Emily Oster tells it like it is. The Professor of Economics at Brown University is known for her books that take a data-driven approach to pregnancy and parenting. Wondering what’s behind the sushi rule during pregnancy or how much coffee you’re allowed to drink? Curious about co-sleeping? Potty Training? Emily provides the data and analysis that drive these well-known rules.
Emily’s first book, Expecting Better, provides information to help women make their own well-informed decisions throughout pregnancy. She then wrote Cribsheet, a similarly data-driven book to help new parents navigate all of the conflicting information about how to breastfeed, sleep-train, and potty training.
Her most recent book, The Family Firm, provides a framework for data-driven parents to think about the key issues of the elementary years: school, health, extracurricular activities, and more.
In this week’s episode, Sonya and Emily talked about many topics of interest in early childhood development.
“The main sources of our guilt are feeling that we’re doing the wrong thing – that there is a right choice and maybe we’re not making it. Maybe there’s a best thing to do with my kid and I’m not doing that thing and then I think that is sort of a source of guilt. So some of the discussion in the book I think is really about trying to make the choice that is right for you, sort of recognizing that in this space, and in any of these spaces, there’s no right choice. There may be a right choice for you and the way you can get to that choice is by thinking carefully about what’s going to work for you and thinking about your kid and thinking about the constraints and coming to a place where you’re confident that the choice is right, that you didn’t make it haphazardly. And once you’re there, I think that there should be a little, hopefully, freedom to be like, okay, this was the right choice and I’m confident in the way that I made the choice and I’m going to try to move forward and not sort of second guess.”
-Emily Oster
Listen Now
Key Takeaways
- Hierarchy of types of research studies
- Confusion around data reporting
- Do childhood vaccines cause Autism
- Does sleep training work and is it beneficial
- How having children impacts marital satisfaction
- What’s best: nanny vs. daycare vs. stay at home parent
- Data around TV watching and learning for kids under 5
- Potty training
- Alcohol and breastfeeding and pregnancy
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Links
- Learn more about Emily Oster
- Check out Emily’s ParentData series
- Check out Emily Oster’s Newsletter on Substack
- Listen to guidelines on Exercising Through Your Pregnancy with Catherine Cram
- Read my article on Breastfeeding and the Athlete and check out my podcast on the subject
- Check out my Substack about high-performance mindset
- Sign up for my weekly newsletter!
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Transcript
Sonya Looney: Emily, welcome to the show.
Emily Oster: Thank you for having me.
Sonya: It’s so great to get to meet you because as we were just discussing, I read your first book expecting better when I was pregnant with my first child. And that really helped me. And then I was really excited to find Crib Sheet which is about raising little guys and girls, and I have an almost two year old son. So it’s been so helpful.
Emily: Awesome. I’m so excited. That’s so nice.
Sonya: So let’s talk about your background a little bit – what is your schooling, and how has that inspired you to write these books?
Emily: My training, my sort of academic training, is in economics. So I have a PhD and undergraduate and a PhD in economics and the kind of economics that I do is really focused on data. At the kind of core I’m like what we call an empirical economist. So I work a lot with data and with evidence and sort of think a lot about evidence and about what we can learn out of data. My topic area is health. So most of my research is about questions in health, about sort of how people interact with health behaviors. And that sort of led me into the kind of writing that I do a lot of now, which is just writing for a lay audience, largely, not so much for academics, although it does some of that too, but uses this kind of training in statistics and data and understanding of health, but in service of, of kind of helping people work through some of this stuff, really in their own life.
Sonya: Yeah, and I found a general just with health, health is a very broad topic, but it’s very confusing for a lot of people. There’s a lot of information out there that is maybe not the best information. And in your book, you talked about different types of studies and you mentioned your books are for the lay person who might not have a scientific background. So can you talk about like the different types of studies if somebody is, you know, reading something, and it’s like, anecdotal evidence, or double blind, placebo controlled, like a lot of people don’t know what that means.
Emily: Yeah. So I think that that this is in some ways interesting, you sort of frame it as like, this is a particular issue in health, because I think you’re right, it’s like much more of an issue, and in particular sort of lifestyle health choices than it is in a lot of other areas. So we kind of think about a continuum of evidence. I think we could say sort of on one hand, there’s kind of evidence that comes out of anecdote. So claim, having a whiskey makes you live a really long time, that could be like a claim. And you’d say, well, here’s some anecdotal evidence. My grandfather drank three whiskies every day, and he lived to be 105. Okay, well, that’s true about that one person. But that’s not really what we think of as kind of good evidence for a general relationship. Most people understand that. Then we kind of move into a sort of kind of evidence, it’s very common in health, which is what I call a correlational, or an observational study. And so in a study like that, you would look at some health behavior, and then you would analyze in the data, how common the health behavior is for people with different health outcomes. So you would take the whiskey example, you would get some data where some people, where people report how much whiskey they have. And you can look at a correlation you can between whiskey drinking and say, longevity, and that would tell you something about the kind of relationship and the data between those variables. The problem is, and this is an issue with all those kinds of studies, the things that determine whether people drink whiskey or not, that choice is not random. So the kinds of people who are drinking whiskey in the evenings are different in many ways from people who are not and it’s very, very hard in studies of health behaviors to separate out the effect of the particular health behavior that you’re studying, from the effect of all the other things that are different about people. And so that comes up in things like diet all the time, right? So I want to identify how important is kale at lowering your blood pressure? Well, people who eat kale, their diets are totally different than the people who don’t eat kale. And how would you really know that it was the kale, rather than the other things they’re eating rather than the fact that they’re more educated, that they’re richer, like, all of these things are kind of really confounded. And then there’s the third kind of evidence, which is sort of the best evidence, which is randomized trial evidence, where instead of relying on variations that kind of just occur because of the choices people make, you, as the researcher, generate your own experiment. So you randomly choose some people and send them a bunch of free kale. And some people, you don’t send them a bunch of free kale and you kind of study them over time. And then because the only difference is this choice that you have randomized, you can be more confident about your conclusions.
