Ep. 43: Should You Sleep Train? Breastfeed? Room Share? Science May Hold the Answer! Talking the Data of Parenthood in the Early Years with Emily Oster, Author of Cribsheet

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Laura Birek: Hi. Welcome to Big Fat Positive with Shanna and Laura. This week we have our weekly check-ins and we have an awesome interview with the amazing Emily Oster, author of Expecting Better, and her new book Cribsheet, which is about the first two years of your baby’s life, and we close with BFPs and BFNs. Let’s get right to it.

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Laura Birek: Hi. Welcome to the show.

Shanna Micko: Hey.

Laura Birek: Hi, Shanna. Let’s start with our weekly check-ins. What’s going on with you this week?

Shanna Micko: My baby is 15 weeks old now.

Laura Birek: 15.

Shanna Micko: So probably about three and a half months getting close to four months and something new this week is that she got a spot at daycare.

Laura Birek: The same one that your older daughter goes to?

Shanna Micko: Yeah, the center that my older daughter goes to goes from infancy up to pre-K. So it’s daycare and preschool, et cetera. Thank God we had kind of a leg up having a sibling in there, because Elle was on the wait list for that facility for two and a half years.

Laura Birek: Wow.

Shanna Micko: It’s really hard to get into. It’s a fantastic center. It’s where we work, so it’s really convenient. We can take them and drop them off and then go to work and CeCe’s been on the list for a few months now and so we got her in just in time for me to go back to work.

Laura Birek: Oh my God.

Shanna Micko: My maternity leave ends in four weeks and I’m already dreading it so much.

Laura Birek: Yeah.

Shanna Micko: If anyone I work with is listening to this, just kidding. I’m so excited to see you and come back. But it does help a lot to know that she’s going to be in a really great facility and really close. I can even pop over on my lunch breaks and hang out with her and nurse her and stuff like that.

Laura Birek: That’s so good.

Shanna Micko: It’s great peace of mind for me that I’ve got this lined up, because I was a little worried that it wasn’t going to work out and I would have to go find a separate home daycare somewhere at a different facility or something. But the downside of this Laura is that I’ve crunched the numbers.

Laura Birek: Uh-oh.

Shanna Micko: Sending both my girls to childcare is going to cost us $34,000 a year.

Laura Birek: That’s how much my private college education cost in 1999.

Shanna Micko: Right.

Laura Birek: Although, okay. That’s two kids and it’s full-time childcare. So yes, it’s for a good cause, but woo. That’s some sticker shock. Wow.

Shanna Micko: Yeah, it’s really tough. So if we were doing an OMG, I’m Freaking Out segment this week, which we’re not, I would talk about this, because I am freaking the fuck out. I’m just like, oh my God, how are we going to afford this? I’m doing all these scenarios in my head, like, maybe I should be a stay at home mom and blah, blah. Then I’m like, but then we can’t afford mortgage. I’m stuck and I’m feeling so much sympathy for mothers in this country, single mothers, especially that have to pay for childcare and work and it’s really hard and I want some sympathy too.

Laura Birek: You deserve some. That is a huge chunk of money and it totally doesn’t get into that cost benefit analysis of, is it even worth it for me to go to work? If I’m paying all this money for some other person to take care of my children, I would rather be with them.

Shanna Micko: I know.

Laura Birek: I will say that I practice what I preach and not what I do, because I am a person who has still not even reached out to a single nanny. I’ve gotten probably like 15 recommendations of nannies and have I called one of them? Not one. Text message, no.

Shanna Micko: Nanny’s usually don’t have two year waiting lists, so I think you’ll probably be okay.

Laura Birek: Ooh, I hope so. But I’m totally in denial about it myself, but I will say from my own feminist cool headed perspective while it may seem like the offset of your salary to how much it costs to put kids in childcare, it just doesn’t make any sense. People don’t often think about the sort of indirect costs. So there’s things like the 401k you might be getting or health insurance. I know you’re on your husband’s health insurance, but there’s also things like the work experience, keeping your resume up to date. Because the thing that happens to a lot of people is they’ll leave the workforce while their kids are young and then when they go back in their skills are out of date or at least they’re perceived as being out of date. They might not actually be out of date.

Shanna Micko: Or they might feel insecure about not being up to date and might not be as likely to apply for jobs or something. Like hold themselves back because of that insecurity.

Laura Birek: Well, women do that so much. I think I’ve read something. These numbers are off the top of my head, so it might not be quite right. But there’s something to the effect of the average man who looks at a job description, if he matches 80% of what they want he’ll apply and if a woman requires to match like 100% in order to apply.

Shanna Micko: Oh, yeah. That’s definitely me. I’m like, well, I don’t have that skill. So they wouldn’t want me.

Laura Birek: It’s a big problem. Anyway, so the point I’m trying to make is that while the sort of cash in cash out factor seems really clear, there’s all these intangibles that are worth a lot of money not to mention your independence and having something else to do outside of the family.

