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Kindle Notes & Highlights
by
Emily Oster
Nearly all people—including elite athletes, but also recreational athletes and those of us who just walk or run for exercise—should be able to resume pre-pregnancy activity levels by six weeks postpartum and some modified version before that.
Exercise can help combat postpartum depression and generally improves mood. Yes, there are other demands on your time, but taking care of yourself also matters.
no sex until six weeks postpartum, after you have had a checkup with your doctor.
Depending on the severity of the tearing, this could happen much before six weeks, or it could take longer. Your doctor will check this at your first postpartum checkup (which is, in fact, around six weeks), but you may be able to tell if you’ve healed before that.
Sex after childbirth can be painful. Breastfeeding promotes vaginal dryness and lowers your sex drive. In addition, injuries during birth can have persistent effects.
The prevalence of postpartum
depression, even if we focus only on diagnosed cases, is high. An estimated 10 to 15 percent of women who give birth will experience
By far the biggest risk factor for postpartum depression is predisposition, or prior experience of depression. Mental health isn’t as well understood as we would like, but there are clearly some genetic or epigenetic factors that affect it. If you’ve had episodes of depression before, they are more likely to crop up again in pregnancy or in the postpartum period.
tool. But women with postpartum anxiety also tend to find themselves fixated on terrible things that could happen to the baby, unable to sleep even if the opportunity is there, and engaging in obsessive-compulsive behaviors around infant safety.
In the first year, breastfed babies had fewer gastrointestinal infections (i.e., diarrhea) and lower rates of eczema and other rashes.
They find no evidence of any long-term health impacts: no change in allergies or asthma, cavities, height, blood pressure, weight, or indicators for being overweight or obese.
Here is the truth: you are less likely to get pregnant if you breastfeed, but it is not—I repeat, NOT—a reliable birth control method, especially as your child ages and if you ever go more than a few hours without feeding or pumping.
One large study from North Carolina showed that at three months postpartum, weight loss was similar in moms who breastfed and those who did not.
Across a wide variety of studies and locations, there seems to be a relationship here, and a sizable one—perhaps a 20 to 30 percent reduction in the risk of breast cancer.
One study of two hundred women in India randomized the mothers into either holding their infant skin to skin for forty-five minutes after birth or having them in an infant warmer.1 The moms who had their infants skin to skin were more likely (72 percent versus 57 percent) to be breastfeeding at six weeks; they also reported less pain while being stitched up after birth.
that breastfeeding support—by a doctor, or by a nurse or lactation consultant—can increase likelihood of breastfeeding initiation and continuation.3
that captures the fact that the baby needs to get a whole mouthful of boob, although not that you have to jam them on.
These shields can make it easier for infants to latch, in principle, and make nursing less painful for Mom.
on. Any pain should be mostly gone after the first minute or two of nursing, not continue.
11 The only thing with any support in randomized trials is the practice of rubbing breast milk on your nipples regularly.
trying.” If you’re experiencing this, get help. Many states have breastfeeding hotlines, and La Leche League can often connect you with a lactation specialist over the phone if you do not want to go as far as seeing someone in person.
Some things will increase the risk of mastitis—including not fully emptying the breasts with each feeding, having an oversupply, or not emptying the breasts frequently enough—but
It is not hard to diagnose—the symptoms are a red, painful, swollen breast and a high fever—and
The system is designed to have a feedback loop where you produce more milk when the baby needs more.
colostrum, an antibody-rich substance.
both feeding on demand and initiating breastfeeding within an hour of birth are associated with a lower likelihood of delayed milk onset.
Doctors may recommend that you pump after each feeding, or at least after some of them, to try to convince your body that you need more milk.
The main problems with an oversupply are that it can be very uncomfortable and can increase your risk of mastitis.
Pumping for a couple of minutes—or hand-expressing milk—right before you nurse can help with this problem. It will also improve as the baby gets bigger and the oversupply problems calm down.
Good news: mostly, breastfeeding moms have no dietary restrictions.
part. The only food women are medically advised to avoid during breastfeeding is high-mercury fish.
there is no need to pump and dump.
You can have a drink, but you need to wait for two hours afterward to let the alcohol metabolize before breastfeeding. For two drinks, that increases to four hours.
The first line of defense is Tylenol or ibuprofen, typically (in the latter case) in quite high doses. These are well tolerated and fine for use while breastfeeding.
All antidepressants are secreted in breast milk, but there is little evidence of negative impacts on the baby.
Infants should be (1) on their back, (2) alone in the crib, (3) in their parents’ room, and (4) with nothing soft around.
The American Academy of Pediatrics recommends that infants be in their parents’ room through at least the first six months, and ideally the first year, of life as a guard against SIDS.
Even with the small risks of bed sharing, you’d be much better off sharing a bed than accidentally co-sleeping on a sofa.
months, a baby should sleep a total of about 13 hours: 9.25 hours at night, and two 1- to 2-hour naps. Weissbluth suggests this same six-month-old should sleep a total of about 14 hours, but with more of those hours falling at night: 12 hours at night, and two 1-hour naps.
newborns sleep an average of sixteen hours a day, which falls to thirteen or fourteen hours around one year.
insufficient. This includes things like the link between the MMR vaccine and multiple sclerosis onset, or between DTaP vaccines and SIDS. In these cases, the authors could find no good evidence to support the link, but also no evidence to firmly refute it.
So let’s start by just framing this not as “What kind of mom will you be?” but “What is the optimal configuration of adult work hours for your household?” Less catchy, yes, but also perhaps more helpful for decision-making.
What is best for your child? (Let’s take
“best” to mean likely to help promote their long-term life success, happiness, etc.) What do you want to do? What are the implications of your choice for the family budget?
Two parents working full time has a similar effect to one parent working and one not.
Parental leave appears to be beneficial. There is a growing body of evidence suggesting that babies do better when their mothers take some maternity leave.
paid maternity leave for moms led to higher education and even higher wages for their children when they grew up.
that attending higher-quality day care strongly correlated with better child language development: kids who went to better day cares seem to talk more.
day-care quality is associated with better vocabulary outcomes, but not with behavior.2
contexts. Day care is associated with better cognitive outcomes6 and slightly worse behavior.7