Sonya: And then what about like double blind and placebo controlled?
Emily: When we, when we say something is placebo controlled, we really just mean that there’s a there’s a non-treated group. So in this imaginary kale experiment that I’ve run, one version is you could just send a bunch of people kale, and you could look at them before and after, and see whether their health improved. But you might worry there that it’s just that you’re studying them that like they know you’re coming back to find out if they’re healthier, so they start doing a bunch of other stuff differently. So you’d like to have a group that is otherwise this treated the same that knows you’re coming back to look for them, but doesn’t get the kale, so that would be a control group. And so there we’d say there’s a placebo control. So that’s kind of just having a control group. What’s tricky in these experiments sometimes is that in really, ideally, you would like people to not know which group they’re in. So if you’re studying something like, how important is it that you eat kale, it’s really hard for it to be what we call blind, right? Because people know if they accept the kale or not, right, there’s no like fake kale. In something like a vaccine trial, you can do this sort of really gold, gold platinum standard, which is a double-blind placebo-controlled trial, which would say half the sample gets the vaccine, half the sample gets a saline injection, that is not the vaccine. They don’t know which one they got the data, the person giving them, the vaccine, treating them doesn’t know which one they got. Only somebody in like the back office of Pfizer knows which thing you got until they unblind later and find out and that’s like sort of the perfect thing, because then you can be confident it really is just what was in that syringe, not that you gave them the shot. Not that they changed their behavior in response to knowing what group they’re in. But you can only run trials like that in very kind of specific situations.
Sonya: Yeah, so it sounds like there’s definitely a hierarchy of validity when it comes to types of studies or “evidence” out there. But I think a lot of people will just go to Google, and they’ll just type in a question. And then they’ll get healthline, or I don’t know, I’m just thinking of random things that I’ve seen pop up. And then they’ll trust that as like, a gold standard of advice. So like, how do people know what to what to trust and what not to trust when they’re Googling?
Emily: Yeah, I think it’s even a huge problem. And it is even in some ways, sort of deeper than kind of what I was explaining there. Because, here, I’ve kind of made this distinction between like anecdotal, and observational and randomized, but actually, within those categories, there’s also huge amounts of variation. There’s really good, giant thousands and thousands of people randomized control trials. And then there’s a randomized controlled trial with 14 people, which like, you don’t learn anything from that even if it is randomized, right? So we’re kind of asking a lot of people if we think that they’re going to get on Google and search something and then find out and somehow like, synthesize the data themselves. I think there are some keywords you can kind of look at, some features that you can try to look for, like is this study randomized. And then there are sources that are some sources that are better than others. So something you know, like WebMD, which is kind of like a pretty up the middle well curated website is going to be more reliable than your aunt’s Facebook feed with the, maybe not your aunt or my aunt but like once a once some relatives Facebook feed that’s got some random study that they found on in who knows where. So there’s kind of ways to curate your sources, which is probably better than trying to like, dig into the details of the study always.
Sonya: Yeah. So how do people know who to trust and what to believe then because it’s kind of brings us back to the question of, well, what do I do?
Emily: I think that that’s really hard. I mean, we haven’t touched on COVID. Maybe we won’t touch on COVID, but I think one of the things that pandemic has sort of highlighted is there’s a huge amount of expert disagreement in a lot of places. And people who are reasonable smart people have different views based on evidence that is often imperfect. And so I think people have found themselves a lot kind of almost expert picking in a way that is sometimes very hard. You sort of end up deciding, okay, this is the person who I’m going to listen to. And that’s almost no better than this is the website I’m gonna listen to, or this is the study I’m gonna believe.
Sonya: It’s basically it’s really hard and you have to select who you want to listen to. But a lot of times people are making almost life changing decisions based on some of this information. So just being armed with understanding that there’s a lot of different types of studies, there’s a lot of different types of experts, both with air quotes and without, so that you can be more selective and not just to trust the first three things that show up on Google, necessarily.
Emily: Yeah, I think that’s right. And I think often, in a lot of my writing on pregnancy, I kind of think of it as kind of scaffolding a conversation with someone who knows more about your particular case, right? Because one of the features of almost any decision you make is that there’s going to be different choices that are right for different people. And the job of sort of what can you learn out of the literature or what can you learn from studies is almost that you should try to learn something that you can then bring to a conversation with someone who is an expert in you, right? So rather than saying, this study tells me that I should get this treatment in pregnancy, your goal of sort of understanding the studies is to your goal sort of learning about that for yourself, is to come in a more nuanced way to a conversation with your doctor, who then knows a lot about your particular situation.