Shanna Micko: That’s true. I’m sad to be separated from my baby, but there is a part of me that’s looking forward to the social aspect of going to work and going somewhere every day and seeing my coworkers. I like that. That kind of interaction really lifts me up. It’s just a difficult situation all around.

Laura Birek: It’s like a real catch 22 I feel like. In our country, if we had a year of childcare provided to us by the government, don’t hold your breath, I think that would be a much different situation. But by the way, there are countries that do that.

Shanna Micko: Yes, there are.

Laura Birek: Or if you were at least paid through a year or even six months of maternity leave. Most developed countries have at least six months of maternity leave. It’s a problem.

Shanna Micko: I have to say it’s a little bit unfair that the first three months are so freaking hard. You’re trying to just keep this little blob alive and then at three, four months they come alive and they’re so playful and smiley and cute and then you have to be like, okay. Here you go daycare provider. Take my adorable child that I spent all my maternity leave… Newborns are great, yeah. But you know what I’m saying? They get just real good around three, four months and then that’s when you got to give them up and go back to work. Not cool.

Laura Birek: Oh God, I’m sure there are people listening who had to go back to work immediately or two weeks later or four weeks later and my heart goes out to you.

Shanna Micko: I couldn’t imagine.

Laura Birek: People do that all the time and I feel like that’s a health risk, honestly. I think even up to three months, the reason we need three months to take care of these babies is to take care of these babies and take care of ourselves. My baby to not to get ahead of ourselves is 11 weeks this week. I’m just barely getting to the point where I could even think about being part of the workforce, being a good employee. I’m self-employed so being a good boss up to myself. But you’re in the shit those first three months.

Shanna Micko: Yeah, the sleep deprivation and you’re just surviving.

Laura Birek: It’s not about like, I’m having a cute vacation with my kid. It’s like, no, no, no, no. We’re all doing everything we can to survive. Again, so much respect for parents who have to go back to work super early. Hopefully, someday this will be a conversation we don’t have to have in America.

Shanna Micko: That would be nice.

Laura Birek: But for now, we’ll stay tuned to hear how it goes for you in a couple weeks.

Shanna Micko: Yes, that will be part of my update. I’m sure. But what about you? Where are you this week?

Laura Birek: Like I said, my baby’s 11 weeks old. This is his last week of the fourth trimester.

Shanna Micko: Ooh.

Laura Birek: Last week I talked about how we chickened out from doing the weaning mode on the SNOO and we’ve still chickened out. We’re still not doing the weaning mode. So let me start the story from the beginning. We’ve been having sleep actually pretty good for an 11-week-old is what I’m told. Not as good as your first daughter who just from six weeks started sleeping through the night like some weird, perfect baby, but he sleeps four to five hours in a chunk at the beginning. Then that’s not including the time before the dream feed. So he’ll sleep from 7 to 10, stay asleep for the dream feed then 10 to 3 in the morning. That’s a typical night. Get up, he eats and then we put him back down and he sleeps till 6:30. I think that’s pretty good and that’s totally livable. I can live this way. It’s not fun waking up in the middle of the night, but it’s so much better than the 2, 3, 4 times a night I used to wake up. That’s fine. Good about that. So on Wednesday, he’s been a little extra fussy. He’s been a little extra clingy. Lately, he’s only wanted to nap if I’m holding him or have him in some kind of baby carrier, so I was thinking he’s probably entering his third leap a little bit early. It says in the app actually that it could be a week early, a week late. So we are right in the window where it could be and I think it’s happening, because he’s just a little bit extra fussy. But on Wednesday, we decided to have a big outing. So I live in Pasadena, which is just north of downtown Los Angeles. People don’t know this, but in Los Angeles we actually have a pretty great light rail system. It’s not like New York or London where there are stops everywhere and you can walk everywhere from it. But it is a very expansive system. You can go from way out in the Inland Empire, all the way down to Long Beach, all the way out to Santa Monica. It’s a big system. We have a Gold Line station 10 minutes from our house, so we decided to have an adventure and we got on the Gold Line and took it to downtown and walked around the Arts District downtown with our friend, Steve, who is on Daddy Daycare. His wife Keri was interviewed on the show. She was the pharmacist and so she’s actually back at work and he took a month off to bridge the gap between Keri going back to work and daycare. So he is doing daddy daycare. We’ve been doing some daddy daycare outings, so we went to the Arts District and this is very like hip district. When we first moved to LA, Shanna, you would not walk around in.

Shanna Micko: No, isn’t that near like Skid Row?

Laura Birek: It is. Skid Row is still there. The homelessness in LA is a huge issue and a big problem and the Arts District gentrification probably isn’t helping, but it was also very industrial, just a bunch of closed down factories. All this stuff. It wasn’t a cute area. There was nothing down there, but now super cute hip area with all this street art and fancy coffee shops and all that stuff. So we met downtown. I took the train. The train took about like 25 minutes and my baby loved it. He was sucking it all in. He was watching everyone on the train and then we were walking around the Arts District and had lunch and then we went and got coffee. Then we got ice cream and all this stuff. By the time I got back on the train and everything, it had been five hours we were out from beginning to end.

