
FWIW If I have 2 glasses of wine I'll be "buzzed" because I don't drink every day. Take a month off from drinking, try two normal glasses (ie not pub measures) and you'll notice.
For example:
So you're saying that it's OK to roll the dice with a child, since after all it's only a 20-sided die? That forcing a mother to restrict all alcohol, and thus suffer stress (which we know to be harmful to the child) is more important than an unknown chance of the child suffering damage from alcohol?
So was the phrasing of the post I responded to. He didn't even raise the question of whether the mother's drinking might have benefits (such as the one you cite) which might outweigh the risk the alcohol poses to the child. He just said, "oh, it's not really all that dangerous". That, IMO, is not a justifiable mindset for a parent.
If there is no compensating benefit, then IMO a parent should not incur any avoidable risk to a child. There must always be a reason for incurring the risk, and it must be a stronger reason than "well, I like drinking". If the mother's stress level would really be increased that much by not drinking, then that could be a valid reason. (Though I would tend to be skeptical of such a claim; is abstaining from alcohol, for a person who is not an alcoholic, really that hard, hard enough to outweigh the risk to the child's health?)
Wait, what? Are you actually serious? Not joking? I'm sorry to ask but I have a problem understanding people and I can never tell when people are pulling my leg or not. I almost never spot satire. So, if you're engaging in some devastatingly witty attack on something or other then I'm afraid it's gone right over my head.
> There must always be a reason for incurring the risk, and it must be a stronger reason than "well, I like drinking". If the mother's stress level would really be increased that much by not drinking, then that could be a valid reason.
We don't know if a pregnant woman drinking a couple of units a week is doing any harm to her child. Thus, the advice is to avoid all alcohol. But this has some disadvantages. It makes people ignore much clearer health advice. (This thread has someone suggesting that the drinking advice is similar to the smoking advice, as an example.) It also causes a great deal of stress to women. Some women may drink their regular amounts and then be very distressed when they discover that they are pregnant and have been drinking during the pregnancy. For most women the stress they experience is more harmful than the alcohol.
> (Though I would tend to be skeptical of such a claim; is abstaining from alcohol, for a person who is not an alcoholic, really that hard, hard enough to outweigh the risk to the child's health?)
Wow. That sentence bundles up so many misunderstandings of pregnancy and societal pressures and all kinds of stuff. It's too hard to respond to.
> There must always be a reason for incurring the risk
I'm quoting this part again because it's the core of your message, and it's very very wrong.
You assume that we know what the risks are, and that we can communicate those risks to pregnant women, and that they have power to control the risks they're exposed to.
Women undergo a bunch of prenatal checks. To get to those checks they have to use some form of transport. Are the risks of travel outweighed by the benefits of the prenatal checks?
What about different types of scans? There's no point in the 3d / 4d scans, and there's a possible risk of harm, so should the scans be banned? Or should we tell women not to get them? And who should we be criticising, the firms making money by pushing a possibly harmful but pointless scan to vulnerable women, or the women who get these scans?
(http://www.nhs.uk/news/2010/02February/Pages/Warning-over-so...)
No, I'm not joking. Evidently I have a very different take on this subject than you do.
We don't know if a pregnant woman drinking a couple of units a week is doing any harm to her child. Thus, the advice is to avoid all alcohol.
Yes; we don't know if it will cause harm, and it's avoidable--at least, that's the assumption underlying the advice.
It makes people ignore much clearer health advice. (This thread has someone suggesting that the drinking advice is similar to the smoking advice, as an example.)
So you're saying that, if we tell a person that drinking might harm her child, and smoking might harm her child, she'll ignore the smoking advice because she doesn't agree with the drinking advice; but if we don't tell her that the drinking might be harmful, she'll be more likely to listen when we tell her that the smoking is harmful? (I haven't seen the subthread you're referring to, so I'm not sure exactly what the argument is.)
I see several problems with this argument. First, many (I would say most) people can drink in moderation without becoming addicted, and can stop drinking, if given a good reason, without suffering significant harm. That's not true of smoking; I'm not aware of any significant number of people who can smoke in moderation without becoming addicted, or who can stop, if they choose, without suffering significant harm in the short term. If a person is a regular smoker, quitting smoking is going to put them under severe stress. Obviously that changes the risk-benefit calculation, but the fact that such a calculation might apply to an addict doesn't mean it applies to a non-addict.
