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Cribsheet: A Data-Driven Guide to Better, More Relaxed Parenting, From Birth to Preschool

Tags: #parenting #data analysis #science #child development #health

Authors: Emily Oster

Overview

My book, “Cribsheet: A Data-Driven Guide to Better, More Relaxed Parenting, From Birth to Preschool,” is designed to empower parents with information and a framework for making the best choices for their families during the often overwhelming early years of parenthood. In a world saturated with conflicting advice and judgment, I offer a data-driven approach, examining the evidence behind common parenting practices and debunking myths and misconceptions.

Unlike many parenting books that focus solely on the child, I acknowledge that parents are people too, with their own needs, desires, and preferences. I encourage readers to consider their own values and constraints alongside the data when making decisions about breastfeeding, sleep, childcare, discipline, and other key parenting challenges.

The book covers a wide range of topics, from navigating the hospital stay after birth to introducing solid foods, managing sleep, and choosing childcare. It also delves into the impact of parenting decisions on the family as a whole, examining the challenges of maintaining a healthy relationship and balancing work and family life.

My goal is to provide parents with the tools they need to make informed choices, free from guilt and anxiety, and ultimately create a parenting experience that works for their unique family.

Book Outline

1. The First Three Days

Nearly all infants lose weight after birth, and those who are breastfed lose even more. This is due to the transition from receiving nutrients through the umbilical cord to feeding. While weight loss itself is normal, excessive weight loss can signal a problem with feeding. Monitoring helps catch potential issues early, but it’s important for parents to understand the normal range of weight loss and not overreact.

Key concept: Many new parents are not expecting the tremendous focus doctors and hospital staff place on infant weight gain or loss… Infant weight is monitored pretty carefully in the hospital. Every twelve hours or so they’ll weigh the baby and possibly come back to report any change in weight to you.

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

This chapter focuses on practical matters during the first weeks at home, like swaddling, managing colic and excessive crying, navigating germ exposure, and the value (or lack thereof) of data collection. It emphasizes using data-driven approaches to understand normal ranges and make informed decisions.

Key concept: One of the features of having a second child is you can have a do-over on all your perceived mistakes. As an ‘experienced parent’, you can make sure that anything you look back on with regret you’ll fix on this round.

3. Trust Me, Take the Mesh Underwear

This chapter addresses the often overlooked topic of a mother’s physical recovery after childbirth. Vaginal tearing is common, as is postpartum bleeding. Both vaginal and caesarean births involve discomfort in peeing and pooping, and lingering effects like incontinence. While recovery varies, asking for help and adjusting expectations are crucial.

Key concept: “After birth, the vagina will be capacious.” Things will just not be quite the way they were before. You may have stitches; the whole area will be painful and just kind of off.

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

This chapter delves into one of the biggest early parenting decisions: breastfeeding. It examines the data on the benefits of breastfeeding, acknowledging that many claimed benefits are not well-supported by rigorous research. While breastfeeding offers some short-term health advantages for babies and potential long-term benefits for mothers, especially a lower risk of breast cancer, the decision ultimately involves weighing these benefits against personal preferences and constraints.

Key concept: There are many big decisions: Should you breastfeed? Should you sleep train, and with what method? What about allergies? Some people say avoid peanuts, others say give them to your child as soon as possible—which is right? Should you vaccinate, and if so, when?

5. Breastfeeding: A How-To Guide

For women who choose to breastfeed, this chapter offers a practical guide to common challenges. It covers latch difficulties, using nipple shields, addressing tongue tie, managing nipple pain, and strategies for increasing or decreasing milk supply. It emphasizes seeking support from lactation consultants and finding solutions that work for both mother and baby.

Key concept: Many infants struggle to latch on correctly. Without a good latch, the baby will not get enough milk, and it can be extremely painful for Mom.

6. Sleep Position and Location

This chapter explores the often-contentious topic of infant sleep, examining evidence-based recommendations for safe sleep. It emphasizes the importance of placing babies on their backs to sleep to reduce the risk of SIDS and explores the complex issue of co-sleeping, highlighting the risks and potential benefits. It also analyzes the recommendation to have the baby sleep in the parents’ room, suggesting that the benefits may be outweighed by potential sleep disruptions for both infants and parents.

Key concept: The latest recommendations from the American Academy of Pediatrics are starkly opposed to the toy-and-blanket-filled crib. The AAP says infants should sleep alone in a crib (or bassinet) and should be placed in the crib on their back to sleep. There should be nothing in the crib with the baby.

