The Data All Guilt-Ridden Parents Need

What science tells us about breast-feeding, sleep training and the other agonizing decisions of parenthood.

Comments: 204

  1. This article supports what has long been my general philosophy when it comes to my own kids: nothing really matters as long as I love and interact with them. Thanks for confirming!

  2. I don't pretend its strictly a choice and not a product of a lot of intense social, economic, and other forces, but I am amazed at how articles on older parenting can ignore the elephant in the room. How can we worry about whether breast feeing or not has a modest rise in the lower risks to eczema when the entire choice to have a baby a decade later than our ancestors provides much greater health risks for parent and baby. The most highly regarded study on this issue does not make the choice a simple one. The results demonstrated that a mother and child is at the least risk for serious disability starting at 17 and with each passing year the health risks to mother and child grow the longer we wait. Our bodies were simply not designed for births in the late 30s and 40s. We are not talking about autism alone which greatly increases over this period as is much discussed. As a society, we should address this reality as well.

  3. @DoctorRPP I dislike biologically deterministic arguments, particularly when they are a veneer for one's opinion. Our bodies were also not designed to visit outer space or the depths of the ocean, but culture and technology allow us to surpass our design specs. I'd also like to see a citation for the startling fact that "our ancestors" didn't have babies in their thirties and forties. Prior to birth control, how exactly did they manage that?

  4. @DoctorRPP Were our bodies designed to live to 70-80-90-100? No. Were our bodies designed to live in heated and artificially lighted houses? No. Were our bodies designed to survive childhood by ingesting antibiotics? No. Were our bodies designed to learn to read? No. Were our bodies designed for office work? No. Your point is?

  5. @Texican I was a history major and as I learned, before birth control most married women had children right up to the age of menopause. There are historically some primitive methods of birth control, such as premature withdrawal, but they weren't very reliable. The Victorians had condoms, diaphragms, and vaginal douches, but many couples did not use them.

  6. Excellent article. Many women do not have the luxury of choice I tried breastfeeding, and did so up to six weeks with my children but with my work, it was impossible to keep it up, plus I had to go back to work after six weeks. I do agree with the author that more paid maternity leave would be extremely beneficial for mothers. At least 3 months paid maternity leave should be mandatory. Having a baby is a tumultous change, especially if a baby is colicky like one of mine was. I used sleep training with all of my children and was happy I did so because they ended up sleeping through the night at 8 weeks and I was able to get the rest I needed to make it through my work day. For most moms and dads today having to work is not a true choice. People work to give their kids a better future, to pay for healthcare, to pay for schooling. I now have the pleasure of babysitting grandchildren whose mothers are choosing more and more to breastfeed as long as possible. This is a good economic choice for them and has worked out well, but only because today, many work places support pumping and give moms time to pump. I agree with all of the points you make. Each child is unique, each family is unique and there is no manual. Grandparents, keep all of this in mind, and don't criticize your grandkids' parents. Just give them lots of love and support.

  7. @Silvana It’s also important to note that having to stay home isn’t always a choice either.

  8. Anthropologists and others who have had signigicant contact with hunter gatherers have noted that their babies hardly ever cry or throw up. The babies are held almost constantly during their first year by an average of 12 individual tribe members per day. They sleep in close proximity to their parents. I know it is unrealistic to expect our society to provide the resources necessary for this kind of intense child rearing. No one is to blame for falling short of this evolutionarily established, 200,000 year old standard given the demands placed on parents these days. But, what we might consider as trivial differences between these two child rearing practices may have profound effects on childhood development that manifest later in a host of adult maladies - many of which are probably due to a chronic dysregulation of the stress response system, a residue of the unresolved loss of secure attachment from childhood.

  9. @Anam Cara I wish this was more widely understood, if only to squash the myth of "traditional" parenting where one mother stays home with her children, alone.

  10. @Anam Cara Maybe this is why we moderns, for all our material advantages and sense of superiority over the people who have come before us, are so deeply unhappy.

  11. @someone Yes, both models - the one with both parents working, even with some initial parental leave after birth, and the one with one parent staying home to care for a newborn are utterly inadequate to establish the mentalization of a secure base within the child that is so necessary for stress resilience throughout life.

  12. I think the key to this is that it is mostly moms arguing with other moms about what to do. What is glaringly absent from this is anyone telling dads what to do. Are they agonizing over any of these issues? Do other men badger or cajole them? No. And if they do, it is only very occasionally, rather than all the time. They are also much less likely to have a major shift in identity after becoming a parent. So, while I appreciate this clearheaded look at all the issues, the most important issue seems to me the constant competition and criticism that women engage in on virtually every topic. (I certainly was expected to go head-to-head about whose labor was tougher.) I have no idea why women are so interested in this, but we are, and that is the real difficulty.

  13. Human’s compete for status over most everything. The more important the thing the fiercer the competition. Pregnancy and breastfeeding are female activities. They are important ones and involve a lot of effort over long periods. No surprise there’s a female culture that forms around them or that it expands to cover other aspects of child rearing. And no surprise that culture includes a lot of status competition.

  14. My wife did not breast feed. She tried but it ain't easy. Yet we, like many other educated couples, did a lot of other things - like making sure our son had a good diet, we spoke to him, read to him etc. Turned out fine and healthy. Sometimes there is too much advice. The doctor's advice not to think about it is spot on.

  15. As a pediatrician of over 30 years I am so grateful for this article. I spend so much time trying to debunk “truths” that are simply not based on convincing evidence and which stress families. I can’t wait to read Dr. Ouster’s book. Based on this article I think it will become a standard recommendation for my new parents.

  16. Breastfeeding has options too - you can always leave your nursing baby with a relative if you go to a wedding - with a bottle of formula, which in my baby's case, was a sometime thing.

  17. @Piemonte A bottle of formula? There's industrial strength pumps out now that work wonders. A bottle of mom's milk is better.

  18. Articles about how difficult it is to breast-feed are just as bad as articles about how important it is. Please remember that many new mothers really DON'T have any problem breast-feeding. There's no point in going into new-motherhood with doubts and with fears. Even if you're over thirty! New mothers have been figuring it out for millions of years.

  19. Disagree. When I had a ton of trouble breastfeeding, the main thing that pulled me through was hearing from other moms who had also had difficulties and eventually were successful. Made me feel much more hopeful and much less alone, which are two things any new mom needs. In retrospect, I would have had less initial angst when I had trouble if I’d known it was tough for many. Telling everyone it’s likely to be easy and women have been doing it for millions of years creates unrealistic expectations that for many of us - and this is anecdotal, but I know only one woman who had an easy time nursing and needed no support - doesn’t pan out.

  20. @Trilby I don't understand why so many mothers complain about how difficult and painful it is to breastfeed. Everyone I knew with infants 30+ years ago breastfed without difficulty. I was in a mother's group so I knew lots of mothers with infants. We are mammals. We have evolved to breastfeed.

  21. @Trilby I disagree. There are endless sources on why it's so great and virtually nothing to make you feel okay when you discover that--at least for you--it's really challenging. It's the first major mother thing you do and--oh no--it's not working! That can be devastating.

  22. It's best not to read any of the advice books at all. I raised my two kids the best of my ability. They turned out fine.

  23. For another perspective, I recommend not having any kids. No kids = no worries. And I'm not heartless; I understand the joy they bring and the blessing of caring for them... as an uncle to my nieces and nephews. Best of both worlds, actually. Try it!

  24. I have two grown children that are amazing. My ONLY advice to new parents is to {if possible} stay with your partner. I think babies, kids, teens, adult children need a tribe of people in their orbit that love and care for them. I realize this is not the point of your article, but I get asked often what I did and I can say that staying in my relationship with my partner, was the most difficult part of parenting, but the most important for the children. I loved your article!!!

  25. Stay with your partner if you’re in a love relationship. If not, get out! Staying together for “the children’s sake” is usually a bad situation

  26. @Kathy Zamsky "I think babies, kids, teens, adult children need a tribe of people in their orbit that love and care for them." Yes, that's the most important thing, whether or not you stay with your partner. In many cases leaving the partner is the best decision, but you can still remember how important it is for the child to have a circle of belonging. Not just one parent, a circle. That means you don't feel jealous of others who love the child, and you arrange for the child to spend time with others who care. In addition to the time you spend listening and loving yourself, of course!

  27. Ms. Oster individualizes and thus misidentifies the problem. Statistics tell us that breastfeeding rates in the US are lower than most other developed countries, with the lowest rates in poor communities. There are other significant inequities in the US when it comes to parenting support. The poorer the parent, the more limited the support (lactation help, healthcare, paid parental leave...and the list goes on). The US is also one of the few countries that does not adhere to the W.H.O code for formula marketing, with maternity wards handing out formula care packages to breastfeeding moms and allowing direct marketing of formula. The problem is not about mothers that can't or opt not to breastfeed, but that those who want to often can't.

  28. Wouldn't meaningful data require shared agreement on what a "successful" outcome looks like? My brother and his wife are high earners who work long hours. Their children we're sleep trained from the start and have, since birth, spent at least 10 hours a day outside the home. They're being raised to view their needs in the context of this earning paradigm, and their individual feelings aren't given much weight. They're also being raised in the church, with much instruction about obedience to authority. I'm sure, when they get older, the kids will be great employees and never question the social institutions that affect their lives, and their parents will be very proud. But if those were my kids, I would feel like I failed them at every turn.

  29. It's been interesting watching my sister have kids. She's constantly fearful of very remote risks over which she has very little control (eg, 1-in-100,000 children types of risks). Part of this is due to bad data/poor research and online hysteria, as this Oped describes, but a lot of it has to do with not reporting the baseline. For example, the author reports that breastfeeding reduces the risk of breast cancer by 20-30%. That sounds very large. But what is the baseline level of risk? What is the baseline risk for SIDS? I watch my sister try to lower the risk of her daughter dying from risks that affect less than 0.001% of kids. Is she 10% safer if that risk drops to 0.009%? Nope. It's a lie without the baseline. She's constantly throwing money away because the parent industrial complex tells her to do so. In some cases, she may actually be increasing the level of risk (eg, not exposing her child to some foods because of fears of allergies, which has been shown to increase the risk of allergies). Rationality goes out the window with parenting. Resource and sleep deprivation has been shown to reduce cognitive effectiveness and lead to poor decision-making. So parents making decisions about risks when they haven't slept or are carrying a large mental load is probably more dangerous. It seems like the best thing to do is to provide the baseline so they can make better choices and also tell them to get some sleep so they make smarter and better choices for their children.

  30. Thank you for the article! When my kids were born, I read the research on sleep training and came to the same conclusion: on average it improves sleep and inflicts no long term harm on the child. However, I personally didn’t want to do it and so I tried to find another kind of data: Does NOT sleep training an infant lead to more sleep problems for the child later in life? I couldn’t find any research on this, and and yet it seemed like an obvious question. Have any studies been done that look at this?