Second, given the overwhelming evidence about the health risks of smoking, a person who has chosen to smoke has already decided to ignore a lot of potential risk. I don't think such a person will be easily convinced to change that behavior if they become pregnant (and, as I said above, it will be very hard and stressful for them to change it even if they try to).
Third, you're basically saying we should hide facts from people because we don't think they will make wise use of the information. I'll comment on that further below.
It also causes a great deal of stress to women. Some women may drink their regular amounts and then be very distressed when they discover that they are pregnant and have been drinking during the pregnancy. For most women the stress they experience is more harmful than the alcohol.
I'm not sure I understand this argument. As you're presenting the situation, it doesn't seem like the choice is between drinking and less stress, vs. not drinking and more stress. The drinking is the cause of the stress: the woman is worried that she might be harming her child. The rational response to that is for her to stop drinking, not to try to convince herself that the drinking doesn't really incur any risk to her child so she won't stress about it.
As for discovering you're pregnant and worrying about the fact that you've been drinking, if you're that worried about the risk of drinking to your child, why wouldn't you stop drinking if you are engaging in activities that might get you pregnant, just to be safe?
You assume that we know what the risks are, and that we can communicate those risks to pregnant women, and that they have power to control the risks they're exposed to.
We do know that alcohol poses some risk to a developing fetus. That's all I was assuming.
I don't understand the problem with communicating the risk; there are plenty of links in this thread to sources that give information about it, so the information that alcohol poses some risk to a developing fetus is out there.
As for women having the power to control the risks they're exposed to, sure, nobody can control all the risks they're exposed to, but that's why I specified "avoidable" risks in the post you responded to. Consumption of alcohol strikes me as a risk that is quite controllable and avoidable.
Women undergo a bunch of prenatal checks. To get to those checks they have to use some form of transport. Are the risks of travel outweighed by the benefits of the prenatal checks?
It depends on the relative risk vs. benefit. See further comments below.
There's no point in the 3d / 4d scans, and there's a possible risk of harm, so should the scans be banned? Or should we tell women not to get them?
No, and no. We should make sure that accurate information about the risks and benefits is available, and let women make their own decisions.
And who should we be criticising, the firms making money by pushing a possibly harmful but pointless scan to vulnerable women, or the women who get these scans?
If the scans really are pointless but carry a risk of harm, then the firm deserves criticism. If the women decide to get a scan that they know is pointless (or that the best evidence available to them says is pointless) but carries a risk of harm, then they deserve criticism.
It seems to me that we have a fundamentally different view of how this process is supposed to work. You seem to be assuming that there is some central authority that needs to decide what information to release and to whom. I see this as a bunch of individual actors, each of whom has a responsibility to provide accurate information and to make reasonable decisions based on the information they have.
No, we don't. We know that a lot of alcohol poses some risk to some foetuses. We don't know that X drinks a week poses any risk to all foetuses. Maybe it's just harmful to foetuses who are compromised in some way? Maybe it's just harmful to foetuses with a genetic disposition to harm? Maybe it's not harmful at all? We don't know.
> I don't understand the problem with communicating the risk; there are plenty of links in this thread to sources that give information about it, so the information that alcohol poses some risk to a developing fetus is out there.
Some research is just poor quality. Let's ignore that for the moment, and assume that all research is good quality. Lots of popular media is hopeless at reporting science. See the links I posted earlier - that website has many examples of research that's reported with hyperbole, or reports that make mistakes with the statistics, or reports that ignore the research abstract and come up with their own pseudo-abstract which doesn't match the research at all.
And then people have different opinions. See, for example, the discussion around "controlled crying". Controlled crying practices exist on a spectrum ("Just let the baby cry it out" on one end, to over-protective helicopter parenting on the other) and we have a pretty good idea that over-protection is bad, and we have a pretty good idea that the extreme end of crying are both harmful. Yet there's a flood of information from both of these extreme ends. Parents will find it hard to find this information.