7. Organize Your Baby

This chapter investigates the challenge of establishing infant sleep schedules, debunking the idea that imposing a rigid schedule from birth is necessarily beneficial. It uses data on infant sleep patterns to show that there’s a wide range of normal sleep durations, and that individual variation makes it difficult to apply universal rules. It suggests that while parents can try to gently guide sleep patterns, a more flexible approach that responds to the baby’s cues may be more effective.

Key concept: How much sleep is enough, and when should it happen? It seems like a simple question, but answers differ widely.

8. Vaccination: Yes, Please

This chapter addresses the controversy surrounding vaccinations, emphasizing the overwhelming scientific evidence supporting their safety and effectiveness. It debunks common concerns about vaccines causing autism and other injuries, highlighting flawed research and fraudulent claims. It encourages parents to follow recommended vaccination schedules, emphasizing the benefits for both individual children and public health through herd immunity.

Key concept: Vaccinations are among the most significant public health triumphs of the past hundred years… Simply put, millions of lives worldwide have been saved by the introduction of vaccines for diseases like whooping cough, measles, smallpox, and polio.

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

This chapter examines the decision of whether to return to work after having a child, challenging the judgmental attitudes and societal pressures surrounding this choice. Data suggests that while early parental leave benefits infants, there’s little evidence that having a stay-at-home parent after that period significantly affects child development. The decision should be based on individual preferences, family needs, and budget considerations, free from guilt and shame.

Key concept: “What kind of mom do you have? I have a stay-at-home mom,” to which my friend’s son responded, “Oh, I have a stay-at-work mom.”

10. Who Should Take Care of the Baby?

This chapter delves into the various childcare options available to working parents, focusing on day care and nannies. It presents a decision-making framework using a decision tree to help parents choose the best option for their family. Drawing on the NICHD Study of Early Child Care, it underscores the importance of childcare quality, providing guidance on how to evaluate quality in both day care centers and nanny arrangements. It emphasizes considering both the needs of the child and the family’s budget and convenience.

Key concept: If you don’t live somewhere with an obvious childcare option, you’ve got to figure this out for yourself. Day care or a nanny are the most standard setups, but you could have a family member pitch in, or have some hybrid of these.

11. Sleep Training

This chapter investigates the effectiveness and potential harms of sleep training, specifically “cry it out” methods. It presents a data-driven analysis showing that these methods are effective in improving infant sleep and reducing maternal depression. While acknowledging the emotional challenges of letting a child cry, it emphasizes that research suggests no long-term harm to infants from sleep training. It also covers different sleep training methods and the importance of choosing one that fits the family’s needs and sticking to it consistently.

Key concept: Good news: yes, this method works for improving sleep. There are many, many studies on this, employing a variety of related procedures (many of these are randomized trials).

12. Beyond the Boobs: Introducing Solid Food

This chapter focuses on introducing solid foods, exploring the transition from breastfeeding to other foods and the timing of food introduction. It challenges traditional recommendations, suggesting they are often based on limited evidence. It highlights the groundbreaking research on early peanut exposure, showing that it can significantly reduce peanut allergies, and emphasizes the importance of introducing allergenic foods early. It also explores baby-led weaning as an alternative to traditional spoon-feeding, providing data-driven insights into this approach.

Key concept: This is a striking finding, to say the least. It suggests that exposing children to peanuts early helps them avoid peanut allergies. The finding is especially notable as it suggests that the standard advice parents were given about peanuts up to this point was entirely wrong.

13. Early Walking, Late Walking: Physical Milestones

This chapter explores the anxiety parents often feel about their children’s physical milestones, emphasizing that variation in development is normal. It examines the wide range of ages at which children achieve milestones like sitting, crawling, and walking, providing data-driven insights into what constitutes typical development. It reassures parents that while pediatricians focus on identifying significant delays, slight variations from the average age are not a cause for concern.

Key concept: In the case of milestones—physical, and language development—we don’t really talk about distributions… But whether we discuss them, these distributions are there. And even just knowing this may relax you a bit.

14. Baby Einstein vs. the TV Habit

This chapter addresses the impact of screen time, specifically television and educational videos, on young children. It examines the evidence on whether babies and toddlers can learn from videos, concluding that while older children can learn from educational programs like Sesame Street, there’s little evidence that infants learn much from screen time. It delves into research suggesting that excessive TV watching, particularly before the age of three, may be associated with lower cognitive development, but emphasizes the importance of considering the quality of programming and the opportunity cost of screen time.

