The sucking responses of 16 newborn infants exposed to cocaine just prior to birth and 16 control newborns were recorded when offered a fluidless sucrose-flavored nipple and a comparable nonsweet nipple. Cocaine-exposed infants showed a significantly greater preference for sweet taste: Compared with control infants, the cocaine group sucked more frequently when offered the sweet nipple and less frequently when presented with the nonsweet nipple. This heightened response to sweet stimulation might reflect (i) a coping mechanism for the perinatal distress of intrauterine cocaine-exposure since sweet taste appears to alleviate distress via an opioid mechanism; and/or (ii) altered dopaminergic activity in a common neuronal pathway that mediates the rewarding aspects of both cocaine and sweet taste.