  31. I'm confused. The author is laser-focused on data-based decision making when it comes to parenting. She is politely skeptical about advice on breastfeeding, sleep training, etc. if it is not built on research that has a clear, randomized, empirical data-driven foundation. Yet she frames her entire argument inside the world of economics and the search for causation - and when focusing on a concept like "marginal value" she admits, "There may not be any useful data on this question, but economic theory still comes in handy.” So theorizing in economics is valuable, but in other areas it's not?

  32. This is a great article, ... although like the Muller Report, there certainly is a temptation to "jump to the takeaways," rather than seriously weigh cost-benefit considerations. Still, many millions of mothers would consider, for one example, breastfeeding differently if - I don't think the author actually broke new ground here - they felt that it did or did not have significant health benefits to their children. One thing that is NOT mentioned, however, is my "pet peeve" - cellphones, and even if one realizes that both the author and the column have more of a focus on babies and toddlers than tweens & teens, THE PROBLEM IS BIG ... and getting bigger all the time. The same "logic" that led my adult daughter and hundreds of thousands like her to buy her child a phone and insist that she "use it responsibly" - namely, this "might make a difference in an emergency" - is probably propelling the age-of-first-phone down from 15 5-10 years ago to 12 (?) currently ... to 6, maybe, in 5 years. And whatever anyone can say about screen-time - particularly tablets - in terms of children's welfare ... IS AS NOTHING, when compared to the seamy side of phone use. Yes - but briefly - I'm talking about cyberbullying and its seemingly tamer variants that all serve to undermine the self-worth of many, if not most, of those using such devices. Nobody would willingly expose his/her child to danger ... but that's EXACTLY what they're doing when they succumb to "but everyone has one."

  33. As a High school teacher, I cannot overemphasize the damage I believe screens are doing to the young. Many, many students simply cannot concentrate on a printed page—during reading time in class, my job is not to walk around defining unknown words or answer questions, as I did as recently as 2012–it’s to enforce the ban on phones. Three minutes in, the whole room begins attempting to sneaking scroll. I would urge all parent to put off screen time until late elementary school—no tv, no iPad, no movies. Trust you child’s ability to deal with boredom and not expect constant entertainment.

  34. @edtownes Speaking of which.... I advised my daughter with her two week old baby, please keep the cell phone away from you, at least 3 feet, when your are nursing, holding, or lying with your baby. At night, same thing, turn it off, put it on airplane mode, or just far away. Your baby will not benefit from being radiated, even if there are no studies for economists to look at. If you have wifi in your home, I'd suggest if possible, turn it off at night, or go wired. Same thing while you are pregnant by the way.

  35. There is research that shows that in the first 6 mos. of life, babies recognize their mothers by their sense of smell and react positively to that odor. If that is the case, it would be great if we could have paid maternity leave during that period to reduce anxiety separation for both mother and child.

  36. I breast fed, I sleep trained and I worked full time. Breast feeding was made bearable by advice from peer moms. Throw a bottle of formula in there when you just cannot nurse or pump. In my case, pumping was not working. I stopped nursing at 6 months. No problem. In my experience, sleep training helped the baby and child self-soothe. My kid was able to put herself to sleep anywhere. No awful bedtime drama. And almost always an enjoyable bedtime ritual with bath and books. Work. I love my career. It is part of who I am. Much better for my family that I went back. I am soo blessed to have had choices. I am also lucky that I ignored the buzz about what I was “supposed” to do. Later in life moms tend to have more choices.

  37. "In the United States, and most developed countries, more educated and richer women are more likely to nurse their babies. This is the result of a host of factors, chief among them a lack of universal maternal supports." I don't doubt that there is a lack of maternal supports for breastfeeding. However, as an economist, have you not heard of Nestle's campaign to hook mothers on feeding their babies formula instead of breastfeeding? When I was growing up in the 1970s, my family boycotted all Nestle products because Nestle had the exploitative practice of giving away "free" formula to new mothers in developing countries. Their breastmilk would dry up and they'd be stuck buying formula. Because they were poor, they'd put less powder into the water than necessary. And the water was many times polluted. Nestle changed the culture of breastfeeding. It was a good lesson for me as a child not to trust corporations. Corporations don't have your best interests in mind, only monetary profit.

  38. I’m all for a more relaxed approach to parenting. Our mantra has always been we’ll do what is best for our family. But many, including the author, find evidence to support their beliefs, rather than the other way around. For example, yes I can find evidence that colic is natural and will go away in time. But I also know that as soon as my wife stopped having dairy, our daughter stopped being colicky. Like overnight. There is strong evidence that the inability to properly digest dairy in the mother’s breast milk early on leads to intense discomfort. It’s so easy to find evidence to back up the choices we’re making. But the author misses one of the most important parenting guides that go beyond evidence: instinct. Humans have been parenting long before we had spreadsheets and science. Sometimes all the data may be pointing one way (like breastfeeding is better for a baby, WHICH IT IS) but if it’s painful or not working for you, don’t do it. Do what is best for your family, which means all members of your family.

  39. @NYLAkid You criticize the author for "find(ing) evidence to support their beliefs, rather than the other way around", and then you cite your personal experience as preferable to her review of diverse research studies? Then you criticize the author for "missing" instinct, a concept you don't (and probably can't) define? The line about "spreadsheets and science" lends still more to the sense that it's you, not the author, who is the master of cherry-picking to see what you'd like to see.

  40. @MA A lot of the effects they are seeing are small, vague, and don’t take into account other needs. Aside from back sleeping for all but the very very small number of babies who just can’t sleep that way, very little of this research leads to big, obvious recommendations.

  41. Thank you for this sensible and sensitively written article. These concerns are the stock in trade of my practice in Reproductive Psychiatry. Clearly it will be reassuring for my patients, but I will also make sure that the clinicians I train will read it too.

  42. This is a great article, but it cites only a meta-study about childhood outcomes for working or non-working parents, skipping the important new work on adult outcomes. The best available data (from large, cross-national datasets) suggests that children of mothers who work tend to have better outcomes in adulthood than children of mothers who stay home. (An article with preliminary findings was in the NYT a few years ago.) Among adults whose mothers worked: education rates tend to be higher for both men and women (compared to adults who grew up with non-working mothers); the daughters of working women tend to be more successful in their own careers; the sons of working women tend to have more egalitarian views about gender and to be better fathers themselves. The study found no difference in happiness or life satisfaction between adults whose mothers worked and those whose mothers did not. Mothers (and fathers) should make their own choices about whether to work or not, and I can imagine all the anecdotes about how people's now-grown children turned out to be "amazing" after (because?) they stayed at home. But since arguments about parents working are often couched in terms of how "successful" children will be later on on life, it is worth pointing out that the best research currently out there suggests that mothers can maximize their children's long-term life success by working, rather than by staying at home.

  43. Great article. And the author didn't even tackle the question of whether it's "ok" to mitigate unbearable pain during childbirth. (Ugh, don't get me started.) Anyway, you do find with most of these decisions that my grandmother was right when she advised my mother, who was worried about my brother giving up the bottle: "When he walks down the aisle, he won't have a bottle in his mouth." Yes, it was very heteronormative, but you get the idea.

  44. My own mother was horrified when I breastfed but I did so for almost a year which was also my last year in law school. I’d had an emergency csection and felt too awful to read the hospital’s brochure that said you might feel too awful to breast feed immediately. So I just did it. My child had asthma and eczema and ear infections anyway. Work. I’m a grandma now but I didn’t work full time for 12 years. I have never understood why people who are never home have kids. I can understand when one person works fewer hours. I can understand when people have 40 hour a week jobs. I can understand if both work part time but I just can’t get my head wrapped around the idea of no one ever being at home. Kids probably turn out ok but what does it say about parents?

  45. @Retiree Lady It says the mother has a life of her own. I’ve never understood women (because, seriously, how often is it the man staying home) who feel they need to be with their kids every waking hour. Once they start school this is even more ridiculous. The opportunity costs of staying home for the woman is in the millions, over a lifetime, and it’s not just economic, it’s social too. Further, staying at home teaches the children all the wrong lessons: dependence, a view that mommy’s job is them, etc. Obviously the most privileged classes of women have not dedicated themselves to playing nursemaid - that alone should answer the question. Cheers!

  46. @Retiree Lady It usually says that the parents can't afford not to work two jobs. I was lucky enough to be able to work part-time during my kids' preschool and school years, but I have many, many friends that cannot afford to pay for basics like housing, food, and medical insurance/expenses without both parents working full-time. This is a well-known problem in our society. In the 1970's and earlier, most families could live a comfortable middle-class existence with one parent working full-time, and one staying home with the kids. That ended, sadly, about the time of the first big recessions in the early 80's, and has never changed. In this era of contract work and "gig" economies, I wonder how younger people will ever be able to afford to raise families.

  47. @Retiree Lady, I was born in 1948. My mother went back to fulltime work at the Red Cross when I was six weeks old. I spent my days with a neighbor who had two teenage daughters. The girls taught me to whistle before I had any teeth. When my brother was born three years later Mother switched to a part time job supervising volunteers over the phone from home. (I learned professional receptionist skills then.) When I was in fourth grade she spent a year subbing for the Red Cross director of disaster relief and life was so much more pleasant. The next fall my brother and I implored her to go back to work. Which she did. It took me a number of years to realize that Daddy was almost certainly cheering us on. Back then we were latchkey kids but that didn't mean that no one was ever home. We had plenty of time with parents on evenings and weekends. We had breakfast with Mother and cooked dinner with Daddy many nights.

  48. With widely varying cultural practices, it must be assumed that there is a mechanism in all babies that allows them to respond to parenting practices such that they (the babies) will develop optimally.

  49. I hope the book goes beyond average effects to talk about heterogeneity. Given the scant evidence on many of these topics, I doubt it does/can. The reality is that all babies are different. I didn’t trust the sleep training research when my son was young for this reason. Even if on average babies aren’t harmed, some might be. And Ferber himself laments that his method - meant for babies with sleep disorders - went mainstream. I think it’s too early and the trials are too small to give parents a definitive answer on this question and many others. I appreciate that Oster is trying to ease guilt but the truth isn’t clear cut yet on many of these issues.

  50. This is all very scientific and heady. In the progressive cutting edge world of pre- and peri-natal psychology, much more emphasis is put on the quality of relating. The author's vision of how breast-feeding would go doesn't seem to include the emotional-physical pleasure of mutual bonding. Is the mother fully present with the baby while nursing? Or while bottle feeding? I'd wager that's a far greater determinant of outcomes. Secure attachment is at the heart of it, and that is directly connected to attuned eye contact (not too much, but often enough) and skin-to-skin pleasure.