Key concept: Which is it? Is showing your nine-month-old a Baby Einstein DVD the way to encourage them to be an early talker? Or are you just developing the Berenstain Bears’ dreaded “TV habit”?

15. Slow Talking, Fast Talking: Language Development

This chapter explores language development, focusing on the distribution of vocabulary size in young children and the anxiety parents often experience about their children’s language progress. It uses data from the MacArthur-Bates Communicative Development Inventory (MB-CDI) to show the wide range of normal language development, noting that girls tend to develop language faster than boys, but with significant overlap. It also examines whether early language development predicts later outcomes like reading ability and school performance, concluding that while there are links, the predictive power is relatively weak.

Key concept: Communicating with one another—talking, signing, writing—is among the things that make us most human. The moment your child stops having to cry and point desperately at the refrigerator and can instead say, “Milk, please” (or even just “MILK!!”) is one in which you can start to see glimmers of a person in there.

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

This chapter tackles potty training, addressing the increasing age at which children are potty trained and the stress this can cause for parents. It analyzes research on the timing of potty training, suggesting that while it’s possible to train children earlier, there’s no significant benefit to doing so and it may actually prolong the process. It emphasizes that the most important factor is finding a method that works for the individual child and family, acknowledging that there’s no one-size-fits-all approach.

Key concept: The main and probably only benefit to potty training a child earlier is that you do not have to change as many diapers. The main reason to wait is that the earlier you start, the longer it takes to complete.

17. Toddler Discipline

This chapter delves into toddler discipline, exploring the challenges of managing tantrums and other challenging behaviors. It highlights evidence-based parenting interventions like 1-2-3 Magic and the Incredible Years, which emphasize consistency, clear consequences, and avoiding parental anger. It also critically examines the practice of spanking, presenting data suggesting that it has negative long-term impacts on behavior and offers no benefits.

Key concept: This is the discipline-as-education philosophy espoused by French parenting (thanks, Bringing Up Bébé!). Discipline is not the same as punishment. Yes, there is a punishment component. But it’s in the service of raising better humans, not punishment for its own sake.

18. Education

This chapter explores early childhood education, examining whether preschool is beneficial and what type of preschool is best. It argues that while there’s some evidence that preschool can improve school readiness, particularly for children from disadvantaged backgrounds, the data on the benefits of different preschool philosophies (Montessori, Reggio Emilia, Waldorf) is limited. It emphasizes the importance of choosing a high-quality preschool that provides a safe and stimulating environment, regardless of its specific philosophy.

Key concept: There is a related question is whether you should favor one preschool “philosophy” over others. The three philosophies you will most commonly encounter in your preschool exploration are Montessori, Reggio Emilia, and Waldorf.

19. Internal Politics

This chapter examines the impact of having children on marital happiness, acknowledging that it often leads to a decline in marital satisfaction, particularly for women. It explores potential contributing factors, such as unequal division of household labor and a decline in sexual frequency, and highlights the importance of open communication and seeking professional support when needed. It also emphasizes that while these challenges are real, many couples find ways to navigate them successfully and maintain fulfilling relationships after having children.

Key concept: Introducing a child into your life will, similarly, lead to some increase in tension for most people. Less charitably, people will tell you that children will “ruin your marriage.”

20. Expansions

This chapter addresses the decision of whether to have more children and, if so, the optimal spacing between them. While acknowledging that these are highly personal choices, it examines the limited data available on family size and birth spacing. It finds that birth order may have a greater impact than the total number of children, with later-born children tending to perform slightly worse academically. It also explores the risks of short birth intervals for infant health, suggesting that waiting at least a year between pregnancies may be beneficial.

Key concept: The choice of how many children to have is even more personal. Does your family feel done with just one? Do you want another? And, of course, sometimes it’s hard to have a second child, and sometimes it’s an accident.

21. Growing Up and Letting Go

This chapter reflects on the challenges of parenting as children grow older, noting that while the number of worries may decrease, their significance often increases. It emphasizes the importance of adapting to changing needs and embracing the joys of watching children develop their own interests and navigate new challenges. It concludes with the message that while data can be helpful in making parenting decisions, sometimes the best advice is simply to let go of anxieties and be present with your children, trusting in your ability to handle whatever comes your way.

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

Essential Questions

1. What are the actual, evidence-backed benefits of breastfeeding for both mother and child?

While many claimed benefits of breastfeeding lack strong scientific support, data suggests some real advantages. These include reduced rates of infant gastrointestinal infections and eczema, as well as a potential long-term benefit for mothers in lowering breast cancer risk. It’s crucial for parents to weigh the evidence-backed benefits against the often-intense personal and logistical challenges of breastfeeding to make the best decision for their family.

