Parenting by the Numbers

At 7:05, Oster hustled the kids down to the kitchen for breakfast. She set out a plate of sliced strawberries alongside the muffins. “I think it’s important to have fruit,” she said.

Mother and children sat around the table, Finn wearing a T-shirt and Stormtrooper underpants. “Guess what,” he said. “These are on backward.” The Stormtrooper logo was on the rear, so he’d turned them around.

“It’s a terrible underwear design,” Oster said.

We talked about their weekend plans, and about a Japanese restaurant where they’d recently eaten.

“You sit on a tatami mat,” Penelope told me. “It’s a thing where you sit on the floor, and there’s a really low table. I found out about it when I started studying Japan in school. I studied Japan for three months.” With her quick, orderly thinking, she reminded me of Baby Emily. She went on, “Now that I’m done with Japan, I’m studying family.”

Oster asked, “Are you going to write about our family?”

Penelope was interrupted by Finn, who shouted, “More fizzy water!”

Please,” Oster said, and refilled his glass.

“Cribsheet” is different from Oster’s first book, in part because pregnancy and parenting are different. When you’re pregnant, the choices you face are more discrete—Should I agree to this procedure? Should I order this entrée?—and you generally have time to think things through. “When you have a kid, it’s like someone is shooting you in the face with a fire hose,” Oster said. “Particularly at the beginning. Every day there’s another decision: Should I be swaddling her? Should he be circumcised? The breast-feeding isn’t working! Should I use this breast-feeding supplement thing that gets taped on my boob? What kind of bottles should we buy? Should I use this formula or that formula? She’s not sleeping! Where should she sleep?”

At first, Oster and her husband made decisions on the fly, like everyone else. They ricocheted between various sleep-training techniques and ordered too much gear from Amazon. When a night nanny advised, “You have to get the Miracle Blanket”—a swaddling product—Oster said, “I was, like, ‘Great, let’s order ten of them!’ ” With Finn, she was able to step back and take a more programmatic approach. She dug into the data on such topics as sleep and childcare, asking, “What, ideally, should I have done?” The answer wasn’t always clear.

For one thing, there isn’t much data on the nonmedical aspects of child rearing, such as the effects of screen time on kids. Even where data exist, they’re not very conclusive. “Can you eat sushi when you’re pregnant? Yes, it’s fine,” Oster said, by way of example. “Should you sleep with your baby? There’s a lot less of a right answer.”

That’s not to say that people won’t tell you there’s a right answer. Exhibit A is breast-feeding. After I gave birth, I was surprised to discover that many people—even men—would ask, “Are you breast-feeding?” I soon realized that the question was an indicator of our collective anxiety about the subject. By the nineteen-seventies, after the baby-formula industry aggressively marketed its product to doctors, breast-feeding had declined precipitously in the U.S. It was revived in the nineteen-eighties, thanks to large-scale public-health campaigns, and later to studies showing such health benefits as improved metabolism and higher I.Q. If you’ve been pregnant in the past forty years, you’ve no doubt been on the receiving end of these campaigns—from the poster in the doctor’s office announcing “Breast Is Best!” to the Instagram influencer doing yoga while a baby suckles peacefully at her nipple. If you’re a certain kind of person—for example, me—you’ve come away thinking, Message received! I am one hundred per cent, absolutely breast-feeding!

But there’s a hitch: there’s a small, squalling person who also has a say in the matter. My daughter quickly developed a firm preference for the bottle over the breast. At first, I overruled her, but, as the lactation consultant informed me, “She just likes the feeling of plastic.” At around five months old, she began screaming with horror whenever she glimpsed my nipple. It was . . . insulting? When I called my mother to vent, she said that I’d rejected her nipple, too. “I’m still very hurt,” my mother added. Oster frequently gets e-mails from distraught mothers who are convinced that, because they’ve failed at breast-feeding, they’ve doomed their offspring to a life of dim-wittedness and obesity. “The saddest are from the husbands, saying, ‘Is there any information you can give me? I just want to be able to tell my wife it’s not so terrible if this doesn’t work,’ ” Oster said.

After reviewing the literature, Oster believes that the health benefits of breast-feeding are real, but that they have been oversold. She zeroes in on the issue at the center of so many debates about medical research: determining causality. It’s tricky to study breast-feeding. In an ideal experiment, you’d take a large group of newborns and randomly assign half of them to be reared on formula and the other half to be breast-fed. But, for obvious ethical reasons, we don’t experiment on infants. So researchers are left mainly with observational studies, which examine the babies whose mothers have chosen to breast-feed. In the U.S., these women tend to be wealthier and better educated than other moms—a result of many factors, including the fact that breast-feeding is time-consuming and that, to do it comfortably, you need sufficient paid leave.

