Damage to the foetus from cocaine exposure could include prenatal strokes and lasting brain damage, premature birth, retarded foetal growth, breathing lapses, absence of part of the gut, structural abnormalities in genital and urinary organs and seizures after birth. Babies that had been exposed to marijuana are likely to be smaller than normal and to show such neurological difficulties as an abnormal startle reflex, an increase in tremors and an inability to shut out disturbing stimuli. At high levels of use, alcohol can cause serious malformation and at moderate levels of use it is associated with an increased risk of mental or physical damage to the foetus.
Children of crack addicts are at extreme risk of neglect and abuse. In one report 73% of all children who died of battering in New York City in 1988 had parents who used cocaine or crack.