Sonya: I’m not going to talk about COVID because I think that’s like a red hot poker. And we’ve spent a lot of time on that I want to keep this focus on primarily what’s in Crib Sheet. But along the lines of vaccines, a lot of people are afraid to vaccinate their child with “ traditional vaccines”, COVID aside, and they’re worried about autism, and I really liked that you touched on that in your book because I was curious, where that was coming from? Can you talk about that?
Emily: Yeah, absolutely. So I think this is a case where it’s so important to be clear on where it’s coming from, because otherwise, I think it takes on this sort of mystique. So this the idea that that vaccines, in particular, the MMR vaccine, might be linked to autism comes from a study from a researcher in the UK, who had this theory, and he published something in the Lancet, a paper that was basically like a case report on 12 people, children, where his claim was after they got this vaccine, they developed some digestive issues and also this was linked to autism. And so it’s kind of like, if you sort of think about this idea of anecdote as data, this would be the next like, tiny step up from then to say, rather than having one person I have like 12 people, but there was no study, no large scale comparison, certainly no randomization of any sort, really just kind of this case report idea that somehow the diagnosis of autism was in timing. proximity to when these vaccines were administered. Now, sort of subsequent to that it’d be has become clear that this individual had just tremendously terrible motives, and was somebody who was hired was trying to get money in class action suit against some vaccine manufacturers. He made up a lot of this data. So he sort of selectively chose the 12 people who he thought fit this narrative. And even within that, he made up facts about the cases. So this paper was subsequently retracted, his license was removed, there was a huge amount of sanctions and yet this narrative has sort of maintained despite that. And despite the fact that subsequently there’s an enormous amount of evidence suggesting there’s absolutely no link here. And that evidence comes from not randomized trials, because we don’t randomize access to these vaccines, because they’re really important, but studies with millions of kids that compare kids were vaccinated, the kids who are not and there’s just no evidence of any elevated risk of autism in those groups. So this is not a true relationship. But it really was driven by this kind of initial, really deeply flawed, basically fake, study.
Sonya: Yeah, and I’ve seen that happen in other areas of health where there’ll be a flawed study, but then the damage is already done. And that assumption carries forward and it just keeps spooling up and spooling up So how could people find the original study? Besides going like Emily Oster is awesome and she knows lots of stuff about this, how can I how can I find more information?
Emily: So I think, in something like that, I think actually, Google is not a terrible approach, because a lot of the information is pretty widely accessible. I think part of what I find problematic about some of our public health messaging is you can find many, many, many websites, which will tell you the truth, which is that vaccines are safe. They actually rarely tried to take the time to kind of explain why you might think that there was this link in the first place. And I think that’s actually a really complicated aspect of how we message that you on the one hand, you don’t want to plant the seed in people’s head, that maybe this isn’t safe. On the other hand, if that seed’s already there, just saying in a kind of dismissive way, oh, it’s fine, is not great. So I think if people are sort of in this rabbit hole a little bit, in some ways, the best thing I can say is just try figure out why. And usually you can find the source of something, usually you can find, well, why did anybody think that? And in a lot of those cases, when you kind of dial into why did anyone think that you will find like, oh, that’s not a good reason to think that. And this is some kernel of something, which got magnified in kind of crazy ways. But if you get down to the kernel, what you see is the kernel is nothing.
Sonya: Okay, so I want to talk about sleep training next. That’s something that people often send me messages about, because I did sleep training with my son and we’ve had really, really great success with that. But everybody has different desires. And something that I like about your book is it stopped judging is a common core theme. There’s all this information, but ultimately, you need to do what works for you, and stop judging other people for what they’re doing. But can you talk about the data on sleep training?
Emily: So sleep training, which, if you’re not a person with a small child, I will say is, is that sort of generic term for using some cry it out approach, or some approach with some crying to encourage your kid to sleep in a lot of different versions of this. They almost all involve some kind of crying. And it is a place where people feel really judged. Actually, what’s interesting, which I sort of hadn’t realized is that, you know, there’s a there’s a kind of judgment aspect of this for people who are who choose to do it, right. So if you if you choose to sleep train, you will definitely get people who will judge you. There’s actually judgment on the other side, too. So one of the things that people will sometimes tell me is I felt really pressured to do this. And when I chose not to, because I didn’t think that it worked for my family, I got a lot of negative judgment. In terms of what the data says, I think there’s kind of two things you could ask here. One is, to what extent does some kind of sleep training encourage sleep in kids? And the other is, is it damaging? So on the question of like, does it work? The answer is yes, sleep training, on average, will improve sleep for infants, for kids. They tend to sleep longer after sleep training. There’s also a fairly significant improvement in sleep and mood for parents. So actually, a lot of when we have like randomized trial data on sleep training programs, some of the most significant impacts are improvements in parental mood, lowering of maternal depression, improvements in marital satisfaction, which presumably result from the better parental sleep that is resulting from the better child’s sleep. Then when you look on the other side, are kids who are sleep trained, are they less happy, less attached, they have any long term impacts, you just see nothing there. So you don’t see particularly that it’s helpful to babies and kids, but you also see nothing on the other side, it just doesn’t matter. You know, so kids are they’re sleeping better. In the long run, they look the same. So the sort of reasons to do this are really that your kid sleeps better and then and then you sleep better. And that’s good for many families.
