The Washington PostDemocracy Dies in Darkness

Parents are drowning in advice. An economist looks at the data — and says we can all relax.

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At my son’s 6-week-old checkup, I was given a wonderful gift by our pediatrician. She waved away my (many) frantic questions about swaddling, nursing and formula and said all she cared about were vaccines and putting babies to sleep on their backs — since those were the issues with the most support from science.

“Pacifiers, breast-feeding, all the rest of it, is really your preference,” she said.

“Cribsheet” is essentially a book-length version of my pediatrician’s wisdom. And like me, many parents will probably find reading it a huge relief from the scare stories that seem to pop up everywhere these days.

The author, economist Emily Oster, burst into the parent-lit world with her 2013 hit “Expecting Better,” which remains required reading for a certain set of pregnant parents. Oster repeats her ingeniously simple formula with “Cribsheet”: taking conventional wisdom and diving into the research behind it, often showing that “the studies” are thin or nonexistent, or their findings that have been overstated.

The raging debate over infant circumcision? The entire issue boils down to a handful of very small risks and very small benefits. Cry it out? Perfectly safe. Co-sleeping? The practice carries a risk, even if you and your partner aren’t smokers.

But it’s a small risk, and Oster — a professor at Brown and mother of two — frankly acknowledges that it might be one worth taking if it’s the only way parents and baby can sleep. Because sleep matters — a zombielike parent could easily drop an infant, fall asleep at the wheel or do any number of deadly things thanks to sleep deprivation. That sort of context is often missing from the Internet and our parenting messaging boards, where everything from swaddling to potty training timing is presented as a matter of life or death.

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Oster’s in less controversial territory here than she was in “Expecting Better,” which suggested that women can safely drink during pregnancy. (Subsequent research has made that idea look even more dubious.) But the information here — covering the first three years of life — is nonetheless useful, interesting and surprising, and I found myself underlining facts in red pen not for reference for this review, but to later tell my husband and fellow mom friends. (Extending parental leave from six months to a year has no effect on a child’s future test scores! Those hearing loss tests at birth turn up a lot of false positives!)

Even without sexy claims about cocktails and pregnancy, there’s something provocative about “Cribsheet” — its suggestion that, even when there is evidence that something could present a harm, it’s okay for a parent to accept the risk and do it anyway. In a world where parents hesitate to let their kids go down a slide without first consulting their Facebook parenting group, that suggestion feels almost revolutionary.

There is something dangerous about suggesting that our instincts as parents can be trusted over official recommendations. That is, after all, how we end up with measles outbreaks and parents who think that a few hours of Googling trumps decades of established science. But in general, we are due for a correction when it comes to how we raise our babies. “Cribsheet” is not another call for the end of helicopter parenting or snowplow parenting or whatever kind of parenting is lighting up social media today, and it’s not a call to overthrow medical wisdom; it’s a call for parenting with context, and it’s freeing.

Perhaps no parenting issue lacks context more than breast-feeding, and Oster offers a thorough and clear-eyed assessment of its benefits. She dispatches with many of the overstated claims about nursing’s powers (it will not raise your child’s IQ) while upholding the benefits (in the short term, it reduces gastrointestinal infections and eczema in infants, and it provides some protection from breast cancer for mothers). Overall? “[I]t’s not a tragedy for your baby, or for you” if you can’t nurse or decide not to, Oster writes. “It is almost certainly worse if you spend a year sitting around feeling bad about not nursing.” That’s a wildly different message from the one women tend to receive before their babies are born.

What is so often missing from conversations about breast-feeding is preference. If the documented benefits of breast-feeding are really so slight, then we come down to: What does a woman want to do? Not what is best for this baby? But what do I — a human being who happens to also be a mother and didn’t stop having feelings and needs because I produced offspring — want?

If a woman wants to breast-feed because she loves the closeness it brings, or she finds it economical, or it simply feels right, then that is enough. No need to exaggerate the science supporting nursing. (Interestingly, this is more or less the same advice Dr. Spock offered on the topic decades ago.)

And conversely, a woman who finds breast-feeding too painful, challenging or time-consuming needn’t tie herself in knots to justify her decision to use formula, or try to suggest that there is no benefit to breast-feeding. She can make her decision and move on.

That seems to sum up much of “Crib Sheet”: Be informed, do what works, and move on. Because the next challenge — potty training, preschool, calculus — is just around the corner.

Jenny Rogers is deputy editor of The Washington Post’s Talent Network.

By Emily Oster

Penguin Press. 352 pp. $28

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