Let's not forget that parents tend to be sleep deprived and thus cognitively impaired too.
Sure we do; you go on to say the same thing. You're just emphasizing the "we don't know" part, while I was emphasizing the "there might be some risk" part. We do not know that there is no risk, which, given that alcohol use is avoidable, is the point.
Some research is just poor quality.
Yes, that's true. But the belief that alcohol might harm a developing fetus isn't just based on research. It's also based on common sense: alcohol is known to have the potential to damage your body (at a minimum, harm to the liver and the brain is known to be possible). Why put such a substance into a developing fetus if you don't have to?
And then people have different opinions.
Yes, they do. If a person's considered opinion is that their enjoyment of alcohol is worth whatever risk they believe there is of harm to their child, that's their decision. I'm simply pointing out that, to me, it seems like a no-brainer: you're balancing something that's just recreational for you, vs. a possible harm to your child.
Parents will find it hard to find this information.
That's true of many aspects of parenting, yes. Which is why, as I said above, one shouldn't rely solely on that kind of information; one should also apply common sense.
Let's not forget that parents tend to be sleep deprived and thus cognitively impaired too.
The decision whether or not to use alcohol while pregnant does not have to be made in a cognitively impaired state; decisions like that about how to care for a child should be made before the situation becomes acute.
Plus, the sleep deprivation usually comes after birth, not before, doesn't it?
Teach the controversy (a la Merchants of Doubt) vs the precautionary principle.
That said, AFAIK whatever benefits have been found for alcoholic beverages are not due to the alcohol, but to some other substance that happens to be in the beverage (for example, antioxidants in red wine). If there is a way to get the other substance without the alcohol, that would seem to be preferable since it eliminates the risk without sacrificing the benefit.
I find it funny how the "total abstinence" people come up with such amount of unproven facts, like "any consumption of alcohol" will cause harm. You'll be hard pressed to find a mother that hasn't consumed any alcohol whatsoever during pregnancy in Europe.
This looks like it works as well as the "total abstinence" for sex works.
In Sweden, where I live, alcohol and pregnancy are not suppose to mix. For example, translating from http://www.vardguiden.se/Tema/Gravid/Livsstilsfragor/Alkohol... : "Since no one knows where the border lies, the recommendations in Sweden and many other countries are to not drink alcohol at all during pregnancy."
Or translating from http://www.lakartidningen.se/07engine.php?articleId=12235: "It's been known for a long time that alcohol consumption during pregnancy can damage the fetus, and most women also stop drinking alcohol when they discover that they are pregnant."
I'm lead to believe that the other Nordic countries are similar.
But about this I'm not so sure: "most women also stop drinking alcohol when they discover that they are pregnant."
Again I ask, how well can you claim to speak for the entirety of Europe? My observation is that Nordic women abstain from drinking during pregnancy at least as often as women who are native born to the US.
What would you accept as evidence that your original statement is incorrect? Perhaps the journal article "Alcohol consumption among pregnant women in a Swedish sample and its effects on the newborn outcomes", which finds: "Before pregnancy, 89% of the women regularly consumed alcohol and 49% reported occasional or frequent binge drinking. Nicotine was used by 15% before and by 5% during pregnancy. During pregnancy, 12% continued using alcohol and 5% also admitted binge drinking." ?
Compare this to the statement in "FOCUS ON: Biomarkers Of Fetal Alcohol Exposure And Fetal Alcohol Effects", which says that "roughly one of every eight women in the United States continues to drink during her pregnancy". 16% is higher than 12%, though I don't know the error bars to tell if that's significant.
If you don't like self-reported tests, then perhaps "Measurement of direct ethanol metabolites suggests higher rate of alcohol use among pregnant women than found with the AUDIT—a pilot study in a population-based sample of Swedish women" is useful. It concludes "Twenty-six women (25.2%) were identified as possible alcohol consumers by the combined use of AUDIT and direct ethanol metabolites."? (Note though that hair cosmetics and other things can cause false positives in a direct metabolites test.)
I interpret this to mean that 75% of Swedish women certainly do not drink alcohol while pregnant.
In other words, it's very easy in Sweden to find women who don't drink while pregnant.