  51. I've really enjoyed reading Emily Oster's book Expecting Better throughout my pregnancy, and as I enter the homestretch of my first pregnancy, I find this article really useful. At the end of the day, we all want to do what is best for our babies and our family. My biggest takeaway from Oster's work: no matter what you decide to do about feeding your baby/ teaching your baby to sleep and self-soothe/ make a decision about how much and when to go back to work (if you're fortunate enough to have that flexibility), there are a million different ways to do it, and someone else will probably think you should be doing it differently. The goal isn't to be the perfect parent, whatever that means; the goal is to do what's best for you and your baby. There are many right ways to be a good parent.

  52. Congratulations and best of luck! The best parenting advice I ever recorded was: “good enough is good enough.” It has become a mantra for me when confronted by well-meaning grandmas, competition parents, and phone calls to school.

  53. My only advice to parents-to-be is to keep a journal (a smart phone and it’s features are woefully insufficient). Diligently record your child’s milestones and your feelings, triumphs, and disappointments. I think ALL other proffered advice is incredibly presumptuous on the part of the advice-giver.

  54. @Human “good enough” was my mantra too - I did an undergrad in developmental psych many years before becoming pregnant, and the idea of “good enough parenting” stuck with me from those classes even though I took a very different career path. There are many ways to raise a happy, secure child and none of us have to meet some specific standard of perfection to get there.

  55. This is an article I'd pass along to parents or parents=to-be. I don't think that the issue (at least not the only issue) is that first time parents think that "working harder" will always get the results they want. I suspect it is because we have developed this idea that there is a way to identify and get the best -- the best shoes, the best cars, the best neighborhoods, the best baby strollers - - and so then, a way to raise the best child. Just do your research, and voila, the Consumer Report top pick will be obvious. Combine that outlook with a need to be seen as better than average - and then the decisions aren't just about good enough child care but ego care. On top of everything,with the internet, the sources of information abound. Too much input can be paralyzing instead of helpful. You want to be knowledgeable; it is not necessary - and utterly impossible - to be know every approach. Most choices that caring people make in nurturing their children do not have dire consequences. Many roads . . .

  56. From the Middlemiss study: All infants exhibited behavioral distress on the first day...On the first day of the sleep training program, all infants engaged in 2 or more bouts of crying. In contrast, by the third day of the program, all infants settled to sleep independently without a bout of distress...also, the fussing was less intense as well as shorter than the bouts of distress on the first day...Overall, outward displays of internal distress were extinguished by sleep training”.

  57. The fact that many women in today’s day and age have the education, time, and resources to spend countless hours “researching” and agonizing over whether it’s OK to bail on breast feeding at 10 months instead of knocking themselves out to do it the magic 365 days (366 if it’s a leap year?) puts them and their children ahead of 99.99 percent of the people who have ever lived. People used to worry about cholera, now we agonize over hair splitting like whether to serve peas or carrots first. It’s like they say about disputes in academia, the fights are so vicious because the stakes are so small.

  58. Thank you, thank you, thank you. As a working mom who had trouble breastfeeding and did sleep training out of necessity, I still look at my two fabulous teenagers and question whether they would be even more fabulous if I had done things differently. This is such a welcome perspective.

  59. @Riley2 Maybe they would have. Does it matter. We just have to let go of the idea that we will raise perfect kids.

  60. My wife and I had quite animated, ahem, "discussions" about whether or not we should sleep train our children. Both sides (me, for; her, against) could find ample books, websites, doctors and even other parents to support our respective position. (Alas, neither of us are clinically trained to assess the quality of data we were given...). We did not adopt a rigorous sleep training schedule. In the end, we got through it. In retrospect, one thing I will advise parents is that most couples really only have a few hours of potential "together-time" in the day - and those hours likely fall in the evening, after the baby should be put down to bed. Don't forget together time is important to being healthy parents too.

  61. Women breast fed for thousands of years, and there were no studies about it. Breast feeding is the natural order of things. It is beneficial to both mom and baby. Skin to skin contact is valuable to both, and important to the child's feeling of security. It is bonding in a way that artificial methods are not. Certainly, there are exceptions, such as a baby who spends a lengthy time in the NICU or medical issues in either the mother or the baby, but this close, early contact is important for the well-being of both baby and mom. I work with babies and children, and I am surprised to find that few moms breast feed anymore. In my view, both are losing out on a wonderful, close time with each other. Do 'studies' measure that? IQ is not a measure for these things.

  62. @TenToes I was breastfed growing up but my younger sister was not. The only difference between us is personality and height. I am my mom's height and my sister is my dad's height.

  63. @TenToes Or lack of sleep while the mother is recovering from giving birth and mastitis and cracked nipples can drive a mother into post partum depression. It’s comments like this that are unhelpful. Remember, for thousands of years the infant mortality rate was abysmal and frankly, formula is a modern miracle that help many children survive into healthy adulthood. Every new mother should read the common sense recommendations of the Fed is Best campaign instead of believing the hokum of the Breast and Best activists, whose strict recommendations send a ton of babies into the NICU for dehydration, jaundice, and even seizures every year. I see all these moms on social media desperately asking for lactation help, swearing they will never use the “evil” formula but asking why their babies cried all the time and were not meeting growth targets. It was painful to read because all those strangers would comment back unhelpful suggestions (e.g. up your milk production with illegal drugs from Canada) instead of saying something with common sense like get a scale to weigh the baby before and after feeding. If there aren’t enough ounces gained, then you don’t have enough breastmilk and need to supplement with formula.

  64. Each child and mother are unique, the situation evolves and there is no one size fits all for everyone. Listen to your heart and trust your instincts. It does help to learn from others experiences so here is mine. My son was "high need" wanting to be held constantly (we used a sling) and refusing to bottle feed breastmilk (didn't even try formula). I breastfeed because I wanted to, he wanted to and, because we were able to live on my husband's income alone, I could. I slept with him in his room for the first year in a queen bed. He used his crib for naps. This allowed all 3 of us to sleep better. I could just roll to my side in the night when he needed to nurse and my husband could sleep undisturbed in the next room. Eventually we developed a family bed. Because he was so attached, I could not leave him at mother's day out because he would cry until I returned and they asked me not to. Any time away from him would have to coincide with his next feeding so babysitting was limited. As he grew more independent, we were able to find a good woman with 2 other children to come to our house for half a day while I went back to work part time. I needed this time away to be in the adult world again. Motherhood can be very isolating, especially if you have no other family to help. My son and his father and I continue a very close and loving relationship. I would not trade that special time I spent with him for the world.

  65. Well thought out and practical advice. So many moms go through guilty feelings. I felt guilty about breast feeding and working but everything has turned out fine with my son. It's good to have data but we have to make decisions to suit our circumstances and needs.

  66. Parents should just relax and do what is most comfortable for them. If they are happy, the child will be happy. Parents need sleep, therefore sleep training is important and will not hurt the child, just the opposite (better rest for all after initial protesting). Breast feeding is great for both mother and child, but an occasional bottle of mother's milk or formula (I made my own from cow's milk) will diffuse any problem. Early toilet training (before stubborn refusal setting in about 12 months) is practiced in many cultures and prevents future fights, is better for environment and socialization (no big kids running around with full diapers). Unfortunately this common sense advice is now routinely ignored by modern parents.

  67. I completely agree with the author’s advocacy for data driven decisions. My wife and I took similar refuge in actual science. However, I object to the gendered assumptions in this article. The author makes occasional reference to “parents,” and maybe dads (did she even?) but in depth she frames all these decisions as maternal (well, breastfeeding really is but other than that...). This assumption of primary responsibility was likely her experience and remains the norm in most families. Its an unproductive assumption, though I doubt the author meant to do this. I doubt it because as a stay-at-home dad I encounter it all the time from otherwise perfectly nice moms: I’m excluded from invitations by the “class moms” at my daughter’s school even though I am listed as the primary contact. I was not invited to the village’s parental support group because of my gender. Me and my daughter don’t get asked on as many play-dates (maybe that’s me not my gender, idk. I’d be curious about the statistics on that). I get bewildered questions like, “so, do you cook?” These moms are all very nice, don’t get me wrong. The husbands of these moms are extra chummy with me when they see me but my wife would have more in common with their experience than I, frankly. Look, I (we dads) work around these things. I also recognize that stay-at-home dadness continues to be a transgressive career choice. No problem. I get it. Still...pushing for a little reflection here.

  68. @Aaron, yes, she does mention daddies. Take a second look. She attempted to be balanced.

  69. @AaronI love your post. Thank you for reminding people of the way gender assumptions can also diminish men. Hilarious: do you cook? Well, yeah, how could you not? The problem is that TV has shown us a generation of bumbling dads, and keeps presenting this as endearing and cute. It is not!

  70. @Northstar5 Cooking is something most adults should do to feed themselves and others , including any child over 6 months old. (Older babies can eat soup, mashed potatoes, rice, and probably several other things.)

  71. There is ONE parenting practice that is tied to much better outcomes for whole societies.... but nobody talks about it. CARRYING you baby. Carrying (and the jouncing around that happens when a baby is worn on the body of a moving adult) helps a baby's brain develop properly. This has been known since the 1970s from the work of James W Prescott of the NIH. The stimulation of carrying has a lot of effects on brain development, because the brain system that is most developed at birth is the part related to movement.

  72. @Megan Yes I carried my child all the time. I never used an infant carrier for him. it struck me as dangerous and, frankly, difficult compared to carrying a baby who hangs on to you and sits on your hip nicely. I didn't walk into the house and dump him into a baby seat, I sat with him snuggled next to me on the sofa while I read the newspaper or whatever. Babies need to be close.

  73. I also enjoyed Expecting Better and always appreciate Emily Oster’s perspectives on these topics. As a parent, we are bombarded with information and direction with the ultimate strive for perfection. We are all just doing our best. Given recent news regarding helicopter and snow plowing parents, it will be interesting to see the research and outcomes that result from this “perfect” parenting. As I reflect, points of struggle have been the biggest learning and life-skill forming opportunities, of course in the context of basic needs always being met - food, shelter, being loved. Our real task is raising independent and community contributing adults, and there are many paths for achieving that goal including potential flawed steps along the way that we as a family - parent and child - learn and from which grow together.

  74. Did I miss something in the discussion of breastfeeding? In a piece written by an economist, I would have expected some mention of the fact that if there are a minimum of logistical impediments, breastfeeding is cheaper and easier than bottle feeding. My kids are all in their 30s now but I breastfed them because there was no way I was going to go through all the nonsense required for bottle feeding back then.

