How formula became the new crack cocaine

drugs in the form of crystals on a black background

The New York Times recently issued an extraordinary mea culpa for its role in fanning hysteria around the purported epidemic of crack babies.

Today, with some notable exceptions, the nation is reacting to the opioid epidemic by humanizing people with addictions … That depth of sympathy for a group of people who are overwhelmingly white was nowhere to be seen during the 1980s and 90s, when a cheap, smokable form of cocaine known as crack was ravaging black communities across the country.

News organizations shoulder much of the blame for the moral panic that cast mothers with crack addictions as irretrievably depraved and the worst enemies of their children. The New York Times, The Washington Post, Time, Newsweek and others further demonized black women “addicts” by wrongly reporting that they were giving birth to a generation of neurologically damaged children who were less than fully human and who would bankrupt the schools and social service agencies once they came of age.

In other words:

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]The idea that formula is uniquely harmful to babies has about as much science behind it as the idea that crack cocaine was uniquely harmful to babies.[/pullquote]

Bad science and a moral panic, fueled in part by the news media, demonized mothers and defamed a generation.

But no one seems to have learned anything from the experience. Instead, we are recapitulating it, but this time infant formula is the new crack cocaine. The idea that formula is uniquely harmful to babies has about as much science behind it as the idea that crack cocaine was uniquely harmful to babies.

The similarities are remarkable.

…[T]he scourge of crack was still new in 1985 when the New England Journal of Medicine published a research paper that changed how the news media — and by extension the public — viewed the epidemic.

The author, Dr. Ira Chasnoff, asserted, based on a handful of cases, that the children of mothers who had used crack remained smaller, sicker and less social than other infants. He noted the limitations of his study and cautioned that rigorous research would be needed.

The lactation profession was still new in the mid-1980’s and there was little scientific evidence to support the insistence that breastfeeding is “best,” but that didn’t stop lactation consultants from making all sorts of extravagant claims about the benefits of breastfeeding and the risks of formula feeding.

No sooner was the evidence for an epidemic of crack babies presented than it was rebutted by further evidence. In addition, the predicted harms never appeared.

The myth of the “crack baby” … was debunked by the turn of the 2000s. But by then, the discredited notion that cocaine was uniquely and permanently damaging to the unborn had been written into social policies and the legal code.

The evidence for harms from formula feeding has been repeatedly debunked in the 2000’s and 2010’s. In addition, the predicted benefits of raising breastfeeding have rates never appeared. But by then, the discredited notion that formula was uniquely and permanent damaging to babies had been written into social policy and the legal code.

Why did fear about crack babies take hold in the absence of solid scientific evidence? Because it resonated with prejudices about race, class and privilege.

The idea of a mentally impaired “crack baby” resonated with long-held racist views about black Americans. It captured the imaginations of reporters, politicians, school officials and others who were historically conditioned to believe just about anything about the African-American poor.

As the medical writer Harriet Washington wrote of this period in her book “Medical Apartheid,” Dr. Chasnoff’s provisional research “was swallowed whole, then regurgitated in a racialized form by newspaper, magazine and even medical accounts.”

Why did fear about the “harms” of formula take hold in the absence of solid scientific evidence. Because it resonated with prejudices about race, class and privilege.

As researcher Catherine Robinson has written:

Successfully establishing and maintaining breastfeeding has arguably become a woman’s ultimate maternal makeover … The growth of a specifically maternal instance of broader ‘makeover culture’ supports breastfeeding as important transformative work …

Further, the breastfeeding makeover is furnished by all manner of expensive consumer and fashion products special to the breastfeeding body. Women prepared for breastfeeding by buying expensive nursing bras and singlets designed to be seen, breastfeeding clothing (including gym-wear), comfort cushions, footrests and armchairs …

Most importantly, breastfeeding’s needed time and space as specific middle class affordances mean that it is middle class women who have the capacity to forego paid work, access both paid and unpaid maternity leave, and focus on developing this tricky bodily competency …

It is hardly a coincidence that breastfeeding rates are lowest among poor women and women of color. Therefore breastfeeding serves the critical functions of making middle class white motherhood normative and demeaning poor women and minority women.