Then for Germany, in "Smoking, alcohol and caffeine consumption of mothers before, during and after pregnancy--results of the study 'breast-feeding habits in Bavaria" the researchers report "25.3% of the mothers reported any alcohol consumption during pregnancy, 69.0% of pregnant women were drinking caffeine-containing beverages. The consumption rates were reduced clearly during pregnancy."
And for France, in "Is pregnancy the time to change alcohol consumption habits in France?" reports that "A total of 52.2% of women indicated that they had consumed alcohol at least once during their pregnancy".
Why did you make such a large, encompassing statement about all of Europe, when (1) there is such a variable rate, depending on the country, and (2) it looks like better than even odds that a 'European' woman does not drink once she knows she's pregnant.
I'm surprised sometimes the lengths people will go through in order to not admit they can be wrong.
"You're presenting facts, {position X} people don't like that."
"I find it funny how {position X} people come up with such amount of unproven facts, such as {exaggerated position X straw man}. You'll be hard pressed to find {an anecdote that supposedly confirms position X}."
"This looks like it works as well as {position Y}."
You are very, very wrong about this.
What I should have said is this: It's trivial to find a woman that has consumed alcohol during pregnancy
Especially in the cases of older woman (whose sons and daughters are adults now)
Amongst most groups I know of, working class and lower-middle, a female refusing an alcolholic drink [at a party] is a sign that you think you're pregnant.
Total abstinence for the entire pregnancy? Wouldn't expect a huge proportion but as a comparison to normal intake it's going to look a lot more like marked abstemiousness than anything else. I think my wife probably had 1 or 2 glasses across each of her pregnancies.
>This looks like it works as well as the "total abstinence" for sex works. //
What are you trying to say here. That abstinence from sexual interaction doesn't prevent conception or transmission of STIs. Or maybe that abstinence from alcohol in pregnancy doesn't stop fetal alcohol syndrome. ?
We do know that any level of tobacco use is harmful to the mother and harmful to the child.
Please don't conflate the two.
> Prior to 1980 or so, whenever the media campaign began, massive numbers of people smoked, including pregnant women who didn't know any better.
You're ignoring all the people who were harmed by those smoking parents.
Every child born to a smoking mother is "harmed"? Depends on the definition of "harmed" I suppose.
There is quite a huge deal of controversy around the heritability of IQ.
If anything, the story in this article shows that IQ is much more influenced by the environment than genetics.
Smugly determining that "crack baby" was some racist code word cooked up to imprison black people is missing the point. Crack lowered the price point of cocaine dramatically, and was devastating to inner city communities.
You should note who the study didn't look at -- premature babies or the rates of premature delivery of crack abusers vs the average.
Hurt's study enrolled only full-term babies so the possible effects of prematurity did not skew the results.
Nonetheless the head of the study does note that crack cocaine can induce premature labor, among other issues:
Hurt, who is also a professor of pediatrics at the University of Pennsylvania, is always quick to point out that cocaine can have devastating effects on pregnancy. The drug can cause a problematic rise in a pregnant woman's blood pressure, trigger premature labor, and may be linked to a dangerous condition in which the placenta tears away from the uterine wall. Babies born prematurely, no matter the cause, are at risk for a host of medical and developmental problems. On top of that, a parent's drug use can create a chaotic home life for a child.
I think the OP's point is that some (political) groups attribute minority group failure to advance socioeconomically to drug use, whereas this study suggests that poverty has a very relevant effect on child development (and thus prospects of long-term economic success).
That's not to say that there is no truth to the "crack baby" myth, but that like the "welfare queen" myth, it is part of a strategy to delegitimize welfare programs or socioeconomic criticisms by blaming the low-income groups for their lack of success.
You'd have to also consider whether smoking the drug is more intense than sniffing, which would possibly compensate for the fact theres less cocaine.
Not a source per se, but some interesting info here on consumption methods: http://learn.genetics.utah.edu/content/addiction/drugs/deliv...
This DEA History Book [2], however, suggests the reasons might be partially economic. "Soon there was a huge glut of cocaine powder in these islands which caused the price to drop by as much as 80 percent."