Shanna Micko: That’s a big day.

Laura Birek: It was a big day and of course, he napped in his stroller a little bit. So when I got home, it was about 3:30, 4 o’clock. He wasn’t sleepy, so we started playing on the mat on the ground and I was like, we need to do tummy time. We haven’t done any tummy time. So I go and he was in a great mood. 

He was smiling and laughing at me, so I turn him over to do tummy time and he’s a little fussy, like he is always is in tummy time, because he does not like tummy time and then he started getting grumpy. I was like, “Okay, tummy time’s over,” because I don’t want him to associate tummy time with trauma. I’m like, “Time to roll over,” and so I’m trying to sort of teach him how to roll over. They tell you that that’s good for the development. So I’m like, “You lift your leg up and you roll over like this,” and I rolled him over what I thought was gently, but he screamed bloody murder. His face turned bright red. He started screaming.

Shanna Micko: What did you do to that baby, Laura?

Laura Birek: That’s what I was worried about. He looked like he looked right after he got his two months shots, that level of screaming. So I freak out, because I thought, did I dislocate an elbow or bend one of his little fingers back or something? What did I do? He’s screaming. Of course, I take him and I put him on the boob and that calms him down a bit and he cloaks out on my boob and then he wakes up about 40 minutes later screaming again, so I just put him right back on the boob. He does this all evening from 5 o’clock to 7:30, because he ended up being a little bit later. Corey comes home and he’s like, “What did you do to our baby?” I’m like, “I don’t know,” and I was worried. We’re Googling, “How do you know if a baby’s really in pain?” I’m palpating his limbs while he’s nursing to see if he flinches or anything. So I’m freaking out about this thinking I’ve hurt him somehow and I feel so guilty, but we can’t figure. He doesn’t seem to be in pain. He doesn’t have a fever. He’s upset, but I can’t find anything specific. Nothing’s red. There’s no injury that I can find, so we are just like, we need to put him to sleep. So I put him in the snooze sack screaming, of course, put him in the SNOO. He passes out, which is great. I go to dream feed him at 10 o’clock right before I go to bed, he doesn’t wake up for the dream feed. I put him down. Next thing I know it’s 6:00 am and he also slept straight through the night.

Shanna Micko: Oh my gosh.

Laura Birek: Your daughter did what we talked about last week. I was like, holy shit. He must have been just exhausted I guess.

Shanna Micko: Yeah, has he done it since?

Laura Birek: No.

Shanna Micko: Why do they tease us?

Laura Birek: I don’t know. Actually, I remember at some point, because the bassinet’s on my side of the bed, Corey perched over me looking at him making sure he was breathing, because he hasn’t woken up yet. I’m like, no, go back to sleep. He’s fine, but this defeats the purpose. But we were both weirded out by it and he woke up super happy and he was fine.

Shanna Micko: He must have been so overtired.

Laura Birek: I think the Arts District wore him out or maybe he’s just really sad about gentrification. I don’t know.

Shanna Micko: I think that’s it.

Laura Birek: He’s like this used to be an artist community. No, it’s just expensive loft. But anyway, so that was really stressful and then really great. Then the follow up is that the next day when I did tummy time in the afternoon, he got similarly upset, so now we don’t do tummy time in the afternoon. Tummy time is a morning activity.

Shanna Micko: That’s good. Babies are usually in better moods in the morning it seems like.

Laura Birek: Mine totally. He’s all smiles. Even in the middle of the night if he wakes up, he’d be like, hey. I’m like, you are way too happy for 3:00 am. But anyway, that was my dramatic check-in.

Shanna Micko: I’m glad he’s okay and he didn’t pull a muscle or something.

Laura Birek: Me too. Oh God. What I’ve learned by the way is that if they’re completely inconsolable and that means even the boob doesn’t quiet them, they don’t want to eat, that is a serious sign that they’re actually in pain and then also to trust your gut, but my gut is usually a bit of an over reactor. So I think it’s fine. Did you also know that people didn’t think babies could feel pain until like the seventies? Did you know this?

Shanna Micko: What? Did they think they were fish or something?

Laura Birek: It’s so weird. So I asked my dad about this, because he’s an anesthesiologist. I was actually just kind of making small talk with my dad and not realizing that he’s an expert on pain management. I was telling him about the story I just told and he’s like, “Oh yeah, there was some doctor in the sixties who started realizing that when they were doing surgery on babies, they started monitoring their blood pressure and started realizing that babies who weren’t getting any pain meds, their blood pressure was going sky high and that babies who didn’t get pain meds also had more intracranial bleeds, because they had such high blood pressure from the pain.”

Shanna Micko: Couldn’t they tell from the extreme screaming?

Laura Birek: That’s something that I don’t understand. It’s like you poke a baby with a needle and they scream. What do you think is happening?

Shanna Micko: That is ignorance. I don’t get that.