Sonya: Yeah. And it seems like having, if possible, when you have kids better marital satisfaction, and a better mood and more energy to show up for yourself, that has a lot of merit in how you’re going to be parenting and in your patience level with your kids too.
Emily: Yeah, I totally agree. I mean, I think that we kind of know from many things that sleep is really important for functioning and that parental mood really does matter for kind of how you show up for your kid and how you show up for yourself. Right, that suffering to the infinite degree is not actually that like the way to be a good parent.
Sonya: Yeah. And you see, you did bring up marital satisfaction, and I’m remembering that that also was in the book, do kids affect marital satisfaction? Can you talk about that?
Emily: Yeah, it’s not the best news in the book. So when they do these studies about kind of how happy people are in their marriage, there is a pretty big, on average, a pretty big drop particularly in the first year of kids’ lives, and then there’s a sort of some recovery, although it doesn’t sort of fully recover for, let’s say, several decades. But there are some things that ameliorate that. So these drops tend to be larger when kids are unplanned. They tend to be large if people sort of say that they’re less happy at the beginning, before they have kids. So sort of looks like kind of doing this, having kids on purpose and with someone that you are having have a good pre child relationship with is good, but, you know, is better. But I mean, anyone who is, well, maybe you’re not like this, but I think most of us who have had children, like the first year of your kid’s life is probably not the time that you are the most excited about your spouse in every day.
Sonya: Yeah, and I actually wanted to bring this up, because just the awareness that having kids could affect and probably will affect your marriage on some level is really important. Because if you just pretend that’s not happening, or you don’t even think about it, then you might not try to take action to create time for you and your spouse or to try and build better communication pathways. So I really wanted to bring this up because maybe people feel like they’re alone, like, oh, this is just me. And it’s like, no, this is pretty common. And there’s some ways and some things that you can do if you have this awareness to try and make it better for yourself.
Emily: Yeah, I think that the two things I sort of wished that I had thought about in my marriage before the first kid was born, was one, the sort of recognition of the need to carve out just time that was just going to be us, right. So you sort of go from this experience where you’re basically it’s just the two of you and so there’s plenty of time to chat and laugh and have a good and kind of just be the two of you together to a point where there could be no time like that. You could find yourself literally you never have this sort of like downtime, unless you plan for it, but you’re not used to planning for it. Because you didn’t have to before. And so I think, you know, I wish we had thought of that. And then the other thing is, there’s a lot of joint decision making that about something that you care a lot about, that you don’t know anything about. And that is a good recipe for conflict. And so if you sort of don’t have a system for making choices that are hard where you disagree, there’s just going to be a lot of a lot of arguing. And I think that when I sort of reflect back on this, I think we argued a lot in the first year for kind of these reasons. The first year of my second, child’s life was totally different because we had kind of put in place a lot of these, we had thought about this, we already had a kid, whatever. So it was like not that there wasn’t anything we disagreed about many things you disagreed about, we had a much better way to kind of resolve those disagreements rather than just moping.
Sonya: So you, you just kind of touched on like time for yourselves as a couple. And just generally, that makes me think about childcare. And you had a lot in your book about stay at home mom versus a working mom. And the different types of childcare nanny versus daycare. And I know people would be really fascinated to hear about this, because there’s a lot of different approaches. There’s a lot of pressure or maybe even guilt that people inflict upon themselves or even your family saying I can’t believe you’re doing it this way. We did it this way 40 years ago. So that’s a really like, broad topic and a broad question. But can you just give us an overview about what the childcare data says? And then we can kind of pick out some topics to focus on?
Emily: Yeah, so I mean, I think the kind of big picture takeaway on this is that when we try to compare, outcomes, when you talk about what outcomes mean, for kids, but it’s usually things like cognitive functioning, and behavior, which are some things that we might care about. But anyway, the things you can measure, when we look at those kinds of outcomes, it actually, they do not vary in large ways, across all of this different set of choices. So if you sort of think about the sets of choices about working or not working, and if you’re working, what’s your kid doing? Are they going in childcare, they have a nanny, all of this stuff, it just does not show up very much in differences across kids. It’s not that there’s nothing, it’s not that we don’t see sort of little effects in sort of either direction, but by and large, any of those effects are very small. And so it kind of puts the onus back on joint this family decision making around like, what do you want to do. That if you’re if your goal was to like do the best thing for your kid, there are many best options. There is no obvious this is the best thing and if you can afford it, that’s what you should do. And here are like the second best things. There are a lot of different things that all kind of work roughly the same in expectation and so there’s a kind of been the choices is almost more about what do you want and what like works practically and financially for your family.
Sonya: So from like a cognitive development perspective, a stay at home parent versus a nanny versus going to daycare, there isn’t any differentiation that is notable in the data.
Emily: Yeah, exactly. So you can start to tease out little things like maybe daycare, so some kind of childcare, is a little better for cognitive functioning, sort of if you’re there between 18 months, and four, and maybe it has a little bit of a negative impact on behavior in the first year, but these effects are tiny, they go in all different directions. It should not really probably be an important part of this decision.
