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Cribsheet

Authors: Emily Oster

Overview

This book, ‘Cribsheet’, is for parents of young children. It’s a data-driven guide designed to help you make informed decisions about your child’s early years. I know parenting is hard, and it’s even harder when you’re bombarded with conflicting advice from all directions. My goal is to cut through the noise and provide you with the evidence you need to make the best choices for your family. In ‘Cribsheet’, we explore a wide range of topics, from sleep training and breastfeeding to childcare and vaccinations. I examine the latest research, separate hype from fact, and offer practical guidance on navigating the many challenges of raising young children. My approach emphasizes that there is no one ‘right’ way to parent, and that the best choices for one family may not be the best for another. I encourage you to use the data as a starting point for making your own decisions, considering both the evidence and your family’s preferences. This book is for parents who want to be informed, empowered, and—hopefully—a little less stressed.

Book Outline

1. The First Three Days

This chapter delves into the often overlooked details of the immediate postpartum period. It addresses common physical experiences like bleeding, postpartum baths, circumcision, and newborn screening tests. I equip new parents with the information they need to understand these procedures and make informed decisions.

Key concept: Most tears are on the minor side, but approximately 1 to 5 percent of women will have more serious third- and fourth-degree tears. More severe tearing is more common with instrument-assisted delivery (that is, delivery with either forceps or a vacuum). There is some evidence that warm compresses on the perineum during the pushing stage of labor can prevent very severe tears.

2. Wait, You Want Me to Take It Home?

This chapter covers anxieties and questions that arise as you bring your baby home. It explores common concerns such as swaddling, excessive infant crying (colic), germ exposure, and the urge to obsessively collect baby data. I offer evidence-based insights to help you navigate these topics with a bit more confidence.

Key concept: “Finn, I’m sorry, but it’s so hot out! We can’t use the swaddle. But don’t worry, you can still sleep. I know you can do it! Now you’ll be able to suck on your fingers! Won’t that be nice?”

3. Trust Me, Take the Mesh Underwear

Focusing on the less-discussed aspects of the postpartum experience, this chapter offers a frank look at the physical recovery process for mothers. I delve into issues like bleeding, urination, bowel movements, and the lingering effects of vaginal birth and caesarean sections, empowering women with knowledge about their bodies in this often-overlooked period.

Key concept: “After birth, the vagina will be capacious.”

4. Breast Is Best? Breast Is Better? Breast Is About the Same?

The widely touted benefits of breastfeeding often overshadow a nuanced understanding of its real impacts. I examine these benefits, separating hype from evidence, and highlight the complexities of studying breastfeeding due to differences between women who choose to breastfeed and those who don’t. The goal is to help you evaluate the data and make informed decisions that work for you, even if they aren’t the ‘perfect’ choices for others.

Key concept: The list is very long, so I’ve divided it into sections.

5. Breastfeeding: A How-To Guide

For those who choose to breastfeed, the initial weeks can be fraught with challenges. This chapter provides practical guidance on common issues like latch difficulties, nipple pain, milk supply fluctuations, and ‘nipple confusion’. I discuss the evidence (or lack thereof) for various interventions like nipple shields, tongue-tie revisions, and pumping, helping you navigate the often-overwhelming world of breastfeeding advice.

Key concept: “MOISTURIZE THE NIPS EVERY TIME.”

6. Sleep Position and Location

Navigating infant sleep can feel like a minefield of conflicting advice. I delve into the data on safe sleep practices, particularly the AAP’s recommendations on sleep position and location. I address the heated debate around co-sleeping, room sharing, and the use of bumpers and blankets, empowering parents to make informed choices based on the evidence and their family’s preferences.

Key concept: The tenets include things like not giving infants formula unless medically indicated, not giving pacifiers, and informing all pregnant women about the benefits of breastfeeding.

7. Organize Your Baby

The pressure to get your baby on a schedule can be intense, but I present evidence suggesting that schedules are not a one-size-fits-all solution and may not even be necessary for young infants. There’s wide variation in sleep needs and patterns among babies. I analyze data on total sleep duration, longest sleep periods, and nap frequency to illustrate this variability and offer a more relaxed perspective on infant schedules.

Key concept: Note that these messages were sent at midnight. Not only was Penelope not on a schedule, but neither, it seems, were we.

8. Vaccination: Yes, Please

The debate around vaccinations is often fueled by fear and misinformation. I dissect the evidence on vaccine safety and efficacy, debunking common myths and addressing the concerns of vaccine-hesitant parents. I explore the science behind vaccines, the history of vaccine resistance, and the importance of herd immunity. Ultimately, the data overwhelmingly supports the safety and effectiveness of vaccinations.

Key concept: Heed the statistics mantra: anecdote is not data. (I might put that on a T-shirt.)