Laura Birek: I know. But he said, when he got trained, he was trained in the seventies. By that point, everyone knew you had to give pain medication to babies during surgery, but they didn’t give pain medication to babies during surgery before that.

Shanna Micko: That breaks my heart for those little babies and probably they traumatize them for life on some certain level.

Laura Birek: Oh God, I feel like it has to. I worry that I traumatized him for life by rolling him over on the damn tummy time mat. Anyway, my dad has never performed surgery without any medication or anesthesia on a baby.

Shanna Micko: Good on him.

Laura Birek: Yes, he sleeps on it. We actually have a very exciting interview as our special segment coming up. So should we take a quick break and then get right back to it?

Shanna Micko: Let’s do it.

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Laura Birek: Hi, everyone. Welcome back. We have a really exciting segment today. We have an interview with Emily Oster who is one of my absolute favorite authors. She totally saved my life during my pregnancy. As I’ve mentioned on this podcast before, she is a professor of economics at Brown University and she wrote Expecting Better, which is a book I’ve mentioned a million times on this podcast and absolutely love and she has a new book coming out, should be out on the shelves now on the digital shelves as well on Amazon called Cribsheet, which is about the first two years of your baby’s life. What the science tells us about how to take care of your baby. So welcome to the show, Emily. Thank you so much.

Emily Oster: Thank you for having me.

Shanna Micko: First off, tell us why you decided to write Expecting Better and now Cribsheet. How does an economist go from doing statistics and stuff to writing books about pregnancy and childcare?

Emily Oster: Yeah, so I got pregnant is the sort of short answer to that and I had this experience I think a lot of women have where you’re sort of frustrated by the things that people tell you and they never tell you why and I started doing a lot of research, which sort of turned out I think surprising to some people to actually have a lot of overlap with the kind of tools and questions that economists think about. Then I sort of wrote it down and yada, yada, yada, then there was a book and I guess I almost say sometimes I came into the book accidentally. I got pregnant, I thought about these things and then I sort of started writing and it kind of all just came out and that’s the first book. Then the second book was something that was sort of a natural fall on, although the first book came out in 2013. So it took me a long time to come up with the second book, even though it was always kind of there in my mind I guess in terms of writing something about babies.

Laura Birek: Well, I felt like you had anything else to do. Do you have two children now is what I was going to ask?

Emily Oster: Yes, my daughter was born two weeks after I signed the contract to do the first book.

Laura Birek: Wow.

Emily Oster: Then I had to write the first book and then now she just turned eight and my son just turned four. So you see kind of both of them in the new book, but it would’ve been I think hard to write again with the two kids.

Shanna Micko: Definitely. Laura, do you have a question?

Laura Birek: I do. One of the things that I really appreciated about both Expecting Better and Cribsheet is that you really take maternal preference into account when you’re analyzing what the data says the best course of action is on say like, breastfeeding or sleep training and all that stuff. But you make a very clear point to say, you should not discount what works for you and what you want in your life as the mother. I feel like that’s really left out of a lot of the discussion. Can you talk about why you make such a big point to point that out for us?

Emily Oster: Yeah, I feel like when we talk about these issues about your baby, whether it’s pregnancy or with the infant, everything is about your baby and of course, you should be about your baby, because our babies are very important. But it ends up feeling like anything that is even a little, teeny bit good for the baby even if it is terrible for the parents or terrible for the mom, you should be doing, because that’s how we know that you’re a good mom. I think that’s misplaced. That’s not a good idea in part, because having happy, relaxed parents is also good for kids and so in the new book in particular, I spend a lot of time saying, hey, actually for many of these kind of decisions, like where should your baby sleep or should you work or not, it turns out there are a bunch of different good choices and a lot of what you should be thinking about is what is going to work for your family, because then everyone in the family will be happy and then you’ll be happy and maybe your baby will be happier and that’s a really important and I think overlooked part of parenting.

Shanna Micko: Absolutely. It makes me feel better. Reading your second book, I felt validated in a way, because I’m at the precipice of deciding to go back to work or stay with my kid and you’re like, “0.2, what do you want to do?” I was like, wait a minute. I haven’t even thought about that. Thank you for saying it.

Emily Oster: No, I feel particularly when it’s around work, it’s sort of like, we all come in with some assumption we have to do something. Of course, you’re going to go back to work or of course you’re not, and I have to do it like that and nobody ever says like, hey, what do you think would be like the most fun for you? Of course, that’s not the only thing, because work has money and money buys stuff and there’s other reasons to work or not. But I think that actually, whether you want to do that should be part of the conversation and sometimes it’s just like totally not.

Shanna Micko: 100% I agree. So thank you for giving us the avenue to even think about ourselves and consider ourselves. I appreciate that.

Emily Oster: Good.

Laura Birek: I know for me that was a really big deal with choosing what to eat during pregnancy. I found that Expecting Better was the only book I found that actually gave me sort of the tools to make an informed decision for myself. We talked about this a lot. I decided not to eat deli meat, but that was my decision that I came to inform and also I felt like it wasn’t a huge deal for me to not eat deli meat for nine months. But Shanna decided the opposite and that’s two very valid ways to come at it.