[1] http://scholar.harvard.edu/files/fryer/files/fhlm_crack_coca... [2] http://archive.is/1wF5
Hint: if you believe your own eyes, your sample size is one, confirmation bias and the availability heuristic are dancing the cha-cha all over your results, and you fail at science.
This study did not include pre-term crack babies. That is a selection method that is going to skew heavily towards 'light' crack users.
Crack or cocaine is very, very bad for development. It can create a child that literally cannot do anything for themselves and some that live in excruciating pain every single day of their lives (that is the very dark side of having such advanced neo-natal care).
Fetal alcohol syndrome is just as bad if not worse.
It is irresponsible to suggest otherwise. The fact that astute HN readers are looking at this and saying "See, it is overblown!" is very scary. That means the broader population reading this article is likely to do the same thing.
The writer of this article owes it to society to be very clear about the limitations and biases of this study.
It is entirely reasonable to select only full-term babies for the study. Including pre-term babies makes analysis more complicated.
>That is a selection method that is going to skew heavily towards 'light' crack users.
Do you have some basis for that conclusion? It sounds reasonable (if beside the point), but are we working off of the folklore or facts?
>Crack or cocaine is very, very bad for development.
Did you read the article? They concluded after a long and careful study that poverty had a much bigger effect than cocaine use.
>It can create a child that literally cannot do anything for themselves and some that live in excruciating pain every single day of their lives (that is the very dark side of having such advanced neo-natal care).
Did you know that the NY Times and others recently recanted much of their sensationalist reporting of the "Crack Epidemic" http://retroreport.org/crack-babies-a-tale-from-the-drug-war...
http://www.nytimes.com/2013/05/20/booming/revisiting-the-cra...
>Fetal alcohol syndrome is just as bad if not worse.
FAS probably is worse. If my recollection is correct, one needs to do a lot of binge drinking during the first trimester.
>It is irresponsible to suggest otherwise.
You mean it is irresponsible to disagree with you? No, skepticism and critical analysis are never irresponsible. It is irresponsible to falsely assign a cause to some phenomena or event, and set about treating that cause without ever checking to see if what you're doing is actually helping.
>The fact that astute HN readers are looking at this and saying "See, it is overblown!" is very scary.
No, it isn't. It means that people are reading and thinking instead of reacting to headlines and summaries.
>That means the broader population reading this article is likely to do the same thing.
What's your basis for that assumption?
>The writer of this article owes it to society to be very clear about the limitations and biases of this study.
The study was narrow in scope in order to obtain a clear and concise conclusion.
Note before you jump to a conclusion about the HN general consensus on in-utero cocaine exposure, is that nobody here has come out in support of it. Rather, at least my take on it (judging by a casual perusal of this paper) is that efforts to reduce infant mortality and morbidity, and developmental defects in early childhood by combating drug-use were misguided; and going forward those efforts should be focused on learning about and mitigating whatever the effects of impoverishment are.
I don't disagree with that and I wouldn't be surprised to learn that such a study already exists.
>I would be surprised if there was no effect observed.
There are a lot of things that can cause premature labor. My personal opinion is that it is just as likely to be some stress otherwise related to their environment, or even stress related to the process of obtaining illegal drugs.
Premature babies account for between 1/5 and 1/4 of all births to crack using mothers. If you decide to ignore those in your study because you want to study something specific then you should make it very, very clear. And anyone reporting on it should make it clear as well. It is like studying coal miners, but only the ones that work in the preparation plant on the surface.
>>Crack or cocaine is very, very bad for development. >Did you read the article? They concluded after a long and careful study that poverty had a much bigger effect than cocaine use.
Yes. For this particularly culled population.
>Did you know that the NY Times and others recently recanted much of their sensationalist reporting of the "Crack Epidemic"
I don't know how that is relevant. I am basing my position on personal experience working with these kids.
>No, it isn't. It means that people are reading and thinking instead of reacting to headlines and summaries.
Frankly, just the opposite. Many, many people in this thread, including yourself, are reacting to this particular headline and summary.
>>That means the broader population reading this article is likely to do the same thing. >What's your basis for that assumption?