  75. @spartanmom Breastfeeding is not “cheaper and easier” for everyone. Time is also valuable which significantly changes the “cost” of breastfeeding for many. And as she noted in the article, breastfeeding can also be significantly harder. Obviously individuals vary but for MANY breastfeeding is more expensive and harder which is why the accurate costs and benefits are so important.

  76. @spartanmom No. It's not necessarily "cheaper and easier". Did you have to go back to work at 12 weeks postpartum? Did one of those precious offspring have a tongue tie or struggled to latch? Drop off their weight/growth curve? I bet in the moment your postpartum experience was light years different that what you remember now.

  77. Finally , after the dinner, the baths, the reading and nursing, the 2.5 year old and 9 month old asleep, my daughter and I had some time together where we hugged and cried and I told's just really hard. My mother (family of 12) acted like it was just so rosy. Now I always stop to talk to moms and dads with babies and let them know how wonderful they are. It's one of life's greatest spiritual connections you'll ever have. Babies, children...can we just love them too much. And, new mothers....just a big thumbs up. I wish it was easier for you.

  78. Breastfeeding success can vary depending on the child, ask any mother with multiple births who had tried to do this. The main reason traditionally is it is the handiest, cheapest and best way to feed your child anywhere, anytime. It also provides the newborns with a boost to their immune systems. Best of all, it gives you a chance to bond with your own child in a way that no one else ever can, and this is very special time that you will never have again for the rest of your lives. It isn't always easy, can be very tiring if you have several children, but giving mothers maternity leave will give them time to do this and to rest.

  79. Great article! Finally someone who gets causality in a newspaper article and who has a proper understanding of chances. And finally someone who thinks independently and does not use science as religion.

  80. The debate about how to best nourish infants is so much more complex than the breast milk versus formula debate and probably no studies from the past reflect the current situation where babies are being fed a steady stream of chemicals from plastics, pesticides and other toxins. The question now is does breast milk or formula have more of these and how do we reduce them in whatever method we choose for feeding infants, In terms of formula, the formula itself can be contaminated as well as the water used to make it. In terms of breastmilk, the mother's exposures to toxins through diet, water, air etc are all passed on through breast milk. This is the world we live in now. Thank you capitalism and corporate greed. We are raising a new generation of chronically ill children (currently 1 in 2 children have a chronic health condition) and it starts in infancy. Actually it starts prenatally. We can make the best, most informed choices, but as individual parents we cannot transform the environment our children are growing up in.

  81. Thanks for this reality check. I breastfed my son until he was five. The reason? He developed asthma ( so much for the studies) as a toddler. During an attack, he didn’t want to drink or eat. But breastfeeding was a comfort to him, and it seemed to help him breathe better. This kept him out of the hospital where many asthmatic children are admitted for dehydration. This is anecdotal, but it worked for me and my son.

  82. A study I’d like to see is one that looks at breastfeeding success and mom’s upper body strength. Of course there will be many factors that influence breast feeding, but I can’t help but think that moms who can easily wrangle the kid into whatever awkward position works best for them will be at an advantage over moms who must build a pillow fort to keep the baby in place.

  83. Interesting discussion, but I came away saddened that at a wedding venue the only option to breastfeed was in a hot closet? Weddings celebrate family life, but yet the resulting 'family' has to eat in a tiny, hot, dark room. Seriously?

  84. All the data in the world can't convince me that letting a baby cry herself to sleep is a good idea. Crying is an infant's way of calling for comfort because of hunger, pain or need of a change. It is not humane to simply ignore the cries. Next time your adult partner asks you for help, try "shushing" them... ..and check out the data on divorce.

  85. @Ed this is the exact point of the article- and spoken like someone who either didn’t have kids or didn’t have a kid they had to sleep train. Read the *evidence* not your “gut instinct”- which is literally the downfall of this country. I *had* to sleep train. I always envisioned myself a crunchy hippy mom who would *never* let my baby’s cry. And yet, when my baby was six months old I was hallucinating from lack of sleep and working full time. My baby had, over the course of several months, started sleeping in shorter and shorter spurts and cry whenever he woke up without a boob in his mouth. Eventually, he was up every 35-45 minutes, all. Night. Long. I did that for a month and a half. I couldn’t co sleep because I couldn’t sleep with him on my boob, and he wouldn’t still cry whenever it fell out. I wasn’t fantasizing about suicide. And you dare judge me for sleep training, based on evidence, at a developmentally appropriate age (6months)? I went crib side and comforted him when he cried for two weeks (but didn’t give him the boob) and after a week he started only crying twice at night, which I judged to be hunger and kept feeding him. He was loved and cherished always. We both sleep just fine one night now, one or two night wakings to eat. We are BOTH healthier and happier. Your judgement is the authors exact point.

  86. Great commentary! As long as we're touting parenting decisions that might actually be beneficial for parents vs. their kids, women staying in the workforce after they have children is better for Mom's financial health, and working out of the home has little to no impact on her children's ability to thrive. People have accidents and become disabled. One spouse can die unexpectedly. And, of course, many marriages end in divorce. It's really important for women to be able to support themselves and their children, should the unthinkable happen. I can't tell you how many stories I've heard in my peer group where a woman who opted to be an SAHM and has been out of the workforce for 20 years, suddenly finds herself at the age of 50 on the wrong end of her husband's divorce papers. They can't find a job to save their lives because their skills are horribly out of date. Even if she's got a great lawyer and gets a generous settlement, who wants to be financially dependent on someone who doesn't want you in their life anymore? It's psychologically damaging, and prevents her from moving on with her life. In the end, let's all stop caving to the perfect mommy propaganda. Because that's exactly what it is: propaganda.

  87. I suspect that any evidence for stronger friendships among nursing moms is because one of the key factors in successful nursing is having a great and knowledgeable support system. It isn't that nursing at brunch strengthens your friendships--it's that friends who will help you latch your baby at brunch strengthen nursing. And on the flip side, having that kind of support can strengthen friendships. Being literally forced into a closet is never going to be a plus in the relationship category.

  88. Anyone who has raised their children through infancy, toddlerhood, adolescence, and teen years, will tell you that all the stress over breastfeeding, making your own foods, etc., is meaningless. What happens before school age is almost completely irrelevant. The family, school, societal, and environment forces that come as the child grows will completely overwhelm anything that happens before age 5. My wife nearly died of stress trying to get our children to breast-feed, in retrospect neither one of us can believe that she put herself through that. Treat your kids with kindness, read to them, challenge them to do well, and make sure they are safe along the way. Everything else is someone trying to sell you something.

  89. @Frederick What happens to children in their first five years has an irrevocable impact on the rest of their lives. This article and the responses seem to indicate that anything that gets in the way of the corporate machine is ridiculous. Skip the kids--go to work and be happy-- have more money, more vacations and larger homes. Don't bother with tiny beings who require all your attention when they're small. Get a cat.

  90. Since we don't even know what all is in human milk, I can't imagine that a man made substitute could possibly be just as good for growing a human infant. Ideally, our society would have all the supports in place to assist mothers with breastfeeding at the breast including knowledgeable doctors, nurses, hospitals, peer helpers and work place policies. No one has mentioned the use of banked human milk for those mothers who even with support are unable to breastfeed or pump. Nor mentioned the use of wet nurses. Human milk for human babies!

  91. Using data in the decisions one makes in caring for a baby ... really? Babies are emotional, feeling and reactive beings. They are need of constant care and someone who understands their needs as they are - not what is listed in some distant, data-driven report that has nothing to do with their moment by moment evolutionary needs. It is too bad that parents find solace in a scientist's opinion about what is right for their personal situation in caring for a baby. We are asking too much of these babies - and yes, asking too much of parents who juggle too much work, and too much societal pressure to keep up. I wish we could stop trying to force change on the little ones and focus instead on the societal and workplace changes that need to occur to afford the options for parents to be more attentive in the early years. Tune in to the baby and your own feelings and use that data to govern your actions first and foremost. I raised two children based on our needs and circumstances - and each child was very different - and it wasn't magic, it was hard (raising children is hard!) but I have no regrets and have two responsive, balanced, independent and loving young adult children as a result.

  92. @Elizabeth Yes! And thank you. You need to write the next op ed on parenting. Most of these "how to parent" articles are getting tedious.

  93. Great article. Multivariate analysis > univariate analysis. We should apply the same lens to the issue of the workplace, where too much has been made of pay and gender/race because of univariate studies.

  94. Whatever one concludes about any given parental techniques, any child is lucky who has a parent determined to find the best strategies for their well-being.

  95. The author is using different standards of evidence for each questions. She required strong evidence to support breast feeding, but she is ok with only limited evidence for sleep training. In any case, consensus in the medical sciences is better advice than an economist selecting few empirical studies without an understanding of developmental psychology, nutrition issues, etc.

  96. Parents should do what they think is the best for their child. I'd also like to state that articles like this rarely take into account the experiences of women of color. I'm a African-American and was a older mother in my early 30's when my first child was born. I resented the fact that it was assumed that I would bottle feed, even though I informed everyone I would not, and the hard sell of baby formula was insulting to me. As a professional costume designer, I breastfed my two children. I was in the fortunate position where I could bring my children (born six years apart) to the theater with me and had incredibly supportive directors and colleagues, along with a wonderful assistant who helped carry the load. My children were satisfied, happy, and docile and we had very few instances of a crying baby causing a disruption. Both also slept through the night throughout infancy. This was 30 years ago and I just assumed this was what you did at the time. Now seeing the struggle of new mothers working in the theater, I realize how fortunate and brave I was. I would breastfeed anywhere, including production meetings, while fully covered. This is not the case now days in 2019 as young professional women in the theater are advocating for more support for working mothers.

  97. @CojettHow things change! Fifty two years ago in the Jefferson Memorial Hospital in Philadelphia I gave birth to my first child. Being newly arrived from England, where breast feeding was the norm, I naturally expected to feed my son. I was told in no uncertain terms that “only colored people used the breast.” I persisted, hard for a 22 year old in a foreign country, and met with scorn. Picture the reaction when I cancelled the circumcision appointment! All this to point out the twisting turning nature of racism. Shame.

  98. The author’s interpretation of the sleep training study that “gets a lot of play” is biased. The study showed that (unsurprisingly) the parents’ and babies’ cortisol (stress hormone) levels were elevated while babies were left to cry themselves to sleep. Once babies started falling asleep without crying, the babies’ cortisol levels remained elevated at bedtime but the parents’ cortisol levels returned to normal. So, babies remained stressed at bedtime despite being successfully “trained” and parents lost emotional synchrony with their children. “Sleep training” was first invented in the late 1800s and has had multiple reiterations by persons looking to profit from selling their advice to ignore one’s parental instincts and train oneself not to respond to baby’s crying. One popular sleep training book states that it’s ok to let a baby cry at bedtime until she vomits.... and still do nothing to console the baby after she’s vomited. I do agree that our work obsessed, income-driven, culture, that is particularly unforgiving toward new parents and babies, does unfortunately force many families to turn to sleep training. Insomnia is a pervasive problem in our society which probably has roots in childhood. We certainly do not have enough data to assuredly state that sleep training does not cause any negative long term consequences.