Shanna Micko: Very much so.

Emily Oster: I think that for so many of these things just acknowledging there’s a choice and that different people could make different choices and they could both be right is a big part of kind of dialing down some of the judgment. So it sounds like the interaction you guys had was like, one of you decided to have deli meats and one of you did not, and it isn’t that your view about Shanna is that she’s a terrible parent because of her deli meat consumption. Nor does it sound like Shanna’s view is that Laura is an overly cautious mini who should have been enjoying turkey. I think in some sense that’s great. We should all be able to acknowledge, yes, some people really like turkey and maybe they’re going to eat some of it and some people don’t like turkey and they’re not going to eat as much of it and those are both okay.

Shanna Micko: Absolutely. Question I just thought of, did you learn anything surprising in any of this research as you were writing these books? What was the most unusual or surprising thing that maybe caught you off guard?

Emily Oster: I think in the pregnancy book I often cite the evidence on bed rest as something that I just hadn’t sort of thought about, because it turns out there is basically no situation in which it’s a good idea to put someone on bed rest, but a lot of women are put on bed rest and the sort of disconnect between what are people told and what does the evidence say seemed so big there. So I think in the case of pregnancy that was something. In parenting, I think one place is that when you look at the evidence on breastfeeding, there’s so much emphasis on how this is the most important thing to do, and it’s the best start and it’s going to matter for all of these things. It’s true that there is some evidence of some positive impacts of breastfeeding in early life, but they’re small and they’re nothing like the things that people cite and again, they’re the sort of disconnect between what does the data really show and what are people saying is so large.

Shanna Micko: Yes, that leads me to one of our next questions is let’s talk about what the science says about some of these huge controversial topics. Like the benefits of breastfeeding and sleep training in particular, are there any specific little tidbits you can give our listeners about what the science says on those things?

Emily Oster: So I think if we take something like breastfeeding, you’ll see cited benefits, like your kid will be thinner and they’ll be smarter and they won’t have any allergies and they’ll have shiny hair. You can find almost anything, right?

Laura Birek: Yeah.

Emily Oster: You’ll have shiny hair, so many things. One of the things I talk about in the book is claim that breastfeeding will give you better friendships.

Shanna Micko: Yes, that cracked me up. I was like, what?

Emily Oster: That is crazy, right?

Laura Birek: I don’t understand, like why? How?

Emily Oster: I don’t know if it’s like maybe your friends aren’t going to judge you and they won’t want to be your friend if you don’t breastfeed. It was hard to parse really what was going on with the better friendships. When you really dig in the data, there are some benefits. They’re much smaller than that. So they are, for example, breastfeeding does seem to lower diarrhea infections in the first year of life. Maybe it has slightly reduced the risk of ear infections in the first year of life and actually maybe more surprising for a mom, it does seem to lower the risk of breast cancer later. So those are kind of three real benefits, but that’s kind of it in terms of what has robust support in the data. If you look at things like IQ or obesity or these claims about later life health for your kids, those are just not supported in the best data that we have and so I think where it comes down is guess there are some good things about this and if you want to do it, that’s great and we should be supportive. If women want to do it, we should make it easy and we should help people. But this idea that this is the one thing you can do to give your kid the best start, I think that’s an overstatement given what’s in the data.

Shanna Micko: Good. That is a relief, because there is so much pressure. I feel it less this time around, but with my first child, I just remember agonizing over the breastfeeding. 

It wasn’t easy and I at times wanted to give up, but it had been so drilled in my head that I had to do it to give her the best future. I’m so relieved to hear you say that and that you have found a way to put that out there so that people can understand that.

Emily Oster: No, I think it really for many women is so almost like shameful if it doesn’t work and sometimes I get a lot of emails from women and also in this case, I often get a lot of emails from dads that are like, “Can you please help me? My wife is so upset that this isn’t working and I keep telling her I don’t think it’s that big a deal, but everyone tells her it’s the most important thing and I think she’s really depressed. Can you please help?” I think that’s so sad that basically people are struggling with this. Of course, you’re struggling internally, but to also put this out of external pressure and say, this is the one thing when it’s not true, I think that’s not fair.

Shanna Micko: Yeah, the voice of the breastfeeding contingency is strong. That is for sure and it does get in our heads. What about sleep training? I know that’s another controversial one and I’m about to embark on that myself soon with my baby and what have you learned about like cry it out? Is it safe? Does it work? Any tidbits you want to share without maybe giving away your entire book?

Emily Oster: Sure. Of course, I think with cry it out, people really worry that there’s long-term damage and your child will not form attachments to you and I talk a little in the book about where that idea comes from. But when you look at the data, there isn’t any support for that. So when studies compare kids who were sleep trained to kids who were not, they don’t look any different in terms of their attachment to their parents or their behavior or anything like that. 