Induction. It may be unfounded, but if relatively smart people make a bad leap of logic it is not unreasonable to imagine that less intelligent people will make the same mistake.
>efforts to reduce infant mortality and morbidity, and developmental defects in early childhood by combating drug-use were misguided; and going forward those efforts should be focused on learning about and mitigating whatever the effects of impoverishment are.
>efforts to reduce infant mortality and morbidity, and developmental defects in early childhood by combating drug-use were misguided;
No, they weren't. Cocaine use does lead to disabled children, statistically speaking. Many of whom are premature. This was a study has no information on the amount of cocaine used throughout pregnancy, only that the mothers and children tested positive at the time of full-term birth.
All we can conclude from this study is that poverty is worse for kids than cocaine exposure near the time of full-term birth. It has no information for the 1/4 to 1/5 of the kids that are born to people that test positive for cocaine that are born prematurely and tend to have much more severe health and developmental problems. Not to mention the ones that don't make it to birth at all.
There are a lot of things researchers want. They write grant proposals to study things which they can, at the beginning of the study demonstrate the possibility of obtaining a useful unambiguous conclusion. I don't get the impression that the researchers misrepresented their study. Is that what you're alleging?
>>Did you know that the NY Times and others recently recanted much of their sensationalist reporting of the "Crack Epidemic" >I don't know how that is relevant. I am basing my position on personal experience working with these kids.
Does your personal experience involve having read news articles like the one we're discussing, or watching television news covering the subject?
>>efforts to reduce infant mortality and morbidity, and developmental defects in early childhood by combating drug-use were misguided; >No, they weren't. Cocaine use does lead to disabled children,
If you have finite resources n to spend fixing problem p and you have been using solution x which after some time appears to have negligible effect, would you continue x, or consider looking for another solution?
>No, they weren't. Cocaine use does lead to disabled children, statistically speaking.
Where are the statistics? The news article is reporting a study that does not, or only barely supports that conclusion, suggesting that the Cocaine use may be merely incidental, and not causal.
>Many of whom are premature.
From the article:
>Babies born prematurely, no matter the cause, are at risk for a host of medical and developmental problems.
Is it even possible to conduct such a study? It would likely require clinicians to closely supervise pregnant women while the women were using illegal drugs.
>All we can conclude from this study is that poverty is worse for kids than cocaine exposure near the time of full-term birth. It has no information for the 1/4 to 1/5 of the kids that are born to people that test positive for cocaine that are born prematurely and tend to have much more severe health and developmental problems. Not to mention the ones that don't make it to birth at all.
What is your hypothesis for how the effects of poverty would be negated for the cohort/time period you're interested in?
I suppose technically, yes. But it also comes from my father working as a neonatologist and my own experience working with severely disabled children, many of whom were crack babies or suffering from fetal alcohol syndrome, throughout my 20s.
> which after some time appears to have negligible effect
This is the problem. This study does not show that cocaine has a negligible effect. It shows that cocaine has a less than poverty effect for children that make it to term. Big, big difference.
>Where are the statistics?
Enjoy. Cocaine causes increased rates of premature birth (between 3 and 4 times the normal incidence). Premature birth, by itself, leads to severe developmental problems. Here are a few recent studies and surveys. [1], [2], [3], [4]
>What is your hypothesis for how the effects of poverty would be negated for the cohort/time period you're interested in?
You could look at women in poverty who give birth without cocaine in their system and compare statistics that way. It has been done. Prematurity is at about a percentage point higher for that group than the population at large compared to around 320% for those that test positive for cocaine.
[1] http://fn.bmj.com/content/94/5/339.short
[2]https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&c...
You're right, I overstated my claim. The effect is negligible with respect to the effects of poverty.