  99. @CB oh wow - "lost emotional synchrony with their children." something else to shame parents/feel guilty about!! Good grief - enough already!

  100. Good article. My only comment is that Nature typically sets up things to benefit the species. Humans are mammals. Mammals feed their young through lactation. There must be significant benefit to this set-up or it wouldn't exist. Trying to measure "benefits" through the gold standard, double-blinded research is impossible. I would trust Mother Nature on this one.

  101. Absent the ability to feed a baby with formula, all mammals, including humans, would nurse their infants, having no other choice. Other mammals, with human support, have been raised on formula, not just humans. Your comment comment does not address the reasons or the efficacy of bottle feeding, and therefore doesn’t prove that breastfeeding is best.

  102. @BA I see where you’re coming from. I usually like to think this way also, but it’s hard when Nature interacts with stuff made by humans. For example, Nature set us up to be able to absorb as many calories from all our food intake, which makes sense if we are mammals trying to stay alive in the wild. But not so if you think that fast-food and other easily high-caloric food is readily available. Some people should not eat as much as they want every time they feel their bodies asking for it. The same with breast-feeding; one needs to consider the alternative. Given the demands for moms in this world, and the fact that we have baby formula (I’m not saying that it is perfect, but it is better than nothing for certain), it makes sense that at least for some families the “right” choice would be not to breast-feed.

  103. @BA That's nice, as long as you are are able to breastfeed. I wasn't, and was immediately shamed for it. My mother than informed me that she had not been able to either - nor had her mother and many of her relatives, or my paternal grandmother either. Our family, on both sides, are tall, thin, athletic, very highly educated (doctors, lawyers and engineers going back four and five generations) and consistently score in the top percentiles of standardized tests. If we had all "trusted Mother Nature," none of us would have survived to adulthood. I gritted my teeth and survived the nasty looks and comments from strangers and so-called "friends" as I bought formula in the grocery store and bottle-fed my son in public. He never suffered from any of the problems or illnesses "linked" with failure to breastfeed. He is now heading for college with a large scholarship after breezing through multiple honors and AP courses and scoring in the 99th percentile on the SAT's. I doubt that an extra IQ point or two would have made a difference. Obviously, however, I still resent the glorification of breastfeeding and the punitive treatment I received, and I do my best to let others know that lactation is not equal to sainthood.

  104. I loved “Expecting Better” and I can’t for her new book. For me having a second child has revealed the fallacy in thinking that my parenting choices have as much impact as I might have thought (or hoped) they do. Our first child, for example, never liked snacks — never had tantrums — and would run into traffic if we let him. Our second child wants to eat all of the time, has regular meltdowns, and can mostly be trusted to follow instructions about her safety. In other words, they have the same parents and have been raised with similar parenting strategies but they are remarkably different in numerous ways. That realization has taken some of the pressure off of my husband and me to parent (there’s that verb our parents probably never used once!) perfectly. What a relief.

  105. Wise words. Isn’t it amazing how different children can be? This is the greatest parenting challenge - let them be who they were meant to be.

  106. @LM Amen. Temperament plays a big role in how children behave and develop and there is often little credit/blame for parents to take.

  107. @LM, can't agree enough! I discovered pretty quickly how individual my children were. I followed their lead and let them be who they were within reason and safety concerns. They are adults with their own children now and they turned out great!

  108. This article makes me sad. I hope it's only a few data loving geeks who have to make natural processes so fraught with doubt and anxiety. Maybe this speaks to the state of our American society: motherhood is supposedly "revered", but definitely not supported.

  109. It really doesn't require a scientific analysis to know that mother's milk is the best thing for young mammals, including humankind. But there's very little support for nursing in America for working mothers, and I'm speaking more of the average female worker in the bottom 95%, not MBAs or other professionals who usually have some clout in the workplace. Too bad the so-called "evangelicals" don't vociferously support making this natural form of feeding/bonding that virtually every mother and child on earth experienced during the time of Christ easier to accomplish today, twenty centuries later.

  110. Stop looking for answers from experts. Mothering is mostly instinct. Just follow what the doc recommends in the way of shots and then relax. Breast milk has carcinogens etc. in it because of the air we breathe and the food we eat. In the end the kid will grow up OK in spite of parental angst. Our kids never had ear infections etc. I think just due to DNA so stop blaming parents for everything your kid develops or not. Older teens and the plethora of anxiety and suicides are more worrisome--save your energy for those years.

  111. Like Oster, I was very curious about "the data" when I was pregnant and wanted to make "evidence-based" choices. I read countless scientific journal articles about gestational diabetes and obstetrical practices. After an emergency c-section, my desire to seek data to inform my decisions waned considerably. I have found so much peace as a mother by simply following the baby's lead. Maybe the joy and challenge of parenting lies in the fact that the data, if it even exists, will never provide meaningful answers. Let's give new parents support (i.e. more time with their babies) rather than evidence-based advice.

  112. @Louise Data can provide meaningful answers on policy decisions, though, for societal benefit. Such as maternity leave. The distinction between data and the individual family is the same as that between statistics vs anecdote. It’s subtle for many. But the point is, general probabilities are certainly helpful and relevant, but only in a limited way, for each individual scenario.

  113. Much may be learned by new parents when listening to other experiences, reading books or observing statistics. But then, maybe not. My friend chose another route. She studied how orangutan mothers reacted to the needs of their babies and adopted many of their responses, including picking up and reassuring him when he cried. The result: That baby is now 17, has a genius IQ, is independent, self-assured, cares about and for others, and is well-grounded. They were not helicopter parents. They had minimum wage jobs. They were raising an older sibling with Asperger's. Their parenting life was beyond difficult but this was the path they chose. Their story is unique to them. Babies are not objects to be counted and used for statistics, only one more way, among others, that parents are encouraged to give way to information that feeds more anxiety and guilt. Each baby is unique and hopefully treated that way. Find other parents you admire and surround yourselves with their empathy and support.

  114. Thank you for putting perspective on the alleged benefits of breastfeeding over formula. As a society we should be celebrating the fact that we live in a time and place where there is an alternative to breastmilk that is widely available and leads to similar health outcomes for babies. Instead American women are experiencing at all-time high of pressure to breastfeed. Why? The whole 'natural mothering' movement does seem to be the backlash of the political left against women's liberation.

  115. Spz, I sympathize with being a first time mother and all that that entails. As a scientist, however, I feel compelled to point out that the benefits of breastfeeding are not “alleged.” This author’s article does a disservice to the scientific community and all of the research performed on the benefits of breastfeeding. See article . The most striking and significant difference is that your breast milk has actual living cells (immune) in it for your baby. This has an impact body wide. There are numerous health benefits and differences. We are learning everyday about the continual benefits of breast milk over formula. A recent study pointed out how breast fed babies have healthier oral microbiomes and receive a boost to their innate immune systems. ( As women, mothers, I believe what we need to be doing is advocating (dare I say demand) better support (linger paid maternity leave, in home breast feeding suppers, etc...) for women in America. Many woman want to continue to breast feed but due to the lack of support, stop. It is criminal how mothers and babies are treated in this country. It needs to change.

  116. Lovely and much needed. One criticism though. Present the data as Number Needed to Treat (NNT) - it is much easier to understand. For example 9% vs 13% diarrhea is a 4% difference so the NNT (the number of moms who do not breastfeed who would need to start to avoid one case of diarrhea) is 25. For breast cancer it is 12% (the lifetime risk of developing breast cancer) x 30% = 3.6% or about. And the death rate is about 10% so the NNT to avoid one death is 250.

  117. This article made me sad, and although my kids haven't been babies in 21, 18, and 14 years, I remember breastfeeding them not for the supposed benefits, but for the connection it gave us. I was fortunate enough to stay home with all 3 and could nurse them through their first year, and that was a very conscious choice. I wouldn't shame another mother for formula feeding, but those days of nursing were, for me, profound. And each of us should only speak for ourselves anyway -- parenting can't be reduced to numbers and can't be learned by a book -- it's about your family, your history, your background, your choices. As long as children are cared for and loved, they will make their way just fine.

  118. @MountainFamily There are many and varied reasons that some babies are not breastfed. These include, to name but a few, tiny little babies who lack the energy to suck, babies who are tongue-tied, babies who never learn to latch on, babies who are in the NICU, mothers who suffer birth trauma, mothers who suffer childbirth injuries, inverted nipples, post-partum depression, and mothers who must return to work within 2-4 weeks. I do agree that each of us should speak for ouselves only. Treat new mothers with kindness, please.

  119. Colic can be treated. It is usually reflux and there is medicine for that. My children all had "colic" before anything was known about reflux, but luckily for me doctors at that time gave medicine to calm their digestive systems before feeding. It was a drug and people now would say it might make them become drug addicts but time hasn't borne that out. I had "colic," my children had "colic." My grandchildren had reflux and got medicine for that, although at first the doctor was reluctant to diagnose it. He told my daughter-in-law that "babies cry." I told her that no, babies don't just cry. If they cry there is a reason. At first we didn't understand that bouncing them made it worse, so we bounced them. A little knowledge can mean a great deal! I tried letting my first child cry herself to sleep once but couldn't stand to think of that tiny baby, all alone in the crib crying. So, I never let my children cry themselves to sleep. That didn't mean that I gave in to their every whim and they didn't end up spoiled. They grew up to be sensitive and caring adults.

  120. I loved this. Thank you. I’m old now, my twins are 32, but I well remember all the guilt, and stress of making decisions on what to do and when.

  121. And data has its limitations..... I breast fed my son while he went from one ear infection to another..... i breastfed my daughter who had no ear infections.....

  122. Thank you for a wonderful humane piece that puts things in perspective. Parenting is oftentimes a fraught business sometimes made more so by other fraught parents. Also thanks for sharing unexpected insights such as the evidence base for a link between breast-feeding and breast cancer in particular.

  123. Thank you for this great article! I’m an adoptive mom to two boys who were not breastfed and guess what—they are healthy, handsome, athletic, intelligent and both attend the top private school in our large urban city. Parental affluence and education played much larger roles in their success (ie reading and speaking to them often as infants and toddlers, attending great preschools, etc) than any extra benefit from breastfeeding. I hope this encourages mothers who are feeling guilt about all the unnecessary demands and fear we now place on women to breastfeed for a year at any and all costs.