Sonya: Yeah. And probably a lot of that has to do with the personality of the child.
Emily: Definitely. Yeah. And I think that that, some kids operate better in one setting where one child care with one kind of nanny. Again, all of these things are like, yeah, your kids are gonna be the way they are. Other things about parenting may matter more.
Sonya: So, yeah, we talked about outcomes as being cognitive development, but what about happiness? I don’t know, that’s kind of a big word, and measuring happiness is kind of a hard thing to measure. But did you see anything about that?
Emily: There is no data on happiness. I mean, this is part of when I start studying bigger kids, you get the same kind of families as your kids age, you really sort of realize, what I’m trying to accomplish with my kids is not like a high test score, or a good performance on the externalizing behavior index, even though that’s all I can see in the data, right? What I’m trying to do is generate people who are nice, kind, thoughtful adults who are happy and content. And we have almost no way to measure that in our data. And I think that’s just a real basic limitation of the way that we do science around these questions.
Sonya: Yeah, and I mean, that’s a big decision for the individual because if you think, well, child care, or sleep training, or you know, whatever, whatever, doesn’t affect cognitive development negatively, but it might impact the happiness of my individual child who has different temperaments. What is that doing? And being able to pay attention to that, I think is really complicated.
Emily: Yeah, and it’s hard, with little kids, particularly with little kids, it’s sort of hard to know, oh, I mean, for them to be happy, they would like to just sit around and eat Doritos all day. But that’s not really happiness… so there is a lot about sort of trying to tease out the kind of immediate versus the aggregate in terms of is my kid, just how is my kid doing? But I do think it’s not impossible to do that. And it’s something that is going to be very specific to kind of, how does your kid seem?
Sonya: And I know, this is more of like a psychology question. But for people who feel guilty about putting their kids in daycare or having a nanny, do you have any advice for them?
Emily: I think the main sources of our guilt are feeling that we were doing the wrong thing. And there is a right choice, and maybe we’re not making it. So maybe there’s a best thing to do with my kid and I’m not doing that thing. And then I think that is a source of guilt. And so some of the discussion in the book, I think, is really about trying to make the choice that is right for you, sort of recognizing that in, in this space, in many of these spaces, there’s no right choice, there, there may be a right choice for you. And the way you can get to that choice is by thinking carefully about what’s going to work for you. And, thinking about your kid and thinking about the constraints and kind of coming to a place where you’re confident that the choice is right, that you didn’t make it haphazardly. And once you’re there, I think that there should be a little hopefully freedom to be like, okay, this was the right choice. And I’m confident in the way that I made that choice. And I’m going to try to move forward and not sort of second guess. So I guess, but it’s hard because I’ve generally have been quite confident about the choices we’ve made around childcare, and so on. But of course, if you send your kid to childcare some of the time or leave with a nanny or do anything, or even stay with them, whatever, sometimes your kid cries, right. You drop them off at preschool, and they cry. They clutch you and they cry. And you’re just crushed, you know, it’s horrible. And then and then everyone’s like, just leave, they’ll be fine. Just give them a big smile, leave to their kids, like on your leg screaming and you’re like, have a great day. And for you, I think almost what’s hard about that is for you like for the whole day, they’re crying on your leg, you know, that’s the thing in your head. Of course, the second you leave, because like then you’re gone, it’s fine. They’re like ooh, the purple blocks today, and so I think that’s part of what’s hard. You really require like a real cognitive shift to get in the car and be like, okay, that was great.
Sonya: Yeah, so it sounds like you making a decision and then trying not to second guess that decision? Because a lot of times we’ll make a decision and then say, I don’t know if that was the right one, and then you spend all this energy, second guessing yourself or comparing again, and going back to that decision. So just trying to make decisions where you feel confident and move forward.
Emily: I talk to them in the book that I have about older kids, I talked to him about this sort of decision structure where one of the steps is move on. It was basically like, think about what the decision is, make the decision and then move on. And try not to think about it again.
Sonya: What’s that book called for people who are interested?
Emily: It’s called The Family Firm. It’s about early school year. So it’s the same kind of approach, but bigger kids.
Sonya: All right. One thing that I am excited to talk to you about is TV and learning. Again, people are going to do what’s best for them, so I don’t want to sound judgmental, or whatever. But my parents are like, I can’t believe… I don’t let our son watch TV. And they’re like, oh, my gosh, you’re terrible. You watched TV, and you survived and blah, blah, blah. And for me, the reason why, and it was great to read your book, but the reason why I didn’t want to is because I want him to my son to use his imagination. I want him to be engaged. I don’t want them already on the screen, because we are going to be spending most of our lives there anyway. But my parents just seem to think that’s terrible thing that I don’t let him watch TV. And I after I read your book, I said, well, like from a learning perspective, there’s some data there. So can you talk about the data with TV and learning for little kids and then a little bit older kids?