Many of the purported harms of crack were actually the result of other substances or of poverty itself.

Researchers debunked the “damaged generation” theory numerous times, finding no indication that children exposed to crack in the womb faced long-term debilitation and that the effects once tied to exposure were attributable to other drugs like alcohol and tobacco, or to factors associated with poverty, including homelessness and domestic violence.

Many of the purported harms of formula are actually the result of other factors like maternal education, socio-economic status and racial discrimination. This has been demonstrated repeatedly over the past decade.

Activists deployed punitive tactics toward mothers supposedly to improve the wellbeing of babies.

…[L]egislators seized upon the twin fallacies of the “crack baby” epidemic — the notion that the drug was uniquely and permanently damaging and that pregnant women used it by choice instead of because of the disease of addiction — to promote the view that fetuses “needed to be protected from dangerous mothers who would kill them.”

Lactivists deploy draconian tactics toward mothers supposedly to improve the wellbeing of babies. They’ve seized upon the twin fallacies of breastfeeding advocacy — that formula is uniquely and permanent damaging and that new mothers use it by choice instead of by necessity — to support the claim that women must be forced to breastfeed through mandatory exposure to the education policies of the Baby Friendly Hospital Initiative.

Innocent women were profoundly harmed by efforts to control the behavior of women who used crack.

…[C]rack hysteria drove a draconian new welfare policy that “sacrificed poor women — especially black, crack smoking mothers — on the altar of ‘reform.’” In 1996, for example, Congress denied food stamps and welfare payments for life to people convicted of drug felonies — many of whom happened to be women with children in desperate need of medical or mental health care.

Innocent women (and babies) are being profoundly harmed by efforts to control the feeding choices of new mothers. Formula hysteria is driving the punitive tactics of the Baby Friendly Hospital Initiative such as locking up infant formula and forcing women to sign consent forms detailing its “dangers.”

The New York Times summarizes the debacle:

The story of the “crack baby” shows how weak science, poorly informed crusaders and racist attitudes can work together to shape public policy… [T]he science around pregnancy needs to be approached with humility and humanity. Because when that’s lost, even in a quest for social good, the results can be irreversible.

That applies equally well to the demonization of formula. Weak science, poorly informed but highly motivated crusaders and privileged attitudes can work together to shape public policy. The science around infant feeding needs to be approached with humility and humanity. Because when that’s lost in the quest for a social good — as it has been lost by contemporary lactation professionals — the results can be devastating.

  • rosewater1

    OT update: Niece in law to be (she and my oldest nephew are engaged not married) is hanging in there. They did an EEG, which determined that she isn’t having seizures-which is a piece of good news. They are still concerned that she is having brain bleeding, but my brother said that they cant tell this without going back in and looking? She has spoken a few words. Depending on how she is today, they may take the baby to see her. Baby is beautiful! I got a picture last night where her eyes were open-that was a first. I am dying to snuggle her, but that will have to wait a while. I’d planned on flying down later this month, but obviously now is not the time.

    I am trying not to get my hopes up. It doesn’t sound like she is out of the woods by any means. I Googled craniotomy last night…scary stuff. I’ll update as I have news.

    Thank you to everyone for your kind words and prayers. It helps more than I can say.

    • Heidi

      I hope you are getting more good news. Take care.

      • rosewater1

        Thank you all so much for your kindness, your prayers, and your concern. It means more than I can say.

        Here’s the latest. She passed her swallow study and is EATING solid food for the first time since her initial surgery on 12/23. She is alert and her spirits seem good. She is talking a bit more. Baby girl has been to see her twice-best medicine ever. Baby continues to get more beautiful each day.

        The news is positive, and I am happy to hear it. But, the news from after the first surgery was positive too. I am trying not to get too excited but still be glad over the good news that is coming. It’s a delicate balance.

        Again, thank you all and please keep praying!

    • PeggySue

      Just what Heidi said. Hoping hard here!

    • Amazed

      That’s wonderful news! Hope for the best!