More on this book
Community
Kindle Notes & Highlights
by
Emily Oster
common and, while not serious, can be scary. Specifically, the MMR vaccine is linked with febrile seizures—seizures that occur in infants or young children in association with
report, others post-date it. One study focuses on children who have an older sibling with autism and who are therefore more likely to
us, and in the absence of vaccination, infection would be common. Vaccination does a very good job of protecting against disease, but it is not perfect. For pertussis, for example, immunity wears
kid for no reason. But the fact of the matter is, they are not. Vaccines prevent disease, suffering, and death. DELAYED VACCINATION SCHEDULES Some vaccine-anxious parents favor a delayed vaccine schedule, in which children receive vaccines spaced out over a longer period of time rather than being given several at once. There is no reason to do this, given the evidence on vaccine safety that I outlined earlier, and in fact, the
are safe. ○ A very small share of people have allergic reactions, which are treatable. ○ There are some extremely rare adverse events, most of which occur in immune-compromised
The title of this chapter comes from a friend whose son was once asked at school, “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.”
Women who work (some of them, anyway) tell me they feel guilty about not being with their child every minute. Those who do not work (some of them, anyway) tell me they feel isolated and resentful at times. And even when we are happy with
Framing this through the stay—at-home-mom lens makes it harder for people to think “stay‑at‑home dad” is a valid choice. But it should be. Never mind that sometimes a family has two moms. Or two dads. Or only one parent. So let’s start by
in the US who cannot get by—and by “get by” I mean have a place to live and put food on the table—without all the adults in the household working. If your family is lucky enough to have a choice, the
I’ve figured out that my happiness-maximizing allocation is something like eight hours of work and three hours of kids a day.
households. Second, what your child does while you are at work is likely to matter tremendously. Once they are older, they’ll all go
One thing that is commonly seen is that children in families where one parent works part time and the other works full-time tend to perform best in school—better than children whose parents both work full-time or who have one parent who doesn’t work at all.3 This could be due to the working configuration, but I think it’s more likely due to differences between these families.
Many people in the US have no paid leave at all, and even unpaid leave (say, through the Family Medical Leave Act, or FMLA) is typically capped at twelve weeks and is available to only about 60 percent of working people.
coverage and hold your job (or a comparable one) for you until you return. Although unpaid leave can be challenging for many families, and there are no federal maternity leave benefits in the US, it is worth exploring whether your state offers benefits. As noted above, a bunch of states do have
purposes of this chapter, we’ll focus on outside childcare options. If you have an extended family member who can help, you can add another limb to your tree. In economics, we teach people to “solve the tree.” To do this, you work backward from the bottom. First, decide
two. Now, rather than comparing the wide range of options in each category, you are facing a very specific choice: Do I prefer my “optimal” day-care setup or my “optimal” nanny setup?
The authors found that attending higher-quality day care strongly correlated with better child language development: kids who went to better day cares seem to talk more. When they looked at behavior problems, though, there did not seem to be a relationship to day-care quality in either direction—the effect was about zero. The researchers doing this study followed the children
More months in day care before eighteen months are associated with slightly lower cognitive scores by four and a half years old, but more time in care after that is associated with higher cognitive outcomes.
On the plus side, these early exposures seem to confer some immunity, with children who were in day care for more years as toddlers having fewer colds in early elementary school.10 In
One of the best pieces of parenting advice I got from my friend Nancy was this: Regardless of what childcare you choose, have a plan for who is in charge when the nanny or the kid is sick. Fighting about who will miss work in the moment is a bad idea.
At some point, the pediatrician tells you, “A baby of this size can sleep for up to six hours at a time.” You want to poke them in the eye with a pen.
Broadly, “cry it out” refers to any system where you leave the baby in his crib on his own at the start of the night, and sometimes let him fall back to sleep on his own if he wakes at some point during the night. The name refers to the fact that if you do this, your baby will cry some at the start.
attachment parenting advocates co‑sleeping as well, meaning there is no need for sleep training of any type since there is no goal of getting the child to sleep alone. Proponents of this point out that if your child is in the bed, you don’t really have to get up to deal with them—you just roll over and stick a boob in their mouth and go back to sleep.
be forever changed. This was a terrible and shameful episode that should never have happened. But it is also not comparable to the experience of most infants whose parents use “cry it out” methods. None of these suggest leaving
types of chronic life stress—physical abuse, serious neglect—often have long-term problems. A few nights of sleep training probably will not do that, but who knows whether they endure smaller damages? Fortunately,
These effects persist through six months or a year in studies that can look this far out. This means that children who are sleep trained are sleeping better (on average) even a year after the training.