Emily: Yeah, so for kids under two, there’s just no evidence that they can learn from TV, right. So you’ll sort of sometimes see these kind of Baby Einstein videos of this famous thing, right? The idea of like, if you just put your kid in front of the television, they’ll turn into Einstein, I guess. And there’s versions of these that are going to teach them to lead and teach them to talk and whatever. And the thing is that kids at ages, they just can’t learn from videos. It’s not that they can’t enjoy them, they might enjoy watching Baby Einstein, but they’re not learning from things. They can only learn from, they basically only learn from people. When you get to older kids like sort of a three to five range, which I have a little bit of evidence from the rollout of Sesame Street, that kids can actually learn something from television. So kids who were exposed to Sesame Street actually, like were better prepared for kindergarten than kids who were not because Sesame Street has this sort of, I don’t know, they’re telling you about your letters and your numbers, and so on. So there’s this sort of flip around the age of kind of two or three where kids can start learning. Now, of course, that flip has it has that kind of opposite side, which is that your three-to-four year old can learn other things from television also, with shows is like some curation that you that you want. But I think that people kind of put too much…one of the things that comes out from this, I think, for me, is the idea that we’re just putting too much emphasis on screens as either good or not good, as opposed to like a thing that you could choose the way that you’re going to make other choices about the things that your kid does. And so you could very reasonably say, look, there’s just nothing we’re doing now. We’re not doing screens, or we’re not using a balance bike or///there’s like tons of these kinds of choices that you’re gonna make about how your kid spends their time. And I think very reasonable people will make different choices about when exactly, they’ll let their kid watch TV, and how much of it and so. It’s not obvious that one of these things is kind of right or not? Right? It’s just a choice.
Sonya: Yeah, and again, when we’re talking about outcomes, we’re just talking about the outcome of learning, we’re not talking about the outcome of mom or dad really needs a break so little Johnny’s just gonna go watch a show for 30 minutes. And that’s totally fine. And that’s a different outcome. Or maybe the kid is happier and in a better mood throughout the day, if they end up getting to watch a show. So that those are all different outcomes that people can consider to.
Emily: Yeah, yeah. And I think there’s a real kind of where does this fit into into the way we’re operating our day? Right? So there’s is your kid watching six hours of television instead of doing anything else? That’s probably there are other things they could be doing with that time. Is it a half an hour in this some particular timeframe that works? I think that makes more sense is like an argument for sort of deliberateness with screens that I think we don’t always kind of fully think through.
Sonya: Yeah, I like that word deliberateness. In your book, there’s a gap between age two and three it was like from zero to two this and after age three this. Is there just not good data?
Emily: Yeah, it’s just not that precise. And, in that age, particularly for some experience doesn’t vary a lot. You know, you’re like how much attention span kids have and how much they like that kind of stuff. And where they are developmentally.
Sonya: Yeah. And developmental milestones. I wish I brought this up earlier, but this is a huge source of stress for a lot of people like well, my kids, 18 months and the neighbor’s kid is talking in full sentences, and my kid isn’t talking at all. There are all these milestones, but there’s such a wide range, but people stress out about the milestones. Can you talk about that a little bit?
Emily: Yeah, I think the biggest stress from the milestones is this idea that they are numbers, right? That the way that walking works is we say kids walk on average at 12 months, like around a year is like the average time that kids walk. But there is a huge range, in the kind of normal time for the sort of typical time for doing that, from, as young as seven months to as old as about like 16 months like, in normal range, 15-16 months, maybe 18 months for walking. And so that range, I mean, that’s not because people have developmental issues or anything else. It’s just some kids walk earlier than others. And yet, when we talk about these milestones, we talk about them like numbers, your kid will roll over at six weeks, your kid will do this for three months, your kiddo did, and then when it’s like six weeks and one day, people are like, oh my God, my baby did roll over and it was just an average. And somehow we were comfortable doing that with things like height and weight with our baby, right? They say, here’s where your baby is, in the end, nobody’s like, oh, they’re only a 30 I thought they’d be exactly a 50. You know, people understand some people are in the 20%, those people are the 70th percentile and that there isn’t that isn’t some kind of like, quality ranking of your baby. But somehow we sort of take these milestones as quality rankings or something. And there’s just almost all of them, there’s a huge range, which is different than saying that there aren’t some things that would cause people to be concerned. But it’s quite important to distinguish between this is a totally normal variation when kids walk or crawl or rollover, or whatever, and this is something that sort of outside of that range. That’s kind of what pediatricians are for and are good at doing. But instead it sort of gets people tpover interpret.
Sonya: Yeah, and I think the comparison thing again, is just stressful for me just in general.
Emily: No, I remember when my best friend had her kid like three months after me. And we live right near each other. They spent all this time together and her son, even though he was three months younger, walked substantially sooner than my kid. She’s like sitting around, but she’s like, really big. And he’s just like tootling around. And he’s like, ah, come on. Penelope. Can you get it up?
Sonya: And there’s like, almost like a competitiveness between parents to have like, oh, my kid did this earlier or whatever. And it doesn’t actually matter.
Emily: No, no, it doesn’t. It doesn’t matter. But you just want, I don’t know how much is you want your kid to be the best? Yeah, parenting,
Sonya: I heard something that was really helpful when my son was really young, it was something to the effect of all kids are going to do with majority of things by age three. So whether they do it like early or they do it late, as long as they’re doing it, it doesn’t actually matter. And it doesn’t make that big of a difference or any difference for like long term outcomes.
Emily: Yeah, yeah. And I think that’s true. I mean, that’s true even of a lot of things they learn later. Kids do learn to read at different ages. But they basically, most people learn to read.