9. Stay-at-Home Mom? Stay-at-Work Mom?

The decision of whether to stay home or return to work after having a child is deeply personal and often fraught with guilt and judgment. I examine the data on the impacts of parental employment on child outcomes, including the effects of maternity leave, and find that the evidence does not strongly support a negative impact of maternal employment. Ultimately, the decision should be based on what works best for the individual family, considering both personal preferences and economic realities.

Key concept: The bottom line from this literature is that these parental-leave extensions have no effect on child outcomes.

10. Who Should Take Care of the Baby?

Choosing childcare can be overwhelming. I break down this decision by comparing two common options: day care and nannies. I explore the data on the impacts of each option on child development, address the importance of quality in childcare settings, and offer practical guidance on how to evaluate different options. Ultimately, the best choice depends on individual family needs and preferences.

Key concept: In economics, we teach people to ‘solve the tree.’ To do this, you work backward from the bottom.

11. Sleep Training

Sleep training is one of the most contentious topics in parenting. I examine the evidence on the effectiveness and potential harms of ‘cry it out’ methods, finding strong support for its effectiveness in improving infant sleep and parental well-being. While acknowledging concerns about potential negative long-term impacts, I find the data reassuring and encourage parents to make informed choices based on their understanding of the evidence and their own parenting style.

Key concept: Good news: yes, this method works for improving sleep.

12. Beyond the Boobs: Introducing Solid Food

Introducing solid foods opens a new world of questions for parents. I debunk common myths about what breastfeeding mothers can and can’t eat, emphasizing that there are very few dietary restrictions. I also delve into the evolving recommendations on introducing allergens, like peanuts, to babies, highlighting the importance of early exposure. I also compare traditional spoon-feeding with baby-led weaning, a method that encourages self-feeding, and find that both approaches have merit.

Key concept: Eat what you want.

13. Early Walking, Late Walking: Physical Milestones

Watching children develop physically can be both exciting and anxiety-inducing. I explore common physical milestones like rolling, sitting, crawling, and walking, emphasizing the wide variation in ‘normal’ development. I reassure parents that hitting these milestones slightly earlier or later than average is typically not a cause for concern. I also discuss how pediatricians use milestones to identify potential developmental issues, particularly cerebral palsy, and the importance of early intervention.

Key concept: The 9- and 18-month milestones are the most crucial here; by 30 months, most major issues have been well identified, and doctors are looking for smaller things.

14. Baby Einstein vs. the TV Habit

Can babies learn from TV? I explore the research on educational television for young children, including the popular Baby Einstein DVDs. The data suggests that while older preschoolers can learn from programs like ‘Sesame Street’, infants and young toddlers do not retain much information from screen time. I also discuss concerns about the potential negative impacts of excessive screen time, drawing on both data and a ‘Bayesian’ approach to consider the opportunity costs of different activities.

Key concept: The idea was to increase school readiness for kids ages three to five.

15. Slow Talking, Fast Talking: Language Development

Language development is another area where parents often compare their children. I discuss the wide variation in when children start talking, analyzing data on vocabulary size and the factors that influence language acquisition. I explore whether early or delayed talking predicts anything about later development, finding that while there are some correlations, the predictive power of early language is weak.

Key concept: Communicating with one another—talking, signing, writing—is among the things that make us most human.

16. Potty Training: Stickers vs. M&M’s

Potty training is often viewed as a major milestone, and I analyze data on the average age of potty training completion, finding that it has increased in recent decades. I explore the factors that contribute to this trend, including diaper quality and parental preferences. I also examine different potty-training methods, finding little evidence to support one method over another, and emphasize that ultimately, successful potty training relies on finding what works for your individual child.

Key concept: It’s just a fact: you cannot force someone to poop.

17. Toddler Discipline

Disciplining toddlers can be one of the most challenging aspects of parenting. I discuss the importance of viewing discipline as a teaching tool, rather than punishment, and explore evidence-based approaches like ‘1-2-3 Magic’ and ‘The Incredible Years’. I emphasize the importance of consistency, setting clear boundaries, and managing parental anger. I also examine the evidence on spanking, finding that it has negative long-term consequences and no benefits for improving behavior.

Key concept: All these interventions emphasize not getting angry. Don’t yell, don’t escalate, and definitely don’t hit.

18. Education

Choosing a preschool often involves navigating different educational philosophies. I discuss three common approaches: Montessori, Reggio Emilia, and Waldorf, highlighting their key principles and differences. I also examine the limited data on the effectiveness of different preschool philosophies and emphasize the importance of quality in any preschool setting.

Key concept: There are some studies showing the children in Montessori preschools perform better on reading and math tests compared to a control group in non-Montessori options.