Do breast-fed babies thrive because of breast-feeding, or because their parents have more money and higher academic degrees? In many areas, such as obesity and I.Q., Oster argues that it’s the latter. Only a few studies meet her standards: sibling studies, in which one child is breast-fed and the other isn’t, and a large randomized controlled trial in Belarus, in the nineteen-nineties. (Breast-feeding rates were low, and researchers encouraged half the mothers to take up the practice.) From these studies, she draws two firm conclusions: breast-feeding reduces gastrointestinal problems, like diarrhea, and rashes, like eczema, in a baby’s first year. Important, but, as Oster told me, “if it doesn’t work, the parents should say, ‘Well, maybe my kid will have more difficulty pooping for a few months.’ Not ‘There go five I.Q. points!’ ”

Another question that people often ask new mothers: “Is your baby a good sleeper?” Sleep is a fraught topic, in part because it’s stalked by the world’s scariest acronym: SIDS, or sudden infant-death syndrome. Over the years, official recommendations for avoiding SIDS have changed dramatically. When I was a child, my mother put me to sleep on my stomach, surrounded by bumpers and stuffed animals. Today, that would probably get you reported to Child Protective Services. Other practices, such as “co-sleeping”—letting a baby sleep in your bed—are, officially, against recommendations and, unofficially, something that people do all the time. Co-sleepers sometimes contend that the safety warnings are too stringent, and Oster provides them with some support. She argues that the increased risk of SIDS associated with co-sleeping has a lot to do with other parental behaviors. If you’re drinking and smoking, it’s dangerous. If you abstain from those activities, and take other precautions, like removing blankets from the bed, the risk of your baby’s dying is .22 deaths per thousand births—still elevated, but less than the risk of your baby’s dying in a car accident. In other words, Oster said, “a reasonable person could make that choice,” especially if it’s helping the entire family sleep.

Economics is a science of decision-making. A major refrain of Oster’s book is that a parent’s preferences are important. What do you want? That seems an obvious consideration when you’re selecting a new car, but less so when the decision involves your child. “In the first book, there’s a central tension between people and the medical establishment,” Oster told me. In the second book, “it’s between you and society. Or you and your own parental guilt.”

Why is child rearing so touchy? Why does it cause us to engage in Facebook flame wars, and to think terrible thoughts about our dearest friends? Ann Hulbert, the author of “Raising America: Experts, Parents, and a Century of Advice About Children,” told me that, in recent years, parenthood has taken on an uneasy dual role in American life. “It’s become both the proving ground for our virtue and the deeply insecure ground on which we hope to create a life of greater economic security for our children,” she said. The U.S., she added, hasn’t had a single voice of authority on the subject in decades. After Dr. Spock, numerous experts popped up, often with conflicting advice. Then came the Internet. “We’re now in an era where mothers and parents can talk to one another, a throwback to this nostalgic time, pre-expert, when mothers gathered at the village well,” Hulbert went on. That sounds nice. “But, actually, it can be horrible! Mothers are perfectly free to be judgmental, dictatorial, and obsessive, and it multiplies anxieties.”

Oster believes that the Mommy Wars arise from a kind of loss aversion. “People get the idea that what they do must be the right thing. Especially since some of these things are very hard,” she said. “Like, if you spent a year lugging your breast pump through airports and pumping in the bathroom at LaGuardia, just so you could keep breast-feeding, it’s hard to later say, ‘Oh, actually, that wasn’t really so important for my kid. I just did it because I liked it.’ ”

In April, Oster participated in a lunchtime Q. & A. session with new mothers at a pillow-filled space on Brown’s campus, over plates of Indian food. The audience was made up of graduate students and young professors—all passionate Osterites.

A woman from the professional-studies program said, “I want to treat you like this oracle who can answer anything!” She had a question about weaning. “My son is twenty months old, and I can’t figure out how to stop breast-feeding him,” she said.

“There isn’t much data on that,” Oster replied, apologetically. (It’s not a common enough problem to attract researchers, she explained.) She offered, “I quit when my son bit me at eleven months. I was, like, ‘Aaah!’ And he never wanted to do it again.”

The conversation soon turned to mommy bloggers. What to do about them? And what, one woman asked, do you say to the “parents and aunts and uncles and stuff who all have their own opinions?”

Oster gave the group a pep talk. “That lady on the Internet is not living in your house,” she said. “She doesn’t know what the right thing is for your son’s penis. And so you shouldn’t let her tell you whether circumcision is a good idea or not.” Part of her goal, Oster explained, was for “people to feel more confident in the choices that they make. And be able to appreciate that other people made different choices without feeling bad.”