Sonya: Yeah. Can you talk about the learning to read information?
Emily: Yeah, so again, this is a place actually, the videos with babies where some people will have this idea that your baby can learn to read. Actually, somebody just sent me, should I do this program with my babies to learn to read? Your baby cannot learn to read, they cannot learn to read. And so when we think about how reading operates. When people actually learn to read, they learn to read through phonics through the idea of sounding out. And that is something that you sort of develop the ability to learn at an older age. So, a kind of three year olds, probably not. A four year old could start to learn to sort of read and in some ways. It’s possible to kind of teach a four year old to read to some extent, some four year olds. But this idea that your baby can learn to read doesn’t really make any sense. Because even if you could teach your baby to memorize words, which you might be able to for some age of baby, that would not be the same as reading.
Sonya: Now I feel like I need a utensil to bang on a wine glass… potty training, potty training.
Emily: So potty training is very simple to explain and difficult to do. There are a lot of different ages you can train your kid to use potty. You can start trying when your kid is like under two, younger than that. You can wait until they’re really old. Here’s the thing, if you start trying to potty train your kid when they’re little it’ll take a long time because they don’t have as much control of their bladder. They don’t have as much understanding of when they’re going to need to pee, so you can do it, there’s like more pee on the floor. It’ll take some time, whatever. If you wait till your kids like three and a half, like they get it, they know when they’re peeing. And so it could happen pretty quickly. The sort of downside is that sometimes then you get into like they don’t want to, they have more emotional control. And also then you spent all that time in the interim cleaning up their poop. But I think there isn’t either a correct time, or a correct method to do this. Just a lot of it is about whether what kinds of time you want to invest and in what way. I will tell you the one thing that often happens with potty training that people do not expect is stool, toileting refusal. So a lot of kids are afraid to poop in the potty. And you can have kids who have no problem peeing in the potty, and they have no problem knowing when they have to poop, but they will not poop in the potty. And that’s really frustrating for parents.
Sonya: Because the poop is the thing that you don’t want to be…
Emily: Yes, that’s what you’re trying to get rid of. Exactly. That’s the thing you’re trying to get rid of. Yeah. And so there are some ways that people talk about trying to get around this, but it eventually typically resolves, but it can last a really long time. That can be like it can be like a year of that… yea, potty training.
Sonya: So what is kind of the average, again, not for people to compare and freak out, but I was surprised about the average age of potty training for kids.
Emily: So the average age is now about three. So it’s crawled up over time from something around two to something around three, or even older than that. So I think partly diapers have improved a lot. Right? When I was a kid in like the 80s, the diapers were just kind of like a piece of tissue paper. And it was a lot of incentive to potty train. Now the diapers are amazing. I think there’s a sort of like, well, the diaper is fine. And then it’s a lot of work to, there’s more of an effort to transition.
Sonya: Yeah, exactly. Like, half the time the kid doesn’t even know their diaper is wet.
Emily: Right, exactly, yeah, they’re not getting the kind of… actually sometimes people will say one potty training approaches to switch kids into crummy 1980s style diapers, because then they know that they need.
Sonya: I was a child of the 80s as well. My parents use like the cloth diaper with the safety pin.
Emily: I was alwasy afraid that you’d like stab the kid with this. Which they probably did.
Sonya: So, this book was written? What year was this book released?
Emily: It’s 2019.
Sonya: Is there anything that you wish that was in this book now that you didn’t put in?
Emily: I think they’re always like, topics where you’re like, next time, when I update, but I actually feel like I hit a lot of what I would want with this. And then one of the things I say sometimes is, I wrote this book, kind of after I had a second kid. And I think if I written after the first kid, it would have been like 3000 pages long. Because it would have been every neurosis that I had with the first kid, every crazy thing that I sort of obsessed about. And by the time I get to the second kid, a lot of things had codified as to sort of like well, just don’t think about that. Here are some things you really need to kind of settle and worry about and kind of occupy your headspace. And then here are a bunch of things you don’t need to do to think about. And so I tried pretty hard to dial the book down to kind of the big things. I mean, I’m sure there’s pieces that…I was just writing something for my newsletter about whether you need to give your kid a bath. And so you know, I didn’t have that in there.
Sonya: Yeah, with our first I tried telling myself pretend it’s your second. And it’s impossible to do that. So I’ll be really interested to see how it goes with the second with things I was really worried about really a stickler and if I’m a stickler around the second time around.
Emily: We had like so much restriction on sugar. And then with the second, we had all these things that you can have dessert, whatever. And then by the time he got to the second, the first kid was like older and so we’d have dessert, and then the second kid just like that all went out the window.
Sonya: That’s actually something I didn’t even think about. So yeah, thanks for bringing that up. So we have a few minutes left. And I know that a lot of people are a fan of your first book. There’s a lot of pregnant women and pregnant athletes that like to follow this type of work that I’m doing. It’s been a while since I read Expecting Better. Can you talk about one of the key things that everybody asks you about that you think would be beneficial?