19. Internal Politics

This chapter delves into the often-unspoken challenges that having children can bring to a relationship. I present data showing that marital satisfaction often declines after having kids. I explore the role of factors like unequal chore allocation and decreased sexual frequency, and offer suggestions for mitigating these challenges, including open communication, couples therapy, and—crucially—prioritizing sleep.

Key concept: The answer to the first question is yes, things are, on average, systematically worse in marriages after kids. It is probably an exaggeration to say you’ll ‘hate your spouse,’ but people (women in particular) do seem less happy after kids.

20. Expansions

The decision of whether and when to have more children is deeply personal. I explore the limited data on ‘optimal’ family size and birth spacing, finding that while there may be some small risks associated with very short birth intervals, these are likely outweighed by individual family preferences and circumstances.

Key concept: All this is to say that the data has very little to add to your family preferences.

21. Growing Up and Letting Go

In this concluding chapter, I reflect on the challenges of parenting as children grow older and the anxieties that arise as the problems we face become less frequent but potentially more significant. I emphasize the importance of finding a balance between taking parenting seriously and recognizing that we cannot control every aspect of our children’s lives. The best parenting advice, I conclude, is sometimes to simply ‘let it go.’

Key concept: “Hmm. I’d probably just try not to think about that.”

Essential Questions

1. How can parents navigate the overwhelming amount of conflicting parenting advice and make informed decisions?

Parents are bombarded with conflicting advice, making it challenging to make informed decisions. My book aims to equip parents with evidence-based insights, enabling them to evaluate the data and make choices aligned with their preferences. This approach emphasizes autonomy, acknowledging that there is no single ‘right’ way to parent and that individual circumstances and values vary.

2. Are the widely touted benefits of practices like breastfeeding supported by strong evidence? How can parents separate hype from fact?

Many widely touted benefits of practices like breastfeeding are based on weak evidence or correlations, not causation. I aim to separate hype from fact by examining the quality of research and highlighting the complexities of studying these topics. By understanding the limitations of the data, parents can make more nuanced and informed decisions that are right for them.

3. What are the impacts of maternal employment on child development? Is it better for children to have a stay-at-home parent?

This is a multifaceted question with no easy answer. The data suggests that the impacts of maternal employment on child development are not definitively positive or negative. While some studies show small benefits to daycare, particularly for cognitive development, others find no significant impact. Ultimately, this decision should be based on family preferences, considering individual needs, financial constraints, and the availability of quality childcare.

4. Does sleep training work? Is ‘cry it out’ harmful to babies?

The data strongly supports the effectiveness of ‘cry it out’ methods for improving infant sleep. This, in turn, has positive effects on parental well-being, including reduced maternal depression. However, concerns about potential long-term harms persist. I examine the evidence for these harms, finding it largely theoretical and based on extrapolation from extreme cases like the Romanian orphanages. While acknowledging the need for further research, the data suggests that ‘cry it out’ is not inherently harmful.

5. How does having children affect a couple’s relationship? Are there ways to mitigate the negative impacts?

The data suggests that marital satisfaction often declines after having kids, likely due to factors like increased stress, sleep deprivation, and unequal division of labor. While this is a common experience, it doesn’t have to be inevitable. Interventions like couples therapy and ‘marriage checkups’ can improve communication and relationship satisfaction. Crucially, prioritizing sleep, for both parents and babies, can have a significant positive impact on overall well-being and relationship happiness.

Key Takeaways

1. There is no single ‘right’ way to parent. The best choices are those that work for your individual family.

In the realm of parenting, as in AI, one-size-fits-all solutions rarely work. Individual needs, values, and circumstances vary widely. The best approach is to empower parents with data and knowledge, enabling them to make informed choices that align with their specific situation and preferences.

Practical Application:

When designing an AI-powered parenting app, focus on providing personalized recommendations based on the user’s individual needs and preferences. Instead of offering one-size-fits-all solutions, incorporate algorithms that learn from the user’s data and behavior to tailor advice on topics like sleep schedules, feeding, and developmental milestones.

2. Be wary of parenting advice that relies heavily on correlations or weak evidence. Look for studies that support causal claims.

Many widely touted ‘facts’ about parenting are based on weak evidence or correlations that may not reflect a true causal relationship. I encourage a critical approach to data, emphasizing the importance of separating hype from fact and acknowledging the limitations of existing research.

Practical Application:

When developing an AI system that analyzes parenting data, be transparent about the limitations of the data and avoid making causal claims based solely on correlations. Provide users with context and guidance on interpreting the results, emphasizing that data is a tool for informing decisions, not a replacement for human judgment and intuition.

3. Prioritizing sleep is crucial for both parents and babies. Sleep training, particularly ‘cry it out’ methods, can be an effective tool for improving sleep.

