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Tuesday, April 30, 2019

New book helps parents make good decisions

In ‘Cribsheet,’ a Brown economist debunks long-held parenting myths
Cribsheet by Emily Oster
Nearly a decade ago, Emily Oster was pregnant and frustrated.

Oster, a Brown University professor of economics, wasn’t satisfied with her doctors’ edicts. Limit your coffee intake, they said. But where is the evidence to show that coffee will harm my baby, she asked? Don’t gain more than 35 pounds, they declared. What’s the real cost of gaining 40 instead, she wondered?

Unsatisfied with the vague answers she received, Oster set out to track down her own. The result, published in 2013, was “Expecting Better,” a book that used data to take on some of the most commonly held beliefs about pregnancy.

"Cribsheet" uses data to address breastfeeding, sleep training and other crucial decisions new parents face.

Six years later, the mother of two has released a sequel of sorts: “Cribsheet,” a data-driven guide for new parents. In the book, Oster compiles years of scientific research to debunk age-old myths about some of the most divisive and controversial subjects in parenting, from breastfeeding to sleep training.

“So many people today want to approach parenting with the same work ethic that got them through school, that got them their first job and their first promotion,” Oster says. “They want to know how to do it right and do it well. I hope my evidence-based guide will help relieve some of the stress they’re feeling.”

“Cribsheet,” published by Penguin Random House, is out now. Ahead of its release, Oster answered a few questions about the book, her research and her own approach to parenting.


Q: What motivated you to write “Cribsheet”?

A lot of new parents want to make evidence-based decisions about how they’ll raise a child. But it’s very hard to figure out what information and advice is supported by evidence. When I was a new parent, I did a lot of research to inform my own decisions. I wanted to share what I learned to take some of the anxiety and stress out of some of those early parenting choices.

Q: Why do you think so many new parents feel anxiety and stress when making these choices?

Having a child is an experience people really want to get right. And for many people, once you have made a choice, it’s often very tempting to decide it was the right choice and to convey to other people that it was the right choice. That ends up creating an environment where people end up feeling judged or like they have to pick a side in a debate. That makes for a much more stressful parenting experience.

Q: Do you think you’ll lay any debates to rest with this book?

What I try to do in the book is to ask, “What does the best evidence say are the actual benefits?” For example, there are data to support that breastfeeding improves a baby’s digestion in the first year, lowers the risk of eczema and lowers the risk of breast cancer for moms. But I found that there is no evidence to support claims that breastfeeding increases a baby’s IQ or lowers the risk of obesity.

So the data really tell people, yes, there are some benefits to breastfeeding. But if you can’t breastfeed, or you choose not to, or you have to stop because it’s not working out, that’s okay. There is so much shame that’s heaped onto mothers who don’t or can’t breastfeed, when really, the claim that whether someone was breastfed will influence their whole life is not supported in the data.

Q: Are there any pieces of advice you’ve heard that are just plain false?

I saw some bizarre claims about the benefits of breastfeeding, aside from the claims about IQ and obesity I mentioned. One article claimed that breastfeeding helps mothers develop better friendships. What does that even mean?

Another topic where people got it wrong was food allergens, like peanuts. For a long time, people were told to introduce food allergens to their kids later — at around 2 years old — because otherwise kids could have an allergic reaction. It turns out that’s the opposite of the correct advice: Introducing allergens earlier makes kids less likely to have allergies, not more likely.

Other than that, I’m not sure there’s much that almost everyone is told that is definitely wrong. In many cases, half of people believe one thing and the other half believe another — and it’s hard for parents to figure out which is right.

Q: What made you feel most anxious when you were a new parent? Did it help to do a little research?

Issues of sleep — organizing your kid’s sleep, that is. The books all said that after about six weeks, my kid would start sleeping longer. That wasn’t happening. I thought, “What’s wrong with my baby?” I have a chapter in the book dedicated to sleep training, where I explain why the baby books tell us these things. I share actual data that demonstrates, yes, six weeks is the average age at which kids start sleeping longer, but the range is very wide. Babies are not predictable. For me, seeing that data was very helpful; it was a reminder not to expect predictability.

Q: What is the single most important takeaway in “Cribsheet”?

That other people’s choices are not necessarily right for you. And conversely, that the choices you make should be right for you, but they aren’t going to be right for everyone else. I think that’s really the message of the book: Even if everyone used data to inform their decisions, they would all make different choices. You need to look not only at data but also at your own preferences and circumstances to find what’s right.

A question I often get is, “What is the one most important thing parents can do for their kid?” And there isn’t anything like that. There is no one choice that is either going to ruin your kid or make them the most successful.

Q: What can we expect from you next?

Right now I’m researching the limits of causality in data, particularly in health settings. What happens a lot is, new research will come out that says, “This is a good thing to do,” and a bunch of people will start doing it. But those are often the same people who are doing all sorts of other healthy, good things. So how can we know whether something is good and healthy in and of itself? How can we know it doesn’t just seem that way because the people doing it are already healthy? I’m examining how that causal bias can potentially influence health recommendations.