  124. I’m not sure what to think about these comments. My generation was mainly formula-fed ( in my family—born 1946-1960). None of us (5 kids) had allergies, asthma, ear infections, etc. We all have above average intelligence. We are all thin. We were all independent from a young age, because my mother threw us out of the house to play with other kids. We used our imaginations, and Ican’t remember ever being bored. When I was growing up, I never knew a kid with asthma, peanut allergies, or diabetes. Overweight kids were rare. Most of all I felt loved, and my family remains close today.

  125. This is the most amazing article! As the mom of two happy, healthy kids, I needed a reminder to stop trying to perfect their upbringing, and just enjoy it a bit :)

  126. Why didn't our parents generation rely on smartly researched info like this? Because they didn't need it- Back then Moms were comfortable in knowing that much of new parenting is "winging it". What is good for your cousin's child is not necessarily going to work for yours'. They were comfortable with the best piece of advice given to me by a member of that generation..... "You cant break a baby" (figuratively, of course). Each child is different, lots of trial and error is needed for each one. Letting certain children (at the appropriate age) cry thru the night is not going to cause them a life on a psychologists couch or hating their parents. Research-based parenting is another manifestation of the internet generation, that Doctor Google has the answer for everything in life.

  127. @megachulo No, it’s not. There were fewer data-driven studies back then, it’s not that everyone ignored the ones that did exist. It’s always better to have research based on data analysis, including for informing parenting decisions, but also for climate-change, the effect of x-rays, the efficacy of drugs, the effect of jail on recidivism, race/sex discrimination, and many more issues that require decisions. It’s also always better to consider the quality of the data and analysis, as Oster points out. She even does some of the quality consideration for us and explains it carefully and clearly. Bravo, Professor Oster!

  128. I've just had a quite wonderful experience at age 85. One of my beautiful granddaughters flew quite a distance just to visit me and bring her 3-1/2 month old son to get acquainted with great-grandma. Of course I loved every minute. And she's a wonderful mother, of course. Watching her and baby, and hearing her "scientific" explanation for every nuance of his development made me secretly wonder how in the world I ever raised 2 beautiful children in the mid-50's, successfully I might add, without the benefit of all of this information. With my first-born at age 22, I returned to full-time work after 3 weeks - no parental leave in those days, but somehow managed by juggling schedules and help from family members. With the birth of my 2nd child I took 3 months off work - what a luxury. In those days we just "did it". And I won't even get started with car seats and blanket binding the arms. One wonders how those children of the 20's and 30's made it into being identified as "the greatest generation". Ahh! Progress.

  129. Wise and calm pediatricians are wonderful. We asked ours if we should be giving our toddler fish oil capsules. She asked, "Did you take them when you were kids?" "Umm, No." "Well, you two seem to have turned out fine."

  130. Building a loving, safe, healthy, fun, inquisitive, progressively more independent childhood should be goal, not mastering or analyzing the latest trend (although economists do view life through analysis so I understand this writer’s approach). It does not matter who feeds & cuddles the baby - mom/dad/nanny/grandparent/sibling - just that he/she feels the love of touch, of soothing sounds, of having needs met. I breastfed my babies and pumped milk so dad could bottle feed because it was easy for me not because I was better or more loving. Several friends struggled and were miserable until they let go of expectations and started bottle feeding exclusively. It’s OK to breast feed, OK to bottle feed, most do a combination. It’s OK to work, it’s OK to stop working, its OK to work off & on - most families don’t have a choice. The one piece of unsolicited advice I give new parents is that its OK to leave a crying baby in the crib or to strap a raging toddler into the car seat and take a break for your own sanity - never hit or shake or scream or deprive. Talk your doctor if things are constantly overwhelming. Be gentle with yourselves and get some sleep.

  131. Data-driven parenting. Oh Lord, just take me now!!! How on earth have mothers managed to successfully rear babies/children since the beginning of time, without "data"!! Have women lost all nurturing instincts? Common sense? I think both mothers and babies were far better off when the others were younger and not so set in their way. When everyone on the block had babies, we all helped one another in innumerable ways. Experience sharing, even babysitting if one of us had the flu (no vaccinations then!). My strongest women friendships were made when I had babies/young children. Fifty years later, they are still strong. We did not compete with one another, we helped one another! That competitions comes straight from the workplace, no where else. We've got it all backwards today. Have babies in ones 20's, stay home with them, go back to work when they are in school full-time if that's your choice or necessity. There is still plenty of time for a career but that time for babies is not infinite.

  132. @India With all due respect to your experience, a working woman today can’t really do what you did, and what you're suggesting. We can’t just pop back onto the career path after taking months (or years) off. It’s hard enough to not feel out of the loop after going on vacation for a couple weeks. Professional life moves so fast now and there is the need to stay in, to stay relevant. Your generation had one reality, and this is ours.

  133. Great piece. I'm a child development researcher and I spend a lot of time with my pediatrician colleagues (who are the main conduit of "official" information to new parents). Our professions often give lots of poorly informed advice. It is sad (at least for me, professionally) to see an economist do it far better. The three most important takeaways are use common sense for your own situation, be informed by data, and don't feel guilty/anxious about your decisions. The first two are easy, the third can be hard for many. A note about the linked article regarding sleep training. Increased HPA axis activity (higher cortisol response) is expectable when infants are stressed. Infants also learn, and thus it is expected that they would continue to have a physiologic response to a previously stressful situation (even if they are not overtly distressed/crying). There is nothing inherently bad about lower physiological synchrony between caregiver and baby for a short period of time, nor is there any consequence for caregiver/child attachment (which has been a critique of sleep training). There are great benefits for everybody involved in being well-slept.

  134. There is so much pressure on new moms these days. I remember being caught in the "working moms don't love their kids" and "stay at home moms don't use their brains" conflict. After a year of working full time after my first was born I dropped down to part time, thinking I had made a Solomon-like decision to work somewhere in the middle. Ha! I went from being criticized by one camp to being criticized by both! It taught me a valuable lesson: do what works for you and ignore everyone else. Best parenting advice there is.

  135. I felt sad and frustrated reading this article. Parenting is a beautiful thing that should not be parsed by data, but felt deeply and informed by love. "Crying it out" is a terrible way to start a child's life, and damages the child's sense of security. Just as important is the effect on parents. Crying is a child's way of communicating a need, and we are hard-wired to respond with empathy and fill that need. Suppressing that instinct damages the parent's sense of empathy toward the child, and I believe that damage lasts. We raised three daughters with empathy, respect and love, and did not experience the "terrible twos", or even the "teenage terrors" that people loved to warn us about. Children behave as well as they are treated.

  136. Agree. Even supposedly enlightened, educated people may push inappropriate advice on young parents. Grandparents are often the worst, interfering with primary attachment bonding with intrusive advice. As much as my in-laws loved their grandkids, there was constant undermining of our primary family attachments. My MIL was the child of an abusive alcoholic married to a functional, 'benign' alcoholic and very emotionally insecure. For us, it meant a lot of stressful interference in everything from nutrition to discipline and continuous boundary violations for us parents and as a couple. There is a lot of love and affection but still a nightmare to manage while raising kids. If grandparents are heavily involved/interfering in parenting and the primary family life, there can be a lot of negative effect because of the ideas and emotional baggage they bring. Still, today, my kids are all kinds of different, but the same kind of wonderful. One is super independent, not too communicative but making his own decisions, guiding his life and at heart, deeply loving. Another is a great communicator, very perceptive interpersonally and a delight to be around. Another is very comfortable with affection and talking, self-motivated, thoughtful. Life is challenging. Raising kids is a special peak experience that nothing else can compare to. My husband and I feel very fortunate to have each other and our children, whom we love, respect and accept unconditionally.

  137. @Virginia Fowler so there were no occasions when a knowing parent who knows what is best for her child tolerates them crying? really?

  138. @Virginia Fowler I think you mean that this is your experience--not an objective truth.

  139. So many of these comments fall into the error of fallacy of composition (thinking what may be true for one part is true for the whole). Yes, many past generations and many individuals today were raised by 'trial & error' or instinct, etc. But that doesn't mean having reasonable data and understanding the difference between correlation and causation won't help parents make better choices. Enjoyable read and probably useful to parents today (mine is grown).

  140. Thank you for this important piece. When I was a new mom to my second child (and a fourth year medical student), I asked my kids' brilliant pediatrician (who was an uber-respected rockstar at one of the country's finest academic medical centers) "what is the minimum amount of breast-feeding you will accept from my this time around?" His reply remains one of the kindest things anyone has ever said to me: "Whatever works for you and your family." I will never forget it. The holistic physical and mental health of the entire family unit is the most important thing for kids.

  141. 46 years ago as a young first time mother I was filled with anxiety. I was convinced that my daughter was not developing at a “normal “ rate according to the books I was reading on infants. When I question my wise old Maine pediatrician if her development was normal, he replied “it’s normal for her”. End of discussion. I stopped reading the books and she turned out to be a smart caring young woman and a less anxious mother than me.

  142. This is certainly an interesting read, and I do like the author's encouragement for mothers (and all parents) to relax. But she may be missing the point of WHY some of these decisions are difficult. Certainly, the overwhelming amount of contradictory advice doesn't help. But I believe these parenting decisions become stressful because our country provides parents with very little support. There is no paid leave, many mothers have no choice but to return to work within a few months of the birth of their baby. When they do return to work, they are faced with the prospect of incredibly expensive and often sub-par childcare. And so, decisions like breastfeeding and sleeping become fraught, knowing that there isn't a "right" way to do anything given the financial stresses and time constraints of trying to find a balance of work and what may be best for your child. As a scientist myself, I appreciate the author's embrace of randomized trial experiments. But even more can be learned if we look to other countries and other cultures to learn how to better support families.

  143. as a pediatrician, I LOVE THIS ARTICLE. too much of parental advice involves virtue posturing, and wishful thinking ( I recently had a mom tell me that she doesn't have to vaccinate her children because she believes in the benefits of breast feeding, as if people hadn't died from the measles before formula was invented!). If there isn't science to prove (or at least suggest something) it is no more than someone's opinion.

  144. Well, what could be more controversial that the Mueller report? Breastfeeding, I guess. I wonder if we'd have this debate if it was men that are breastfeeding. Let moms do what moms do best: decide over their own lives and bodies. Then the rest of us should support those choices, not make them for them.