2. Does sleep training harm babies, and what does the data say about its effectiveness?

Contrary to popular belief, consistent research shows that sleep training, including “cry it out” methods, is not harmful to infants. In fact, it leads to improved sleep for both babies and parents, and studies show no long-term negative effects on children. The key is to choose a method that parents can consistently implement and that aligns with their parenting philosophy.

3. Is a nanny better for a child’s development than day care, or vice versa? What factors should parents consider when choosing childcare?

Data suggests that the “ideal” childcare situation may not exist. High-quality care, whether provided by a nanny or at a day care center, is the most important factor in promoting positive child development outcomes. The choice between a nanny and day care depends on factors such as family budget, logistics, parental preferences, and the child’s individual needs.

4. How can parents navigate anxiety about their children’s developmental milestones, and how can data help?

While it is natural to compare our children’s developmental milestones to others, focusing solely on averages can lead to unnecessary anxiety. Understanding the wide range of normal development and the limitations of correlation vs. causation can help parents make informed choices based on their child’s individual needs. For example, while early intervention is crucial for children with significant developmental delays, slight variations from the average are usually not a cause for concern.

5. How does becoming a parent affect a couple’s relationship, and are there ways to mitigate the negative impacts?

Research shows that parental happiness often declines after having children, and this decline can be exacerbated by factors like sleep deprivation, unequal division of household labor, and a decrease in sexual intimacy. However, these declines are often temporary, and couples who are happier before having children tend to recover more quickly. Open communication, shared responsibility for childcare and housework, and seeking support from therapists or “marriage checkup” programs can help mitigate these challenges.

Key Takeaways

1. Babies and Toddlers Don’t Learn From Passive Screen Time

Research suggests that children under two years old learn very little from passive screen time, including educational videos. Instead, they thrive on real-world interactions and hands-on experiences. Their brains are not wired to effectively absorb information from screens at this early stage of development.

Practical Application:

When designing an AI-powered educational app for young children, focus on creating interactive content that encourages active participation and exploration rather than passive viewing. Incorporate features that prompt children to make choices, solve problems, and engage in imaginative play.

2. Infant Weight Loss is Normal, But Monitor for Extremes

Most newborns, especially those who are breastfed, experience weight loss in the first few days after birth. This is a normal physiological process as they transition to feeding. It’s important for parents to understand the normal range of weight loss and not overreact to slight dips, but also to monitor for excessive weight loss, which can signal a feeding problem.

Practical Application:

When developing an AI assistant for parents, incorporate evidence-based information about normal infant weight loss patterns and provide reassurance to parents who may be unnecessarily anxious. The assistant could offer personalized guidance based on the baby’s age, birth weight, and feeding method, helping parents avoid overreacting to normal fluctuations.

3. The Breastfeeding Decision is Personal and Should Be Free From Judgment

The decision of whether or not to breastfeed is intensely personal and often fraught with societal pressure and judgment. While breastfeeding offers some benefits, many of the claimed advantages are not supported by rigorous research. It’s essential for mothers to make this decision based on their own preferences and circumstances, free from guilt and shame.

Practical Application:

When designing AI-powered tools for parents, avoid reinforcing societal expectations and judgment surrounding breastfeeding. Instead, offer neutral and data-driven information about the benefits and challenges of different feeding choices, empowering parents to make the best decision for their individual circumstances.

4. Flexibility is Key in Infant Sleep Schedules

There is a wide range of normal sleep durations and patterns for infants and toddlers. Imposing a strict sleep schedule from birth is unlikely to be successful and may lead to unnecessary stress for both parents and babies. A more flexible approach that responds to the child’s cues and allows for individual variation is often more effective.

Practical Application:

For an AI product aimed at helping parents manage sleep schedules, incorporate flexibility and personalization rather than promoting rigid, one-size-fits-all approaches. Allow for variations in sleep durations, wake-up times, and nap schedules, empowering parents to adapt to their child’s individual sleep patterns.

5. There is No One “Right” Age or Method for Potty Training

The age at which children are potty trained has increased in recent years, and there is no one-size-fits-all approach. While some children may be ready earlier than others, starting intensive training before 27 months doesn’t seem to lead to earlier completion. The best method is one that works for the individual child and family, whether it’s child-led, parent-led, or a combination of approaches.

