Earlier quoted context omitted.
It could also be a matter of public health advocates being savvy about how their messages are received. If we say it's probably safe to drink d drinks per week, then some percentage p of the population will assume it's okay to drink x*d drinks per week and may harm their babies. Also, simple rules are easy to state and simple to follow. The words "never" and "always" are very clear and leave no room for misinterpreta…
Saying "never" without a reasonable basis is a great way to lose credibility.
'Crack baby' study ends with unexpected but clear result
211–220 of 265 posts
Re: 'Crack baby' study ends with unexpected but clear result
#212Earlier quoted context omitted.
>>This study did not include pre-term crack babies. >It is entirely reasonable to select only full-term babies for the study. 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…
>If you decide to ignore those in your study because you want to study something specific then you should make it very, very clear. 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 t…
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...
Re: 'Crack baby' study ends with unexpected but clear result
#213Earlier quoted context omitted.
IQ not intelligence. IQ is meant to be a measure of intellectual capacity. It is nonsensical to say that someone is unable to be intelligent because they are poor. Let's talk about intelligence, though. Lets say that everyone had the same intellectual capacity, but we still saw the same descrepancy in how well they did on standardized tests. Having little to eat and poor schools do not keep a child from learning from…
> Having little to eat and poor schools do not keep a child from learning from others. There is ready access to the internet through libraries in the U.S. with a wealth of information online, and a lot of books on the shelves there also. If you take away all genetic factors (tendency towards aggression, lower intellectual capacity, etc.) and environmental factors (is the child worried about being shot, peer pressure…
Re: 'Crack baby' study ends with unexpected but clear result
#214Earlier quoted context omitted.
Your phrasing is frustratingly confrontational. 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, t…
> If there is no compensating benefit, then IMO a parent should not incur any avoidable risk to a child. 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 m…
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.
Re: 'Crack baby' study ends with unexpected but clear result
#215Earlier quoted context omitted.
Saying "never" without a reasonable basis is a great way to lose credibility.
Sure, but "it would require a Ph.D. $3000 to estimate the amount you can safely drink over the course of a pregnancy, so the only accurate amount I can recommend that we know won't cause issues is 0" might actually be a reasonable basis.
Re: 'Crack baby' study ends with unexpected but clear result
#216Earlier quoted context omitted.
Saying "never" without a reasonable basis is a great way to lose credibility.
Sure, but "it would require a Ph.D. $3000 to estimate the amount you can safely drink over the course of a pregnancy, so the only accurate amount I can recommend that we know won't cause issues is 0" might actually be a reasonable basis.
Re: 'Crack baby' study ends with unexpected but clear result
#217Earlier quoted context omitted.
My understanding of the reason for total abstinence is while there may be a shoulder in the graph (eg. more than 5 drinks a week) beyond which FAS begins to take effect, nobody knows where that point is. It's not exactly the sort of thing you want to run a controlled test for. 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 re…
The studies have not proven that there is a level of alcohol consumption below which there are no negative effects, but they fail to demonstrate long-term negative effects from low levels of alcohol consumption. 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 pr…
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.
Re: 'Crack baby' study ends with unexpected but clear result
#218Earlier quoted context omitted.
> If there is no compensating benefit, then IMO a parent should not incur any avoidable risk to a child. 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 m…
Are you actually serious? Not joking? 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…
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.
Re: 'Crack baby' study ends with unexpected but clear result
#219Earlier quoted context omitted.
| We do it because we as a society love to | control women This is a ridiculous claim. If anything erring on the side of caution and telling pregnant women not to drink alcohol falls under the "Think of the Children" banner. It's an effort to prevent babies from being born with issues, rather than some need to tell women to 'get back in the kitchen.'
So my wife was a summer associate at a law firm while she was pregnant. The difference between having a drink with dinner and not drinking at all was the difference between being a regular summer associate, interviewing for a job, and "the pregnant one." 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 o…
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.
Re: 'Crack baby' study ends with unexpected but clear result
#220Earlier quoted context omitted.
Sure, but "it would require a Ph.D. $3000 to estimate the amount you can safely drink over the course of a pregnancy, so the only accurate amount I can recommend that we know won't cause issues is 0" might actually be a reasonable basis.
An abstruse way of saying "I don't know what you should do" is likely not particularly credibility-enhancing either.