  145. Thank you Emily Oster. It is true; reliable and valid results drawn from normal data samples confound. What do we really know? I mean about anything. Never mind something as horrendously complex as child rearing. The generation of immigrants who live here often marvel at how we were raised by impossibly overwhelmed, impoverished, struggling set of people who regarded running water and indoor plumbing as total luxury, and never thought electricity would be a full time thing. Superstition drove them into the same level of parenting as data is driving me now. We survived contaminated, amebic water with high levels of lead. Food was mostly spoiling, low on protein. Schools were distant treks, shoes were luxury, no one had text books (till class 3 I had a slate and a chalk). If you were born during harvest, you spent the first few weeks pretty much left on the floor for long periods of time without clothes to be cleaned at the end of the day by completely exhausted people. Not sure whether my statistics-based understanding of child rearing has produced any better or tougher kids. Our kids live in luxury, and are raised by paranoid, driven parents. Results are comparable to those produced a hundred years ago; statistics has not liberated us at all, they have confounded. I could argue that better parenting data has served equally to better equip them as it has to deskill them and render them self-absorbed. Thank you for your effort.

  146. I breastfed all my babies, not because I really believed in any amazing benefits, but because it seemed so much easier than bottlefeeding. I didn't have to worry about bottle warmers or sterilizing or choosing the right formula, or mixing or any of that stuff. I was also too lazy to do cry it out. My babies ended up good sleeper despite that lapse.

  147. Helping our kids take calculated risks is part of parenting. Calculating the risks is as well. There's nothing wrong with using all the data you can find to help you in what is likely your life's most important project. Look around you at nature. Helicopter parents, all.

  148. Interesting points but the description of "working" and "at home" parenting states that children of "working" parents do better than those with a parent "who does not work at all." Staying at home to raise children should be seen as a serious decision and at home work is a profession in itself, using many diverse skills.

  149. Some of the comments here are frustrating, in that they assume that the author is someone pushing the argument that you need to use data to drive how you parent. She's not doing that. What the author is doing is recognizing that we have a complete and utter information overload in our parenting era, which has produced tons of anxiety and misinformation, along with a cultural bias that you MUST do something (i.e. breastfeed) or else you are a failure of a parent. By recognizing that the cat is out of the bag, and parents have access to a ridiculous amount of information - from error-prone studies to the comments from the mommy blogger down the block - the author is trying to get the conversation back to a rational, factual place. She isn't saying you have to do it one way - in fact, she's saying that all those people who say "you have to do it this way" are wrong...and here's the data to prove it. My therapist - who is a post-partum specialist - always says the right thing when it comes to parenting. She says "if that works for you, great. If it doesn't work, try something else." It's an incredibly refreshing thing to hear. Because when it comes to bringing up an incredibly complex, unique human being, who comes in one out of an infinite number of possible forms, there IS no one way. And that's what the author is saying: do what works for you and your child, and no one else.

  150. @Phil Edelstein @drgmpls Fabulous well written response. This overload of data is wrecking havoc on parenting! When the pendulum swings the other way- these chikdren will follow their intuition and instincts. That is what those qualities are for.

  151. I think a lot of people are missing the point if this article. Oster isn’t saying you need to base your parenting on studies. She’s saying that much of the advice and recommendations parents receive are really based on little to no evidence.

  152. Best parenting article ever. Can't believe how many parents (usually moms) are stressed out by the pressure to breast feed/pump, stay home, hold the baby 24/7, and all it does it make everyone frustrated, and in some cases clinically depressed and angry, and you can't have quality time as a family when everyone is fed up. For heaven's sake, there is no one answer for every family, and this is a great affirmation for frustrated parents who are willing to listen. Be flexible. And rational.

  153. The amount of knowledge and mastery that I feel compelled to have in every aspect of my kids' lives is impossible and overwhelming. When I think of what my parents and my husbands parents understood about the decisions they were making on our behalf I am eternally jealous. I think of me playing in the back of our station wagon with no seatbelt on as we drove, my mom smoking Benson & Hedges out the window. Now we are supposed to hire car sear installation experts! But I also see the effects that my husbands undiagnosed ADHD and learning disabilities have had on his life. Our son has the same disabilities and attending to the doctors appointments, insurance, school meetings, IEP meetings, advocacy, research, and reading over the last 9 years has given me symptoms of PTSD. My husbands parents utter ignorance and trust in systems of authority to know what was best (his fancy British boarding school telling them he was lazy and stupid) essentially meant it was up to my husband to figure it all out when he was and adult. I know the data on what the consequences of doing the same for my son would be. All of this data is informative, but somehow, no matter what the data says, it always lands back on the parents having to do more.

  154. @Micaelady Excuse me, I have actual Post-traumatic- stress-disorder from having been repeatedly terrorized and abused by my mentally ill mother when I was a child. I will be on medication for the rest of my life in order to be able to breathe. So please don't use the term PTSD lightly nor as a way to dramatize the self-induced hardships of hyper-parenting.

  155. @Independent I sympathize with the hardship you experienced in your childhood and wish you healing. I do hope you can step back a see that micaelady is experiencing real distress in her life as she struggles to care for a child with special needs. I am sure that she means no disrespect to anyone suffering severe PTSD but given the tone and palpable anxiety in her comment, can we avoid negating her experience which seems to be approaching a level of stress that is compromising her in a manner that may well be a degree of disordered stress response on a continuum, though well below what many such as yourself suffer. She is stressed and suffering and I do not read it as being dramatizing.

  156. @Independent I had twins, one of which was a medically fragile child with a gene mutation who died after 18 months of feeding tubes, seizures, and respiratory infections. The other twin also has special needs- ADHD and learning disabilities. I have spent 9 years navigating the hellish world of the medical and educational horror that is the social-darwinist social support system we have for children in this country. You will find many studies that show that parents of special needs children suffer trauma similar to that of combat veterans. This was a diagnosis I was given by my therapist- not due to the severity of my children's disabilities, but from trying to get them support services. My point is that we, as parents, are slammed with a firehose of information without the proper support systems to navigate it. I believe this article attests to how frightening and stressful all of this information is without knowing what to do with it.

  157. I wish Dr Oster would stop framing data analysis and evidence-based reasoning as some special trick of economists. Most economists I know, including collaborators of Dr Oster’s, have excellent but rather narrow quantitative skills, and most of these skills are standard education in many scientific fields. This is not to disparage the work she is doing (although I know some reproductive scientists disagreed with some of her interpretations of the literature in her other book, and I will be curious what psychologists and human development scientists will think here). This is mostly a plea for economists to back off the horn-tooting a bit. Dr Oster is not the worst: read Ayres & Nalebuff for a painfully self-congratulatory and slow re-discovery of the scientific method, cluster randomized design, and causal inference. But Dr Oster, maybe you can help your profession improve its reputation a bit. The recognition that economists are using basic statistical and scientific approaches might actually improve the flow of ideas into economics and strengthen research. Other fields might learn things too.

  158. @Scientist Economists will stop pointing out the difference between causation and correlation when other scientists start recognizing that difference for themselves. Public health is the worst offender in this regard. So many recommendations that come out the organizations supposedly run by trained scientists and doctors are based on observational data with absolutely no indication of causation. I think this has to do with the fact that in the basic sciences, it is feasible to run controlled experiments, and so inference is quite straightforward from a statistical perspective. Scientists then fail to recognize that this is not the case when using observational data. The methods available to deal with this problem, for example, instrumental variables estimators, originated in econometrics departments, not in public health departments.

  159. Thank you for framing parenting as work.

  160. Has this economist gathered data on the effects of breastfeeding on mother baby bonding? Not everything in the world is measurable.

  161. Best advice I got: Trust yourself. Enjoy your baby. If they are crying, don’t take it personally; babies cry, just accept it and be with them. Half the time it’s because they are tired.

  162. Thanks for this! The reality is that the real but modest benefits something like breast feeding provide do not outweigh the reality that many women struggle with it for a variety of reasons. Shame on the medical establishment and society for the undue pressure driven by oversimplification of this [and other issues] you discuss with thoughtfulness.

  163. I’m so tired of these anti-breastfeeding opinion pieces that pop up regularly here. Look, nature designed human milk for human babies. Just like she designed elephant milk for elephant babies and kangaroo milk for kangaroo babies. Breastfeed or don’t breastfeed, but don’t pretend that a healthy mother’s milk isn’t the perfect food for her baby.

  164. @Patricia Sears Nobody is arguing that it isn’t nature’s Plan A. What many people object to is the strident hounding of women for whom it really doesn’t work out. Thank heavens we have a safe and effective Plan B, and being glad for that is not “anti-breastfeeding.”

  165. @Patricia Sears And I’m so tired of the insane, lactivist rhetoric that makes “healthy mothers” who can’t breastfeed (despite lots of interventions, medications and an overwhelming sense of despair about not being able to breastfeed, compounded by postpartum hormones that already make one feel overwhelmed) feel that they’re failing their children by not relying solely on breast milk. Breast milk is great if you can provide it, but if not, formula is just as good, because the alternative is your baby dying, or in the case of some, allowing your baby to suffer irreparable brain damage (cerebral palsy is a real danger) caused by severe dehydration. I’m tired of the sanctimonious opinions of other women who don’t understand what an emotional roller coaster it is to try for months to breastfeed, and to simply have to give up, because your body just won’t comply. Or what it is to carry that sense of failure years after your child is grown, healthy, and shows none of the signs that formula was in any way harmful for the few months out of their life that they had to drink it. I’m sorry, but if you haven’t been on the other side of this “breast is best and you’re a horrible mother if you don’t breastfeed” crock of baloney, then you should just sit down and stay silent. Because you’re just perpetuating mommy-guilt and mommy-shaming and who does that benefit? You want a balanced view on this topic? Read “Lactivism” by Courtney Jung.

  166. So basically this article is saying that you should just trust yourself, use common sense and know whatever you worry about, or do, you are not alone. There is no "right" way to parent other than do your loving best, and don't compare yourself to anyone else. More data is not necessarily helpful because, as we know, data can be made to prove or disprove anything. It doesn't matter what books or experts "advise" - by all means listen or read, but if it doesn't work for you the advice is useless.

  167. @Sam "More data is not necessarily helpful because, as we know, data can be made to prove or disprove anything." This claim is anti-intellectual at best and outright misleading at worse. Data can be manipulated sure but that can be sniffed out. Data CAN and often does reveal objective truth, to say otherwise is nihilistic and frankly, cringy.

  168. I’m a full time working mom (physician, so I love data) and I’m still nursing my 15 month old. I agree with some of other comments here that articles like this that espouse the viewpoint that “breastfeeding is hard, so just use formula because the outcomes are not significantly different” are not helpful. Breastfeeding is the biologic norm and does not need to be proven superior to the alternatives. It is hard for many because maternity leaves are short, sufficient time is not provided at work for pumping, and women feel the need to nurse in 100 degree closets with covers on. I have continued to breastfeed because it makes my baby (and me) happy, which is normal. It was not easy to get through the first year while working, and I completely understand why other women choose formula. But if we as a society continue to demand evidence that breastfeeding is superior to formula, support for nursing & pumping will continue to diminish, and women will feel increasingly pressured to forgo breastfeeding. We can support breastfeeding without vilifying formula.