By the time I finished “Cribsheet,” I was feeling very empowered. I knew my preferences, and I had obtained the relevant data. I was becoming a pro at data-driven parenting. Then I spoke to people in the medical establishment, and my sense of certainty fell apart. Dr. Lori Feldman-Winter, the chair of the American Academy of Pediatrics’ Section on Breastfeeding, told me that Oster is getting it all wrong. Public-health experts have specific ways of interpreting research, and Oster wasn’t following those protocols. “That’s the really scary part of having a person like Oster, who is not an epidemiologist, distilling this information to the lay public,” Feldman-Winter told me. “It’s basically as bad as the anti-vaxxers.”

Apparently, if I’d really wanted data, I should have downloaded the U.S. government’s recent summary review on breast-feeding, which found evidence of long-term effects that Oster dismisses, including a reduction in asthma and in Type 1 diabetes. Feldman-Winter told me about how human milk raises the I.Q. of preterm babies, and how exclusive breast-feeding—with no formula—seeds the lower intestinal tract with good bacteria, protecting against inflammatory-bowel disease, Crohn’s, and ulcerative colitis. Oh dear. Now I felt truly awful. Why had I given up so soon? Feldman-Winter tried to reassure me: “You did the best you could.”

Unsurprisingly, Oster stood by her analysis. “There are many ways to collate this literature,” she told me. And economists are extremely skeptical of the methods that epidemiologists use. Whom, then, to believe? Such arguments come up all the time in discussions of medical research. They are a reminder that, far from being infallible, data can be slippery. Preferences, too. They’re informed by all kinds of factors: sentiment, lived experience, religious beliefs. In reporting this story, I found that, the more I learned about breast-feeding, the more passionate I became about it. Like Oster, I was an unapologetic wine-sipper during pregnancy. But, after speaking to doctors who have treated fetal alcohol syndrome, I wished that I could take back even the tiniest drop. Is this rational? Perhaps not. But neither are a lot of things about parenting.

“Cribsheet” hasn’t been as controversial as Oster’s first book, because her conclusions, for the most part, fall in line with what your pediatrician has been telling you. Vaccinations are safe. Sleep training—otherwise known as the “cry it out” method—will not scar your child for life. The one area where, Oster says, “book research preceded behavior change” in her own life was toddler discipline. Because her children are well behaved, she wasn’t planning to do any research on the topic, but her editor, the mother of two young girls, begged her to look into so-called “positive parenting interventions”—programs like 1-2-3 Magic, the Incredible Years, and Triple P, or the Positive Parenting Program. She was surprised to find that, as she writes in the book, “they just work.” A number of large randomized controlled trials have shown that, after parents are taught the techniques, they report that their children are more compliant, and that they themselves are less stressed—even years after the program has ended.

Oster has started using 1-2-3 Magic with her kids. The basic idea is that, when a child misbehaves, instead of getting angry you slowly count to three. If she hasn’t taken the remote control out of the toilet by “three,” there’s a consequence: a time-out, or a loss of privilege. “You have to be consistent,” Oster said. Thomas Phelan, the psychologist who created 1-2-3 Magic, recommends bringing a “time-out mat” to deal with tantrums in, say, the grocery store. I’ve ordered his book. It’s hard to imagine becoming the kind of person who carries a time-out mat in her purse, but parenting can take you to weird places. Oster now finds herself brainstorming punishments that a four-year-old will find “devastating.” Lately, she said, she’s been having success with “If you don’t stop doing that, I’m going to take away your lunch cookie.”

Talking about this subject, I was reminded of a recurring episode in “Narratives from the Crib.” It takes place at the beginning of each tape, before Baby Emily’s dad puts her to bed. There’s a push and pull between parent and child. He’s trying to get her to go to sleep, and she’s trying to keep him in the room. She experiments with different strategies: jumping on the bed, asking him to repeat the story that he just told her, and, of course, crying. “Big kids don’t cry,” he tells her at one point, trying to sneak out of the room. After he leaves, she repeats the phrase over and over, through sobs. “I’m glad my kids didn’t do much of that,” Oster told me. “Listening to it, you’d be, like, What am I doing to my child?”

What are we doing to our children? We fret, we helicopter, we listen to the wrong people. We pore over transcripts of two-year-olds chattering and turn ourselves into amateur statisticians. But, ultimately, many of the outcomes aren’t in our control. And that’s a problem that all the data in the world won’t fix. ♦

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