“Many of the negative outcomes observed in children of drug users can be attributed to care-giving factors,” not biology, according to Roger Bakeman, Ph.D., of Georgia State University and colleagues.

Their work appears in the journal Child Development.

The researchers compared 83 children exposed to cocaine in the womb to 63 nonexposed children. Cocaine-using mothers had given birth to more previous babies, were less likely to have graduated high school or have had prenatal care early in pregnancy.

As Bakeman expected, the study found no differences in mental and language skills or in physical growth between children of using and nonusing mothers.

Children of addicted mothers were once written off as permanently damaged “crack babies,” but recent research refutes that assumption, says Bakeman. He cautions against attributing differences in cocaine-exposed children to unchangeable physical characteristics developed in the womb.

“These results suggest that in fact, many of the negative outcomes observed in children of drug users can be ameliorated,” he says. He found that who raised the child had an important influence.

Some cocaine-exposed children in the study continued to be cared for by their mothers after birth. But 41 percent of the cocaine-using mothers gave up care of their children, compared to 3 percent of the nonusing mothers, Bakeman says.

About 49 percent of the cocaine-exposed children, but only 6 percent of the nonexposed children, were involved with child protective services by 24 months. Slightly more than half these nonparental caregivers were grandmothers or other relatives, while the rest were unrelated to the child.

Nonparental caregivers were older, had higher incomes and were more likely to be married than cocaine-using birth parents who cared for their children.

The cocaine-exposed 2-year-olds scored better on a battery of tests the further they got from their parents. Children in nonparental care scored better than those in a parent’s household, but children overseen by unrelated caregivers did even better than those in related, nonparent care.

Part of that result may be due to the fact that using cocaine in any environment doesn’t make for good parenting, Bakeman says.

Children of cocaine-using mothers could better achieve their potential by helping them directly, by helping women recover from drug abuse and by teaching the mothers better parenting skills.

This study was funded by a grant from the National Institute on Drug abuse.