Effects of maternal cocaine use on the infants are identified, including chromosomal abnormalities, congenital defects, anemia, miscarriage, prematurity, and low birth weight. The high rates of venereal disease, including acquired immune deficiency syndrome, in drug-abusing mothers and their infants also is noted. State child abuse laws and protective services relating to parental drug abuse are described. Data on cocaine use are presented, and initiatives in this area undertaken by the National Institute of Drug Abuse are described: studies of the effects of maternal cocaine use on infant loss and development and the role of cocaine in teenage pregnancy; development of a medical curriculum for managing patient drug abuse; and increased attention to prevention, diagnosis, and developmental intervention. Programs targeting this problem include outreach, intensive neonatal care, parent education, and drug abuse treatment. Recommendations focus on the need for increased professional and public education; prevention programs; drug abuse identification, referral, and treatment services; improved child abuse legislation; and increased funding for programs, services, and research.