Emily: I think a lot of the questions that people have in pregnancy are this sort of like this early stage restriction stuff, so Can I have sushi? The most common question is can I have sushi? I don’t know why pregnant women really enjoy sushi? And you know, the answer there as it was with one of these things is like, yes, the rules that you are getting around a lot of these food restrictions, in particular in pregnancy are not really based on very much. They’re kind of based on a sort of some kind of complicated overabundance of caution. And that it would be you know, better, it would be fine, it is fine to have some sushi. There are certain kinds of cheese restrictions, which are probably over overblown. So, I think a lot of the message of that book is that data can lead you to a more relaxed, less neurotic place.
Sonya: Yeah, one thing that I wanted to bring up was alcohol, the choice to, have a sip of something or have a drink in pregnancy. And I feel like nervous even bringing this up, because a lot of people have opinions on this. So I wanted to hear what you wrote.
Emily: Of course. So I spent a lot of time in Expecting Better on this question. And on sort of coming back to what we said at the very beginning about, what is the sort of source of evidence for things like this. I think, in the case of alcohol in pregnancy, we don’t have what we what we sort of ideally like I guess, which is a big randomized trial, where we have our studies, which compare women who have some, drink occasionally during pregnancy to women who don’t, and it’s sort of very clear that drinking a lot during pregnancy is dangerous, you should not do that. But then, if you want to know about sort of smaller amounts, you can kind of dig into this data. And it really varies in quality, there’s actually some very high quality data, like from Europe, where occasional alcohol consumption is just much more common. And there you really in that better data, you really don’t see any differences, any sort of impacts of small amounts of alcohol consumption on anything we measure with infants. And so the data there is really quite reassuring, and there is a lot of it around the view that there isn’t any clear evidence, there isn’t really any evidence of harm of small amounts of alcohol consumption. When you try to isolate the sort of sets of research that maybe do show more of those links, there’s not much there, but to the extent it is there are a lot of other differences across the women. For example, differences in how much cocaine they use, which are likely to be contributing to some of these differences across infants. So it’s a little bit of a complicated space. But I think in kind of really digging into the evidence, it does not look like there’s any reason, there’s any strong evidence, suggesting that occasional alcohol consumption is problematic.
Sonya: Yeah, and I think the hardest part for people is what is moderate, what is a small amount, and people think I’m just having a glass of wine, but they’re drinking they have a big glass. And they’re putting way more than a small glass of wine, or they think they’re drinking X amount of days per week, and this goes for when you’re not pregnant, if you’re trying to drink a moderate amount, what is moderate? And then our perception of what we’re doing is actually not as moderate as we might think it is, in some cases.
Emily: Yeah. And I think there’s this sort of argument for this both in pregnancy and out that when we think about our consumption of alcohol, that we want to have a kind of realistic understanding of how much we are having. And so we talked about a glass, it’s not nine ounces, it’s four ounces. And that is a part of this conversation also. And I think for a lot of women, one of the things that’s sort of interesting, is this part of the book got a lot of attention. I think there are a lot of people were like, oh, I it was good to know, I could have like, a half a glass of champagne to celebrate this and that and I felt more relaxed. But there’s a lot of people were like, yeah, I’ve read that. And I totally see what you’re saying, but like, it’s not for me. I don’t feel that’s something that I care that much about, or is an important part of my life, or just in general, I don’t feel good about that. And I think that that’s what I mean, obviously, that’s also great. And I think a lot of this is about sort of thinking about where you are yourself on these choices and how they’re going to make you feel.
Sonya: That’s something else that I liked in Crib Sheet as you talked about alcohol and breastfeeding, because a lot of times, there’s a lot of stress around that, especially if you’re doing the dream feed with the baby at 10 o’clock, and you want to have a drink after the baby goes to bed. Should you not breastfeed the baby. Can you talk about that?
Emily: So that turns out to be actually much easier to evaluate than the pregnancy thing because you can literally see what kind of alcohol there is in the breast milk. Right? And so rather than like having to rely on thinking about how the placenta works, you just be like, okay, drink some alcohol, pump and then we’ll test how much alcohol there is in your in your breast milk. So it turns out even if you drink quite a lot, the concentration of alcohol in your breast milk is very limited, because it is reflecting the concentration in your bloodstream at the at the time. And so they do the studies where they have people have like four shots of tequila in an hour. And still the concentration in their breast milk is really low. And sort of if you then kind of like translate that into your evening glass of wine, that’s even better. And even easier. And then the other thing is like, if you want it to wait two hours, then it’s kind of metabolized. But just in general, this is the concentrations in breast milk are really low.
Sonya: Yeah, I had a lot of paranoia around that when I was breastfeeding my son, partially because I am kind of a lightweight when it comes to drinking. So I actually got some of those test strips on Amazon. I don’t know how accurate those are, because it would show there’s concentration in here, but it would be based on a color and what color blue. Where does this shade fall? And I thought I this probably is not very accurate at all.
Emily: Yeah, yeah, I think that may be a hard way to get good data on this.
Sonya: Yeah. So I was happy to read that. It’s probably fine. Well, you mentioned your newsletter, some of your other books, where can people find you and all of this great information you’re putting out there for us?
Emily: So the newsletter is a good place to find me. It’s called Parent Data, and it’s on Substack. I am also on Instagram @ProfEmilyOster, and on Twitter, and the books are Expecting Better, Crib Sheet and The Family Firm.