Agricultural commercialization, or the transition from food to cash crops, has gained increasing attention over the past few decades. Plans for developing world farmers to focus on labor-intensive cash crops, to exploit their natural comparative advantage, typically depend on stable food markets to supply these formerly subsistence households. The trade-off between cash and food crop production requires reevaluation in the context of numerous food price spikes and general food price increases experienced globally over the last decade. Discovery of a correlation between Malawian cash crop production and low nutritional health outcomes creates questions of the traditional development path. This paper clarifies the causal effect behind that negative relationship. A nationally representative data set and the 2002-2003 Malawian domestic food crisis allow for time-specific comparisons between the health of children in utero during stable and increasing food price markets. Identifying children exposed to in utero food shocks is the first step to explaining the recent changes in the nutritional outcomes of cash crop producers. Estimates of the effects of Malawian crop adoption on children’s health are obtained using robust inference techniques. The causal effects of cash crop production are identified by instrumenting endogenous adoption decisions with predetermined variables. The findings show children of cash crop farmers experienced disproportionately negative effects if they were in utero during the food price shock. The results support the argument that food price shocks negatively influence those more reliant on the market for food purchases, suggesting the need for targeting small scale commercial farmers during times of staple food price spikes.