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Kindle Notes & Highlights
by
Emily Oster
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January 17 - March 4, 2023
Most important, sleep interventions seem to be very successful at reducing maternal depression.
night. This particular study found that, in fact, infant security and attachment seemed to increase after the “cry it out” intervention. It also found improvements in daytime behavior and eating as reported by the babies’ parents.
A 2006 review of sleep-training studies, which included thirteen different interventions, noted the following: “Adverse secondary effects as the result of participating in behaviorally based sleep programs were not identified in any of the studies. On the contrary, infants who participated in sleep interventions were found to be more secure, predictable, less irritable, and to cry and fuss less following treatment.”
This study—as well as the others I cited earlier and various review articles—does not point to either long- or short-term harms from “cry it out.” And it works, and it is good for parents. This paints a pretty pro–“cry it out” picture. But it is not one that everyone agrees with.
Most “cry it out” methods are variants on one of three themes: Extinction—just leave, and do not return; Graduated Extinction—come back at increasingly lengthy intervals; and Extinction with Parental Presence—sit in the room, but do not do anything. Ferber is a proponent of the second, whereas Weissbluth is more in favor of the first.
The only general principle from these is that consistency is key. Choosing a method—whichever one—and sticking with it increases success. So the most important consideration here is likely what you think you can do. Will knowing you can check on the baby help you feel better? Or would you rather just close the door and leave it closed?
This also highlights the importance of having a plan. Sleep training should not be something you decide to do on a whim because your baby is being a jerk today. It should be something you plan—ideally with both parents and caregivers, and perhaps also with your doctor. And once you have a plan, stick to it. There
Generally, it will be easier to sleep train a six-month-old than a three-month-old, and probably harder to train a two-year-old. But these methods seem to work on a variety of ages.
You should not expect your two-month-old to sleep for twelve hours, and you similarly shouldn’t be frustrated or feel like a failure if they do not. The goal of sleep training a ten-week-old baby is to encourage the baby to fall asleep on their own at the start of the night and then only wake when they are hungry later in the night.
Put simply, the goal of sleep training is not (despite what some would say) to deprive your child of basic needs like food and diaper changes. It is to encourage their going to sleep independently once those needs are met.
Finn will go to bed during Penelope’s bedtime, around 6:45. We will put his pj’s on and read him a book as part of the bedtime routine. He will nurse, and then we’ll put him down in bed. We will not return at all before 10:45 p.m.
Will feed Finn the first time he cries after 10:45 p.m. After the first feeding, do not respond again until at least 2 hours after the end of each feeding.
Wake-up is between 6:30 and 7:30 a.m. If he is awake at 6:30 we get him up. If he is not awake he can sleep until as late as 7:30. At that time we wake him up if he is not up already.
Children who were exposed to peanuts were far less likely to be allergic to them at the age of five than children who were not.
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.
Peanut timing is not the only recommendation that you’ll hear about food. The American Academy of Pediatrics (among other sources) has whole websites devoted to transitioning your child to eating solid foods. For the most part, there is little real evidence behind these recommendations.
Nearly all allergies are caused by one of a few foods—milk, eggs, peanuts, and tree nuts—and it’s sensible not to introduce these foods all at the same time.
An alternative, which has grown in popularity in recent years, is referred to as “baby-led weaning.” In this practice, instead of introducing pureed foods and feeding the kid with a spoon, you wait until they are old enough to pick up foods on their own and then have them more or less eat what your family eats.
Baby-led weaning involves just giving your child the food you are eating.
Advocates of baby-led weaning do not typically focus on the lazy-parenting benefits. Instead, they cite benefits to your child: infants learn to regulate the amount of food they eat, leading to less incidence of overweight or obesity; they show acceptance of a wide variety of foods; and you have better family mealtime experiences.
However, even if you eat all kinds of weird stuff while breastfeeding, and carefully expose your child to Brussels sprouts for weeks on end, they may still end up being somewhat picky about their food. Researchers classify this pickiness into two groups: food neophobia (fear of new foods) and picky/fussy eating, in which the child just doesn’t like a lot of different foods.
Before getting into these, and how you might fix them (hard), you should know that most kids become more picky around two and then slowly grow out of it in their elementary school years.
Kids are more likely to try to eat it with what researchers call “autonomy-supportive prompts”—things like “Try your hot dog” or “Prunes are like big raisins, so you might like them.” In contrast, they are less likely to try things if parents use “coercive-controlling prompts”—things like “If you finish your pasta, you can have ice cream” or “If you won’t eat, I’m taking away your iPad!!”
Other studies show that parental pressure to try new foods or to eat in general is associated with more food refusal, not less.13 These studies also show that food refusals are more common in families where parents offer an alternative. That is, if your kid doesn’t eat broccoli and then you offer him chicken nuggets instead, he may learn that this is always the reward for not eating new foods.