Sleep deprivation is a major challenge for new parents and can have significant impacts on well-being and relationship satisfaction. Sleep training, while controversial, has strong evidence supporting its effectiveness in improving infant sleep, leading to positive downstream effects for both babies and parents.

Practical Application:

Incorporate sleep tracking and analysis into AI-powered parenting apps. Provide parents with data-driven insights on their baby’s sleep patterns, offer personalized recommendations for improving sleep, and connect them with resources like sleep consultants if needed.

4. Parenting is hard, and there’s no need for added shame or judgment. Focus on making choices that work for your family, and don’t be afraid to ask for help.

Many parents, particularly mothers, feel intense pressure to conform to societal expectations around breastfeeding, sleep training, and other parenting choices. I advocate for a more compassionate and understanding approach, emphasizing that parents are people, too, with their own needs and limitations. The goal is to make informed choices that work for the whole family, without shame or judgment.

Practical Application:

When designing AI systems for healthcare or parenting support, ensure that the system is sensitive to individual needs and avoids making judgments or promoting shame. For example, a chatbot that assists with postpartum depression screening should provide non-judgmental support and connect users with appropriate resources.

5. Positive discipline approaches, such as those outlined in ‘1-2-3 Magic’, can be effective tools for managing toddler behavior.

Evidence-based parenting programs like ‘1-2-3 Magic’ emphasize consistency, clear boundaries, and managing parental anger as key components of effective discipline. These principles can be helpful for parents of toddlers and older children, providing a framework for guiding behavior and promoting positive social and emotional development.

Practical Application:

Consider incorporating the principles of ‘1-2-3 Magic’ into the design of AI systems for behavior management. For example, an AI-powered virtual assistant could use a similar counting system to provide reminders and enforce consequences for undesirable behaviors.

Suggested Deep Dive

Chapter: Chapter 4: Breast Is Best? Breast Is Better? Breast Is About the Same?

This chapter tackles the highly debated topic of breastfeeding. The analysis of the data surrounding breastfeeding is highly relevant to AI development, as it showcases the importance of critical data analysis and the potential pitfalls of relying on biased or poorly conducted studies when making recommendations or designing interventions.

Memorable Quotes

Introduction. 9

One of the features of having a second child is you can have a do-over on all your perceived mistakes.

Introduction. 11

The swaddle breaking was, of course, a tiny incident. But it illustrates what will be one of the great themes of your parenting life: you have way less control than you think you do.

Introduction. 16

Preferences are very important here. Two families—with the same food costs, the same value of time, the same options—may make different choices because they have different preferences. This economic approach to decision-making doesn’t make a choice for you, only tells you how to structure it.

Colic and Crying. 54

But you basically cannot defeat a crying baby with hard work.

Growing Up and Letting Go. 291

“Hmm. I’d probably just try not to think about that.”

Comparative Analysis

Cribsheet distinguishes itself from other parenting books by its rigorous reliance on data and its emphasis on empowering parents to make informed choices that align with their values. Unlike prescriptive guides that offer one-size-fits-all solutions, Cribsheet encourages a nuanced understanding of the evidence, acknowledging that what works for one family may not work for another. This data-driven approach resonates with the growing trend in AI and technology towards personalized experiences and data-informed decision-making. While books like ‘What to Expect When You’re Expecting’ focus on the biological and developmental aspects of pregnancy and infancy, Cribsheet delves into the often-overlooked behavioral and social challenges of parenting, providing evidence-based insights on topics like sleep training, breastfeeding, and childcare. This focus on data and individualization aligns with the principles of AI-driven personalization, where algorithms are used to tailor experiences to individual needs and preferences. Cribsheet also shares similarities with books like ‘Bringing Up Bébé’ in its exploration of cultural differences in parenting styles, offering a broader perspective on the choices parents face.

Reflection

Cribsheet provides a valuable service by challenging the often-prescriptive and anxiety-inducing world of parenting advice. Oster’s commitment to data analysis is commendable, especially in a field saturated with anecdotal claims and personal opinions. However, the book’s reliance on observational studies, while acknowledging their limitations, requires a careful reader. The inherent complexities of human behavior, especially within family dynamics, make it challenging to isolate the causal effects of specific parenting practices. While the data offers insights, it’s crucial to recognize that correlation doesn’t equal causation, and many factors beyond parental choices influence child development. Oster’s focus on individualized decision-making based on both data and personal preferences is empowering for parents. It moves away from a ‘one-size-fits-all’ approach and encourages a more nuanced and less judgmental understanding of the parenting journey. This resonates with the broader shift towards personalized experiences and data-informed decision-making in various fields, including AI and technology. While Cribsheet may not offer concrete answers to every parenting question, it equips parents with the tools and knowledge to make informed decisions, navigate the complexities of data, and ultimately find what works best for their unique family.