The bottom line is that there is simply a tremendous amount of evidence suggesting that “cry it out” is an effective method of improving sleep.
worth noting that most of these studies—and, indeed, virtually all sleep books—recommend a “bedtime routine” as part of any sleep intervention. There isn’t much direct evidence on this—the review refers to it as a “common sense recommendation”—but it is generally included with all intervention approaches.
depression. To take one example, an Australian study of 328 children randomized half into a sleep-training regime and the
mothers in New Zealand over a five-day inpatient treatment in a sleep lab.15 The goal of the stay in the lab was to sleep train the infants. Nurses in the study collected data on the stress hormone cortisol in both the babies and their mothers, and were also responsible for putting the infants to sleep, and monitoring the sleep training. Before the sleep training each day, the babies’ and moms’ cortisol levels were tested and recorded.
this kind of heterogeneity. A related argument is that although children may look fine at five or six years old, the damage from sleep training may not manifest until they are adults. Again, very hard to study. I think it
But if you do want sleep train, you should not feel shame or discomfort about that decision. The data, imperfect as it is, is on your side.
There is relatively little guidance on the appropriate age to start sleep training. Most studies focus on children in the four‑ to fifteen-month-old period,
Penelope looked at me—very seriously—and told me, “Mom, whatever you do, you can’t go in. He needs to learn to sleep on his own. We have to help him do that.” In the presence of a child who was sleep trained and obviously does not hate you, it is hard to hold on to your fear.
Using a questionnaire, covering about five thousand children in each location and focusing on Jewish children in both Israel and the UK, he found that school-age children in the UK were about ten times more likely to be allergic to peanuts than children in Israel.
The researchers selected a group of children who were more likely to have peanut allergies than the general population—this was important to make sure they could draw strong conclusions even with a relatively small sample size—and they also divided the sample into children who had no sensitivity to peanuts at baseline and those who showed some sensitivity.
The results—I put them in a graph below—are striking. 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.
The finding is especially notable as it suggests that the standard advice parents were given about peanuts up to this point was entirely wrong.
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.
Western way to introduce your children to food. This begins, between four and six months, with either rice cereal or oatmeal. You feed your child with a spoon. Make sure to take some adorable pictures to send to the grandparents! These will also be helpful at your child’s wedding.
Finn thought those cereals were a joke. The only rice cereal he ever ate was congee at our favorite Chinese restaurant.
“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.
Perhaps it isn’t difficult to produce a child who will eat chicken nuggets and hot dogs, but how do you end up with one who loves sautéed kale and kimchi with squid? Or at least one who will try them?
Related to this, once children are starting to eat solid foods, there is randomized evidence that repeated exposure to a food—say, giving kids pears every day for a week—increases their liking of it. This works for fruits, but also for vegetables, even bitter ones.9 It reinforces the idea that children can get used
you should know that most kids become more picky around two and then slowly grow out of it in their elementary school years. This is sometimes a surprise to parents—your eighteen-month-old eats like a horse, then all of a sudden around two, they start being very selective and just generally not eating much.
followed sixty families of kids aged twelve to thirty-six months as they tried introducing a new food. The families videotaped their dinner interactions for a night so researchers could study what seemed to influence the new food adoption.12 This study
It is frustrating to sit at a meal that you know to be delicious with a four-year-old who screams that they hate it and will not eat anything. I don’t have a great solution for this, other than earplugs.
on), and clearly due in part to a lack of early introduction. Milk, eggs, and peanuts make up a large share even of these. We covered the peanut evidence earlier. Other research suggests a similar mechanism is at work for eggs and milk.14 The evidence
a toxin interferes with neurological functions, including affecting the infant’s ability to breathe. It is most common under the age of six months and
vitamin D, like bone growth. In two that did—very small randomized trials of supplementation—there were no impacts on bone growth or bone health, even though supplementation did increase the concentrations of vitamin D in babies.18 This isn’t to say you shouldn’t use vitamin D supplements. And certainly
