Parenting book negates commonly held beliefs

By Dr. Ananya Mandal, MDApr 24 2019

Economist Emily Oster has come up with her new book called Cribsheet that has debunked several myths surrounding parenting and its challenges.

Parenting books come in all shapes and sizes and they are loaded with different tips and plans to be a good parent. The debates start way before delivery – home birth or water birth or hospital delivery or assisted normal delivery or C-section? Which one is best for the baby? How long and how to breast feed? How to potty train or sleep train? Whether to leave the child at the day-care or with a nanny or become a stay-at-home parent? How will the baby’s arrival change or alter the marriage? Which cereal to choose from? Organic food or no? How much sugar/salt/trans fats? The list is longer than the scope of any article or book!

A professor of Economics, Emily Oster from Brown University has faced all sorts of advice, wanted or unwanted and hurdles with her firstborn. She said, “It’s hard to be thoughtful about any one of [the choices],” adding that there are a host of other choices to be explored. So she decided to research a bit and wrote this handbook of sorts for parents called the Cribsheet: A Data-Driven Guide to Better, More Relaxed Parenting, From Birth to Preschool. This came after her blockbuster pregnancy book called Expecting Better in 2014.

Oster is at heart an economist first so what she did for her book was gather data and collate them to create decision trees to help new parents decide on which options to choose for their precious bundles of joy. The book deals with babes at birth till they are preschoolers. So now readers get a taste of advice that is backed by evidence and actual hard facts and numbers rather than conventional wisdom.

For example the book has a section on breastfeeding, nipple confusion, on co-sleeping, on sleep training and on effects a baby has on marriages. She explains that there are no randomized controlled trials on parenting issues. These trials are the gold standards when deciding on which option is the best. She said, “Randomized controlled trials are difficult to implement, and comparing families who make different choices is fraught with problems. Having said this, there are some cases where I think the data is better.” On breastfeeding she says, “Most of the studies on this are done by comparing the kids whose moms breastfeed to the kids whose moms don't. The issue with that is that the kind of moms who breastfeed are different than the moms who don't, on average. So, in the U.S. in particular, moms who breastfeed tend to be better educated, higher income, more likely to be married.” This means that the long term effects of breastfeeding on either IQ or obesity in the baby cannot be determined from the existing studies she says.

On co-sleeping for example, Oster says that it may not necessarily be a risk for the baby but may allow parents to sleep more. “More sleep” are two words that are like music to any new parents’ ears. There are two sides of the debate she says. Co-sleeping helps bond better with the baby and there are experts who advise against co-sleeping because it may smother babies. Oster says, when done correctly, co-sleeping can be safe and effective. Oster warns that if the parents are smoking and drinking the risk of babies being smothered while co-sleeping may be higher. She writes, “To be more specific, the breastfed babies of nonsmoking, non-drinking moms who co-sleep experienced 0.22 deaths per 1,000 live births, compared to 0.08 deaths among moms with the same behaviors who just shared a room (not a bed) with their child. “In the US, the overall infant mortality rate is around 5 deaths per 1,000 births. This therefore represents a very small increase relative to the overall mortality rate.”

Another issue addressed is whether being a stay-at-home mom is a better option than being a working mom. Oster says that there is no clear evidence that being a working mom can harm a baby any more than being a part-time working mom or a stay-at-home mom. Oster says that moms who take some time off after delivery in forms of maternity leave may be doing their babies good. Maternity leaves reduce preterm birth and also infant mortality she says. But there is no evidence of maternal leave or work on a long term basis. She said that parents need to plan their family budget before thinking about making decisions on maternal work schedules.

Couples face a few rocky years after their babies are born – or so say parenting advice sites and books. Oster says, “That’s on average true — marital satisfaction declines — but those declines are larger in some groups and in some families than others.” She said that for babies that are planned and if the couples have financial stability and social support may not be unhappy after arrival of their babies. “It correlates in the way you might expect with differences in socioeconomic status,” Oster said. “Part of it is that there are a lot of stresses — financial and time — that come with having a kid, and those are more acute if you don’t have other resources.”

According to Oster, internet is one of the most used resources for parenting tips and what works for others may not work for some. She said, “I think the problem in the case of parenting is that, particularly when people are looking to make choices based on evidence or data, it can be very difficult to get a complete picture of the facts based on what people are writing on the internet.” She said that when they say on the internet that so-and-so could improve your child’s IQ, it could be by a miniscule number which could be quite insignificant. Oster says, “What I do in the book is actually try to comb through these studies and figure out which of them are giving us the best information. So then you can make these choices having the best information, not just the first thing that comes up when you Google it at 3 o'clock in the morning.”

She explains that when making a decision regarding parenting a baby, “Step one is to kind of really figure out what the best evidence says about the choice. But then there's a really important second step, which is to combine that with what is going to work for your family.”