Putting this together leads to some general advice: offer your very young child a wide variety of foods, and keep offering them even if the child rejects them at first. As they get a little older, do not freak out if they don’t eat as much as you expect, and keep offering them new and varied foods. If they won’t eat the new foods, don’t replace the foods with something else that they do like or will eat. And don’t use threats or rewards to coerce them to eat.
The vast majority of allergies result from eight food types: milk, peanuts, eggs, soy, wheat, tree nuts, fish, and shellfish. The incidence of these allergies has grown over time, perhaps as a result of better hygiene (so less allergen exposure early on), and clearly due in part to a lack of early introduction.
Importantly, although the language here is about “introduction,” these studies include regular exposure as well. It is not enough to have your kid try peanut butter or eggs. You need to actually keep giving it to them regularly. Which leads to the question: How?
generally, young children should have formula, breast milk, or (once they start eating solid foods) water. Whole fruits or fruit purees are preferable to fruit juice.
The concern is that cow’s milk is not a complete infant nutrition system, and if your infant drinks a lot of milk, it will restrict formula or breast milk intake. In particular, infants who have cow’s milk as their primary milk source are more likely to be iron deficient.
The evidence says only that you shouldn’t replace formula or breast milk with cow’s milk. As an addition to, say, oatmeal or cereal, it isn’t a problem.
The Bottom Line Early exposure to allergens reduces incidences of food allergies.
Kids take time to get used to new flavors, so it is valuable to keep trying a food even if they reject it at first, and early exposure to varying flavors increases acceptance.
Toddlers are a new ball game. They are funny, playful, exciting to be around. But they also bring resistance. And at the same time, there are more things you are trying to accomplish, things that you need their help with.
Sleep training, vaccination—you can do these without your child’s cooperation. Potty training, not so much.
Parenting a toddler also seems somehow more consequential than parenting a baby. As you see your child’s personality come through, you also start to see what they will struggle with.
It is sometimes easy to ignore the way your children differ from the average, but it’s made much harder if you see the average all the time.
(There are always more neuroses around the corner when you’re parenting.) I
Children who are very delayed on early milestones—head control, rolling over—are more likely (not very likely, just more likely) to have serious developmental issues.
Some of these issues will also manifest in cognitive or behavioral problems, but we do not see evidence of delays in these areas until kids are much older.
In the past it was believed that CP was exclusively a result of injuries at birth, but more recent evidence suggests prenatal conditions may also have an effect on whether a child is born with CP.
Cerebral palsy isn’t a disease—like a virus or cancer—or a genetic defect. It’s a term to describe motor issues that result from nervous system injury. The issues resulting from CP vary widely—it can affect different limbs or body parts, and be more or less severe.
Typically, developing babies roll over between 3 and 5 months; if they have not rolled over by 9 months, that is definitely outside the normal. Similarly, although typical development calls for walking between 8 and 17 months—with an average of 12 months—looking at 18 months catches children who are outside the norm.
Milestone Range Sitting without support 3.8 months to 9.2 months Standing with assistance 4.8 months to 11.4 months Crawling (5% of kids never do) 5.2 months to 13.5 months Walking with help 5.9 months to 13.7 months Standing alone 6.9 months to 16.9 months Walking alone 8.2 months to 17.6 months From this data, we see the logic for Dr.
Basically, yes. Kids younger than school age get an average of six to eight colds a year, most of them between September and April.7 This works out to about one a month. These colds last on average fourteen days.8 A month is thirty days. So in the winter, on average, your kid will have a cold 50 percent of the time.
On top of this, most kids end their cold with a cough that can last additional weeks. It adds up.
Of these complications, ear infections are the most common. About a quarter of kids will have an ear infection by the age of one, and 60 percent by the age of four.
You should also invest in a good general pediatrics book, which can do a more complete job at listing childhood symptoms than I can here. There are some references in the back; my favorite is The Portable Pediatrician for Parents by Laura Nathanson.
In the past thirty years, there has been tremendous progress both in educational programming and, in the past decade, other educational screen media. Where our parents had only Sesame Street, we as parents have a plethora of educational iPad games, DVDs, streaming videos, and so on. All of which promise early literacy and numeracy.
The American Academy of Pediatrics falls squarely in agreement with the second answer. They recommend no TV or screen time at all for children under eighteen months, and no more than an hour a day, ideally consumed with a parent, for older children. In addition, they recommend choosing “high-quality” programming, such as that featured on PBS. That would include Sesame Street, although it would also include less learning-focused shows, such as the parent-despised Canadian-export Caillou.
The study’s authors noted that the most significant predictor of both how many words the children spoke and how fast their vocabularies grew was whether their parents read them books. Other authors have extended versions of this study to kids up to age two and found similar results.