Practical Application:

When designing AI tools to assist with potty training, provide information and support for different approaches, including both child-led and parent-led methods. The tool could help parents identify their child’s readiness signs, track progress, and offer encouragement and troubleshooting tips tailored to their chosen method.

Suggested Deep Dive

Chapter: Chapter 6: Sleep Position and Location

This chapter’s deep dive into the data surrounding co-sleeping and SIDS is particularly relevant for AI engineers developing products for infant safety and monitoring. Understanding the nuances of risk assessment, parental decision-making, and the ethical considerations around promoting safe sleep practices is crucial for designing responsible and effective AI tools in this sensitive area.

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. As an “experienced parent,” you can make sure that anything you look back on with regret you’ll fix on this round.

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. 13

We can do better, and data and economics, surprisingly, can help. My goal with this book is to take some of the stress out of the early years by arming you with good information and a method for making the best decisions for your family.

Wait, You Want Me to Take It Home?. 41

In this chapter, I cover some concerns that come up right away: germ exposure, vitamin D drops, colic, and, finally, the value (or lack thereof) of data collection. These may seem mundane and minor. But they can loom very large for the brand-new parent.

Breast Is Best? Breast Is Better? Breast Is About the Same?. 87

The pressure on moms to breastfeed can be immense. The rhetoric makes it seem like this is the most important thing you can—and need—to do to set your child up for success. Breastfeeding is magic! Milk is liquid gold!

Comparative Analysis

While many parenting books rely on anecdotal evidence or expert opinions, “Cribsheet” stands out by its rigorous data-driven approach. It aligns with the work of other data-centric parenting authors like Dana Suskind (“Thirty Million Words: Building a Child’s Brain”) in emphasizing the importance of early language exposure. However, Oster challenges some commonly held beliefs, such as the notion that specific parenting choices, like breastfeeding duration or sleep training methods, have dramatic long-term impacts on child development. She diverges from attachment parenting advocates like William Sears, who emphasize the importance of responding immediately to a baby’s cries, by presenting evidence suggesting that “cry it out” sleep training methods are not harmful and can improve both infant and parental well-being. Overall, “Cribsheet” offers a refreshingly balanced and evidence-based perspective on parenting, encouraging parents to make informed choices that align with their values and circumstances.

Reflection

Cribsheet provides a refreshing and much-needed antidote to the often overwhelming and judgment-laden world of parenting advice. Oster’s rigorous examination of the data allows parents to understand the real risks and benefits associated with various parenting choices, empowering them to make informed decisions that align with their values. However, it’s important to acknowledge that even the most robust data has limitations. Some areas of parenting, like the long-term impact of specific sleep training methods, are difficult to study, and the available data may not capture the full complexity of these issues. While Oster is careful to present a balanced perspective, her personal opinions, shaped by her experiences as an economist and a mother, sometimes color her interpretations. This doesn’t diminish the book’s value, but encourages readers to engage critically with the data and consider their own unique circumstances when making decisions. Overall, “Cribsheet” is a valuable resource for parents seeking an evidence-based guide through the often turbulent waters of early parenthood.

Flashcards

What is the “Back to Sleep” campaign?

The practice of placing babies on their backs to sleep, which has been shown to significantly reduce the risk of SIDS.

What are the key findings on the impact of breastfeeding on infant health?

While breastfed babies have lower rates of certain illnesses like diarrhea and eczema, the overall impact of breastfeeding on long-term health and IQ is less clear and likely influenced by other factors.

What is the most important factor in choosing childcare?

High-quality care, regardless of whether it’s provided by a nanny or at a day care center.

What is the relationship between the age at which potty training is started and its completion?

While later initiation is associated with later completion, starting intensive potty training before 27 months doesn’t seem to lead to earlier success.

What are the key principles of effective toddler discipline?

Consistency in rewards and consequences, clear communication, avoiding parental anger, and focusing on teaching positive behaviors.

Can babies and toddlers learn from watching TV or videos?

No. While children ages 3-5 can learn some things from television, especially from educational shows like Sesame Street, there’s little evidence that infants and toddlers learn much from screen time.

Is reading to young children beneficial?

Yes, there’s good evidence that reading to children, starting in infancy, can promote language development and later reading skills. Interactive reading, with open-ended questions, is particularly beneficial.

Do children benefit from having a stay-at-home parent?

Yes, but the data suggests that the impact of having a stay-at-home parent on child development is small and likely less important than other factors like parental involvement and childcare quality.