> Cocaine causes increased rates of premature birth
The studies you've linked do not support your statement. The studies say that cocaine use is associated with, not that cocaine is the cause.
re: [1] I never disputed that PT infants have developmental problems.
re: [2] "Studies revealed that in most domains, the neurobiological effects of PCE play a subtle role, with effects no greater than other known teratogens or environmental factors. Associations between PCE and negative developmental outcomes were typically attenuated when models included conditions that commonly co-occur with PCE (eg. tobacco or alcohol exposure, malnutrition, poor quality of care)." and "Preconception and prenatal cocaine use is commonly associated with poor pregnancy outcomes with psychosocial, behavioral, and risk factors, such as poverty, poor nutrition, stress, depression, physical abuse, lake[sic] of social support, and sexually transmitted infection. Illicit drug use during pregnancy is a major risk factor for maternal morbidity and neonatal complications."
re: [3] "Cocaine use during pregnancy was associated with significantly higher odds of preterm birth"
re: [4] "Prenatal cocaine exposure is significantly associated with preterm birth, low birthweight, and small for gestational age infants."
I don't know how cavalle could be more clear:
s/he's not judging the study design, but rather the popular report of the study results.
"Hurt, who is also a professor of pediatrics at the University of Pennsylvania, is always quick to point out that cocaine can have devastating effects on pregnancy."
You saw the outcome; you failed to adequately question the etiology. Those babies now have a mental label in your memory, "crack babies", which you use to reason from. But the label itself is incorrect.
Fetal Alcohol Syndrome has some very recognizable symptoms that have nothing to do with being born into poverty. A very specific skull shape for the worst cases, for one.
Crack babies not included in this study, the ones that are premature (20 something percent of crack user births fall into this category compared to 3-4% of births in general), also have very characteristic physical problems.
It is not poverty or malnutrition or stress that comes from poverty causing these very specific families of disorders. The crack kids are not coming from poor rural areas. They are coming from the inner city from crack using mothers.
How many healthy kids born to crack-using mothers and severely messed up kids born to non-crack-using mothers did you work with to make a basis for comparison?
While I agree with the general sentiment, it is worth noting that the original law that created the sentencing disparities between crack and powder cocaine, the anti-druge abuse act of 1986, was supported by the congressional black caucus [1] because crack was such a serious problem in the black community at the time. So it was not a case of white people conspiring to put black people in prison, it was black people trying to impose prohibition on themselves, which of course backfired badly as prohibition always does.
I don't see any part where the talk about the "amount" of drugs consumed?
There were rougly 1600+ babies who were used as control and ~338 who tested positive for "weed". Some of the things that aren't broken down is the distribution for infant mortality. Perhaps there were outliers in the control group such as premature babies, which, if taken into account might explain some of the differences in mortality rates.
Very funny though, with actual data to back up some part of your claim, made me think... :)
What I meant is that if cannabis does confer some sort of protective benefit, then by definition the benefits would have to come from use that was above some minimum level, and perhaps also below some maximum level.
> Mortality rates between the drug-positive group or specifically, the cocaine-positive, morphine-positive, or cannabinoid-positive groups were not significantly different from the drug-negative groups (P < .3)
A number of 8.9 to 15.7 deaths per 1k live births doesn't necessarily imply a protective factor, especially when considering all the variable factors and a much smaller sample size compared to the drug negative group.
Also, caffeine isn't mentioned once on there, sure you don't mean cocaine?
Probably more importantly these are not just "inner city kids". Nearly all of them are African American which means they are less likely to enroll in/graduate college overall; and they are all the children of parents who were addicted to crack at some point (and probably continued to struggle with it). That puts them at even more of a disadvantage.
Yes, the homicide rate is high, but I find the low college graduation rate more disturbing.
On a side note: shot, stabbed, or strangled doesn't make much difference to the homicide victim or their loved ones. Hopefully you'd have the same reaction if two of them were stabbed to death.
I was thinking it is rather high, all things considered. The statistical norm would expect only about 25 people to graduate out of that group. It would be interesting to compare against people in similar situations, but without the crack influence. I expect that the attainment rate will be similar.
Is 'people' a euphemism for 'parents?'
Not all communities, especially those on the poorer side, are like that at all. Education is even demonized in some locations. Parents are just a small part of the social attitudes towards such ventures.
This is science correcting itself after power has ceased to care what position science takes on the existence of the crack baby.
There's a much more dangerous drug than cocaine, for babies. (http://en.wikipedia.org/wiki/Prenatal_cocaine_exposure) It's alcohol, a legal drug. (https://en.wikipedia.org/wiki/Fetal_alcohol_syndrome)