But one thing I will say is that you do see some benefits actually to the parents, because if you sleep train your kid, they will sleep better on average and it is pretty good at lowering maternal depression and improving mood. So I think this is another example of a time when we spend so much time talking about the baby and what’s good for the baby and is this hard on the baby and so on without recognizing that this is actually a potentially pretty important thing for parents and for marriages and for happiness and that’s just not something we should ignore.

Shanna Micko: Absolutely. The parents are a big part of the equation in parenting, for sure.

Emily Oster: Yes, they are the parents.

Shanna Micko: They are. One thing that I found interesting in that section was how a lot of the negativity about the cry it out came from researching babies at a Romanian orphanage and how that hurt those children, but it’s kind of way off. It’s not relevant to the way we live today. Can you speak to that?

Emily Oster: Yeah, sure. There was this experience in Romania in the eighties where there were a lot of babies born who were not wanted and many of them ended up in orphanages and these were really horrible places with a lot of kinds of abuse and children were not held and were not taken care of and so there were all kinds of terrible things and in some sense those kids have struggled for their whole lives. The idea of sort of attachment parenting, the importance of being responsive to your kid all the time comes in part from observations there and noticing how important having a close attachment to an adult is and then people have said, when you came to these orphanages, the kids were not crying, because they knew no one would come and doing sleep training with your kids is comparable to that. That does not seem correct if you sort of think about it on its face and of course, nobody really thinks that having your kid cry for 20 minutes for three nights in a row is the same as having them in a Romanian orphanage. There’s this idea that there’s a continuum, but even if it were on a continuum that is a very long continuum and as I said, there are some of these sort of positive benefits, like better sleep for the kids, better sleep for the parents, which given the way this is actually practiced could mean that this was good for people and so I think that just to sort of take this experience and extrapolate so far is just not responsible.

Laura Birek: I actually had a question about that, which was one thing that really surprised me was how the American Academy of Pediatrics recommendations are not necessarily in line with what the data actually shows us. One example was the room sharing issue. I was shocked I actually learned this in your book that the AAP recommends a full year of room sharing with babies and then I think in England they recommend six months. Can you talk about what the studies actually show about where the benefit is and where it’s limited?

Emily Oster: So when studies look at room sharings, the idea of having your kid in your room as a way to lower the risk of SIDS, to the extent that there are benefits in those studies, they really are only there for the first few months and I talk a little bit in the book about how in my opinion those studies aren’t that great and so I’m not even sure that you can convincingly argue that they show benefits in the first few months. But they definitely do not show any evidence of benefits later and in addition, sort of on the other side of this, the kids who are sleeping on their own by four months tend to sleep better at four months and better at nine months and better at two and a half. So there actually are some reasons that you might want to move your kid to their own room at least after the first few months. I think that the AAP there goes a little far and they’ve actually oscillated back and forth also between six months and a year and I think a lot of pediatricians push back against that recommendation just, because it really doesn’t work for a lot of families and it isn’t well supported by the evidence.

Shanna Micko: Thinking of parenting beyond your book, our audience will read your book, get lots of great information. How can we move forward analyzing evidence on our own as our parenting journey continues? Can you speak to what makes a good study and what we can look for good evidence?

Emily Oster: I find this so hard, because I really always say my least favorite phrase is studies show, because of course studies show anything. There’s always a study that can show the thing that you want and many studies are not good. Even studies that are published in reputable journals often have a lot of problems. I think there are a few things that people can look for if you’re sort of looking to see if it’s covered in the media, is that a good piece of evidence? So one is that studies that are randomized where they actually tell half the people to do one thing and half the people to do another, those tend to be better than studies that just compare people who do one thing to people who do another and then you can look for things like, is this sample size big? Is this a study of 35 people? Or is this a study 35,000 people? You’re going to be able to draw better conclusions if you have 35,000 people than if you have 30 people. So I think those are a couple of sort of things to look for, but evaluating studies is hard. Part of what I try to do in this book is sort of say, okay, my job is to evaluate studies so let me try to give you a little bit of sense at least in these topics of what the studies show.

Shanna Micko: Laura, do you have another question?

Laura Birek: Well, I have about a million questions, but I don’t want to keep our guest too long. I basically just want to have you on speed dial at all times, but actually I think what we should do is our show is called Big Fat Positive and we like to ask our guests if they have a BFP they could share with our listeners, something that helped them during pregnancy or anything you might want to share. Do you happen to have one for us?

Emily Oster: I do. This is a sort of weird one, but I think its somehow sort of release this on this stuff. For me, if you ask what do you do for yourself that relaxes you? I really like to run. For me that’s like a thing and when I was pregnant with my daughter, I sort of didn’t run at all and it made me kind of sad. So with my son, I was like, okay, I’m going to keep running. I’m going to try to keep doing this, but of course, eventually your belly kind of goes up jostling and at some point I was like, “I guess I’m going to have to stop running,” and my midwife was like, “Why don’t you buy this belly support thing?” So I bought this belly support thing that sort of you could use for weight lifting almost, but it’s for pregnancy and you just put it on under your belly and I ran until I was 37 weeks pregnant.

Laura Birek: Wow.

Emily Oster: It was totally great, so I highly recommend that.

Shanna Micko: That’s awesome. Does it just strap around your belly or is it one of those that has also shoulder-like straps?

Emily Oster: No, it doesn’t. It just straps around your belly and sort of supports the thing. The only problem is once you get really pregnant, then you have to pee all the time when you’re running and so you’re running along and every two minutes you’re like, I have to pee and then there’s really no pee.

Laura Birek: That’s a problem.

Shanna Micko: I’m impressed that you ran till 37 weeks. That’s cool.

Laura Birek: Me too.

Emily Oster: But then I pulled a hamstring.

Shanna Micko: Oh, no.

Emily Oster: My husband was like, you’re so ridiculous.

Shanna Micko: I think that’s to be commended. Do you have any other books or anything in the works are you thinking about? Now your children are older, are there other areas of adolescence or anything you’re thinking about?

Emily Oster: I’m not sure that there’s another book about kids. I think as your kids get older, parenting is about what each kid is like. So in these early years, things like sleep training, most kids respond to sleep training and the question about breastfeeding is not really about your kid’s personality. When you start asking like, what kind of school should my kid go to? What kind of after school activities they could do? Or whatever are the questions that come up with an eight-year-old, really the question is what kind of eight-year-old do you have? So I think this approach of using data is more challenging when kids are so different. I haven’t made much progress on book three.

Shanna Micko: That completely makes sense.

Laura Birek: I feel like Shanna, especially now that you have two kids, it’s so clear how their personalities are so different and what works with one kid just does not work with another kid. For example, Shanna’s first daughter, she was sleeping on her own through the night in her own room at eight weeks. Is that what you said?

Shanna Micko: Yeah, I didn’t have to do anything. She was so easy and this one’s a little bit harder, so now I’ve got to take all that into consideration.

Emily Oster: My daughter is very into rule following. So when the first time she tried to touch the stove, we were like, “Never do that,” and she was like, “Okay, I’m never going to do it,” and she never did it again. My son, the first time he touched the stove, we were like, “Never do that,” and he was like, “Uh-huh,” and did it again immediately. We were like, no, this is a different kind. Okay.

Laura Birek: Wow.

Shanna Micko: That’s good. They keep us on our toes.

Emily Oster: No, exactly. You can’t get too comfortable.

Shanna Micko: Definitely.

Laura Birek: Well, we’re just so, so grateful you would come and talk to us and talk to us about Cribsheet, which everyone, a reminder is available now. Please go buy it.

Emily Oster: Please.

Laura Birek: I can attest to how great it is and I found out that the release date was in April, but my baby was due in January and I was distraught until I found out that I could get an advanced copy through some connections I had at Penguin and I was so happy and I read it cover to cover and I’m just so glad to have this resource in my life. So thank you so much.

Emily Oster: Thank you.

Laura Birek: Anytime you want to come back, we’d love to chat with you.

Emily Oster: That would be great. Thank you guys so much. It’s been very fun.

Laura Birek: Great.

Shanna Micko: Thank you, Emily.

[Music]

Laura Birek: We’re back and like we always do, we will be ending our episodes with our BFPs or BFNs of the week, big fat positives or big fat negatives. Shanna, what do you have for us?

Shanna Micko: I have a BFP.

Laura Birek: Ooh.

Shanna Micko: I said that like, da, da, da, da.

Laura Birek: What’s your BFP?

Shanna Micko: Some fanfare, please. I think it’s because of what I’m about to say: my baby rolled over for the first time from her back to her tummy.

Laura Birek: That’s an exciting development.

Shanna Micko: She did the tummy to back a few weeks ago, but she has been working her ass off on this one for like two weeks. It’s so cute. She brings her legs up in the air and rolls on her side and she’s been going back and forth and back and forth on her side, so I’ve been waiting for it. I know you’re not supposed to get attached to milestones and all that stuff, but it is just so cute to see them do something different and hard that they haven’t done before and you know they’ve been working on it and then they achieve it and you’re like, oh my gosh. Yay, baby!

Laura Birek: They work so hard. My baby he’s been working so hard on grabbing things and bringing them to his mouth and it’s just so interesting to watch them just do it over and over and over until they get it. It’s fascinating.

Shanna Micko: Yes, they really have a lot of persistence. I should take note. I should take their lead on that.

Laura Birek: The persistence of children.

Shanna Micko: She screams while she does it, oh my God. Then she gets on her tummy and she’s like, fuck, this is what they got me, because she doesn’t really like tummy time. She screams trying to roll back over, because she hasn’t mastered yet the tummy to back. Even though she has done it, it’s still really, really hard for her. She just screams in determination. It’s so funny, but I’m proud of her. So that’s my BFP for the week.

Laura Birek: We watch a lot of tennis in this house and you know how female tennis players, especially, but also male tennis players really grunt and scream every time they hit the tennis ball, that’s what makes me think of like. She’s just like, ooh, I have to get on to my back again.

Shanna Micko: That is so true and I have to keep that in mind while I’m watching her, because there’s an instinct in me to save her like, she’s uncomfortable. She is upset and I have to find that fine line between she’s grunting out of determination versus crying, because she’s just gone way too far. So I let her grunt it out.

Laura Birek: Grunt it out, girl.

Shanna Micko: All right. What about you? What do you have this week?

Laura Birek: I have a BFN.

Shanna Micko: Oh, what you got?

Laura Birek: So as you probably know, we’re supposed to be giving our babies vitamin D supplements, at least according to my pediatrician.

Shanna Micko: Same.

Laura Birek: I don’t know when they started doing this. As far as I know, when we were babies did not give vitamin D supplements, but at some point it became a thing. There’s various forms. It’s obviously always liquid, but some of them you just do one drop. Some of them you have to do a whole syringe. Anyway, I got the stuff that was recommended by my doctor, which is a very small bottle that’s just one drop and in the instructions it says, you just drop it on your nipple before the baby eats and that gets his daily vitamin D allotment. I was like, great. Okay. Cool. No problem. I was using it and not thinking much of it for a while, but then much my ability to remember to take vitamins, I kept forgetting to give him his vitamins and so I went like three or four days and I had completely forgotten and felt a terrible person. Then I remembered one afternoon, chopped on my nipple, he ate and then he vomited so bad, like terrible spit up, because there’s a difference between spit up and vomit a lot of times and there’s also a difference in how he feels about it. He’s what they call a happy spitter, so he’ll spit up a lot, but he’s totally chill most of the time with it. It just comes up and he is literally smiling while it’s happening. But this was screaming like it clearly hurt. It was that gross curled stuff like real vomit and I was like, man, it didn’t occur to me that he had been better the last few days when I had forgotten to give him his vitamin D drops and I was like, is this correlated? So I’m like Googling and of course, nowhere online does it say it might be a side effect, but of course on babycenter.com, there’s tons of threads of moms who had the same experience who were like, “Vitamin D drops made my baby throw up. What do I do?”

Shanna Micko: Wow. What’s in it that causes such a problem? Is that the D itself?

Laura Birek: It might be. I’m not 100% convinced, but I did the same thing where I waited a couple days and then I gave it to him again and same thing happened. So I ordered a different brand and I’m hoping that might fix it. It has like a different base, because the one I have is coconut oil and vitamin D and that’s it and I tasted it. It doesn’t taste like anything, but maybe it’s the coconut oil. So I ordered a different brand. I’m going to see. But it kind of sucks, because it makes me not want to give it to him and then I feel like a bad mom, because I’m probably going to give him rickets.

Shanna Micko: Is that what happens when you don’t get enough Vitamin D?

Laura Birek: Apparently, then I’m like, wait, we live in Southern California and he’s very fair skinned. Does he get enough vitamin D anyway? I don’t stick him out in the sun directly, but he still gets sun, because we go out on long walks and there’s just no avoiding him getting small exposure to direct sunlight here and there. So I’m like, maybe he’s getting enough that way. My BFN is basically I don’t know if it’s causing problems, but it seems like it is and also, it just opens that Pandora’s box of mom guilt in all the directions, like if I give it to him, it makes them sick and sad. But if I don’t give it to him, I’m ruining him forever.

Shanna Micko: Yes, it opens the Pandora’s box of going down every single vitamin D product out there trying to find one that does work or doesn’t. I’ve bought so many swaddle sacks trying to find this perfect magic one and spent a fortune. You could do that with vitamin D, too.

Laura Birek: Right. Then I guess one option is I could take a bunch of vitamin D myself, but you have to take a really high dose for it to pass through your breast milk. I told that to my mom. I’m like, “Maybe I’ll just take a ton of vitamin D,” and she’s like, “Ooh, I don’t know if you want to do that, because that might give you kidney stones.” I was like, “Great. Okay.”

Shanna Micko: You can’t win, Laura.

Laura Birek: Oh my God.

Shanna Micko: But rest assured your baby’s not going to get rickets.

Laura Birek: Sure. I don’t think he will.

Shanna Micko: I don’t think really don’t think that’s going to happen.

Laura Birek: So you don’t think I’m ruining my baby forever?

Shanna Micko: No, absolutely not. He’s going to be fine.

Laura Birek: Thank you.

Shanna Micko: Is that it? Are we going to wrap?

Laura Birek: On that note, I think we should wrap it up.

Shanna Micko: This has been such a great episode. You guys, if you have any questions or comments for us, we would love to hear from you. Please feel free to drop us line. Laura, how can they reach us?

Laura Birek: We have a website, bigfatpositivepodcast.com. We also are on all the social medias. We got Instagram, we got Twitter. We got Facebook at BFP Podcast. On Facebook we also have a community group that’s really fun that you could join and talk about all things, mom, baby, and BFP.

Shanna Micko: Big Fat Positive is produced by Laura Birek, Shanna Micko and Steve Yager. See you guys next time.

Laura Birek: Bye.

Shanna Micko: Bye.

[Music]