  169. @SD. You should know that many of us needed to breastfeed in a closet because our highly obervant and social babies wouldn’t feed well with the distractions out in public and a closet might be the only place with the proper lack of stimuli. As a physician you should be aware that every baby is different and not major assumptions.

  170. I didn't breast feed our son because I had to relocate to another country with my husband. My husband insisted on sleep training on our son. I did quit my job and stay at home as a full time mom for several years. I had never joined any mommy groups or listened to any moms' advice. My son has always been a great kid, mentally and physically healthy, hard working, intelligent and a bit nerdy. As a parent, I realize that every kid is different and what makes a kid thrive is gene, stable and normal family, loving atmosphere, caring parents, solid and consistent support and most importantly, parents behavior as role models. Breast feeding or not, it doesn't matter that much.

  171. With 8 billion people and counting, having children is just an expensive vanity project in this day and age. Don't try and act like it's anything else.

  172. @Childfree Woman Maybe large families are an issue and you should aim your bitter censure in that direction. Family per se isn't a vanity project but a leap of faith, a beautiful affirmation of humanity. I am sorry you cannot see the value of that. People don't need to stop having children, they just need to stop having too many.

  173. I am so sick of people trying to downplay breast feeding. I get that it's hard. I've breast fed three kids while working full time and have spent my fair share of time in uncomfortable places with a cry/hungry baby and pumping in closets. Breast feed or don't breast feed. Do want works for you, your family, and your situation. Don't feel guilty if you don't breastfeed, or when you stop breast feeding. Ignore other people's opinions because they are not you, they are not feeding your child, and they get no say. But please stop touting reasons why breast feeding is just not that great, not worth it, or over hyped. Breast feeding is good, and it's okay to not do it too. I saved money by not buying formula, but spent money on pumping supplied. This whiplash of breast is best and now it's not is ridiculous. Judging people on either side of this also is ridiculous. New moms need to hear that they should do what works for them and ignore the naysayers on either side. Also, come out of those closets - it's okay to breast feed in public. Once I came to terms with that, and as my baby and I got better at nursing discreetly, it made my life a lot easier and made me less self conscious. Generally, people are not paying attention to you and won't even notice.

  174. @Vmaria honestly everyone has different experience. Formula is almost as good as mom's milk nowadays. I genuinely don't see why you have to be sick of people's different opinion or experience. Take it easy. There are many ways of raising up a kid.

  175. @TT there have been several opinion pieces lately in this same vein regarding breastfeeding. I’m tired of parents who feel the need to downplay its benefits. I’m sorry others are so judgmental about mom’s choosing to do it or not do it. My point was that parents should make the choice they want and not feel the need to degrade the opposite decision.

  176. @TT It's impossible - and false - to say that "formula is almost as good as mom's milk nowadays". To begin with, they still haven't even identified all of the multitude of components in human milk. It simply cannot be artificially replicated. Yes, formulas are better than they ever have been, but they are not and will not be "as good as" breastmilk.

  177. Data. Who raises children based on data? This horrifying opinion piece relegates breastfeeding to a primitive practice that civilization has finally freed us from. We're back in the '50's when we were told science had all the answers. Then there is the bias against that icky practice that I just have to at least try if I am going to be a good mother. One question: Why is an intelligent, independent woman in a closet feeding her baby?

  178. my experience is that short of abuse, neglect or deprivation, people generally turn out fine. there don't seem to be parental fine tuning knobs on shaping personality or intelligence. how many of you think your parents created your personality? I think parents of infants overestimate their influence on personality or disposition. so far as commenters boasting about their kids with genius IQ, my experience is that high intelligence generally doesn't correlate to self actualization.

  179. @just a mom Certainly parents can be abusive or particularly bad examples, but the biggest influence will be the friends the child has or doesn't have.

  180. @Pundette, by telling a woman who produced very little milk about sitting in the sun to make breastfeeding less painful, you have completely and utterly missed AhBrightWings point (and the point of this article). I had the same problem. When we put a bottle in my 2-week-old son's mouth for the first time, the relief was visible on HIS face. At last, he was getting food, rather than working for 40 minutes to get too little. After that day, he finally started gaining weight. That was a horrific two weeks for all of us, but especially for him. Yet before and after that day, I felt hounded by smug breast-is-BEST (and bottle is WORST!!) types who sent a clear message that I was failing by using a bottle. They were "concerned" and invited me to "drop by the clinic for help." For the life of me, I can't understand why this kind of ideological pressure is put on women, especially when we're most in need of honest, objective help. I salute Dr. Oster!

  181. " I work because I like to. I love my kids! They are amazing. But I wouldn’t be happy staying home with them. " . This quote pretty much says it all. When you decide to have children, their needs come before yours. That includes setting up their microbiome for LIFE by breastfeeding , figuring out WHY a child would scream fro hours ( clearly there is an issue that needs so be worked out , like possibly digestive issues from some chemical laden formula, or say, life long abandonment and attachment issues from " not staying home with them" because you wont be happy. Mind blowing.

  182. Working mothers have higher ratings of self worth and self esteem and this translates to long-term happiness. Having something for one's self provides an identity other than "mother". When you're holding a newborn, it's hard to realize that, soon enough, the infant to toddler to elementary school transition will be complete and that per-adolescent is ready for independence-- including time away from parents (especially omni-present mom) and in their own space or with friends. I think there is a sadness and possibly even a kind of depression akin to post-partum that mother's-- particularly those that have been so very involved in their child's development-- experience. With all of the research on being a good parent, I wonder about the need for research examining how to be there but also on how to not be there and to be ok with that. Raised right, our babies grow into good citizens that can think, feel, and act on their own. They get to have their own desires, preferences, and secrets. And they should-- after all, we did (didn't we)?

  183. As one who came down on the easy-to-criticize side of all three topics here (I did NOT breastfeed, we DID sleep train and I DID go back to work after my maternity leave -- and ooh boy did I get a lot of feedback from other mommies on all three...), I enjoyed this and loved the ultimate suggestion that every family situation is unique, and there is no right or wrong; as a researcher, I also appreciated the data analysis and alternate translation of results that can yield to different recommendations (which is good advice that all should heed when reading research). At the end of the day, parents need to make the decisions that are best for themselves and their kids; my daughter is 18 now, and did not suffer from chronic ear infections, is not obese, and does not appear to suffer from attachment issues (most days at least...). Others should suspend their judgement and often ill-informed and/or intrusive advice!

  184. I have three adult children who turned out very well - intelligent, socially and politically engaged, successful careers, lovely partners and loving relationships, really close to their parents but independent in running their lives. It is kind of what every parent hopes for. I had a 6 month maternity leave with each child and worked 3-4 days a week while they grew up. I breastfed but moved mostly to bottles when I returned to work. I let my children cry it out, travelled for work and pleasure without the children, spent time with the kids but also prioritized my own need for sleep and mental stimulation to keep my sanity. Maybe I was a selfish mother but I was happy and so were my kids. Why do so many teens and young adults suffer from anxiety? Mothers who always put their kids before their own (and their partners' needs) aren't always raising independent and self-reliant people. Live your life and enjoy your children. They will turn out fine.

  185. As grandma, I am enjoying learning all the new data-driven parenting behaviors that are helping new moms and dads better enjoy their babies. Dr. Karp's 5 S's are a perfect example; going thru the list never failed to quiet "colic". How else can a three month old tell us that he is tired of being held and just wants to lie quietly on his stomach? Sleep training isn't a big deal when it's used routinely on a well-fed baby from an early age. Breastfeeding and putting baby to sleep safely in his own bed work well together. No need to risk SIDS. My daughter is a much better parent than I was thanks to the new data.

  186. I've breastfed, co-slept with them instead of sleep-trained, and stayed home/homeschooled 2 children who are now in college. Do you know what is best for all children and families? Nothing! What worked for me and my family may or may not work for you are your family. Breastfeeding, co-sleeping, homeschooling are no more a panacea to society's and one's family than bottle feeding, sleep training, and public schooling. Ultimately the hardest decision you will make as a parent is to listen to your children and yourself and do that regardless of what society, friends, or other parents say is best.

  187. @Pegeen Yes! Thank you. What i was trying to say in my sarcastic way.

  188. Dr. Oster deserves our admiration for exposing, repeatedly and systematically, that much of the advice we receive from fellow parents or even from physicians is farfetched, based on little more than hearsay and speculation.

  189. There are many ways to say “Do what makes your life and your baby’s life easier and more relaxing.” Parenthood is a volunteer situation. At least it should be, by choice and design (looking at you, you “pro life” forced pregnancy folks). When seen as such, and accepted it becomes a bit easier to get with the program as it were. But can we please ditch the nursing covers? The nursing in closets? Bathrooms? I nursed everywhere from the Madison Ave bus to the bread aisle at the supermarket. I looked at my baby, figuring that if I can’t see them, they can’t see me. Modesty can be maintained with a modicum of effort. If folks are put off by doing what comes naturally, it’s their problem not mine.

  190. @Pam Nursing class for both parents before the babe is brilliant. Would have probably not tried nursing a screaming baby in a 100 degree closet. I am cheerleading the class, not criticizing the Mom.

  191. So true! How is it that breastfeeding our babies in 2019 is still deemed some sort of shameful activity, such that it needs to be covered up? I nursed both my babies in the 1980s. Nursing "covers" did not exist except in the form of what we used to call receiving blankets. I nursed my kids in public all the time and was able to do so discreetly simply by wearing a top that lifted easily from the bottom. Many times people would stop to gaze at my son or daughter, having no idea they were breastfeeding, thinking only that they were cuddling or sleeping.

  192. @Eileen I did the same--once the lift from the bottom method was discovered (probably re-deiscovered). My first was born in 1969, though, and I struggled horribly in toilet stalls, and under blankets on hot days; mostly I felt horribly isolated even though my Mom was a strong support. I won’t even go into how UNhelpful the hospital was in those days!

  193. "But their mothers were also richer, had more education and had higher I.Q. scores. Once the authors adjusted for even a few of these variables, the effects were much smaller." I've been waiting a long time for someone to finally admit this non-starter. I was breastfeeding in the moment when a rabid obsession had overtaken society about it. It was clear to me very early on that it was not working. It was painful and I produced almost no milk. Any putative gains were offset by my dawning awareness that my children might very well be nutritionally impaired by the effort to breast feed. I was not alone. The year my son was born, "ER" had an episode, drawn from headlines, where a baby died because the mother had been hounded into breastfeeding alone; he starved to death. That jolted me into sensible action and I immediately began using formula with as much breast milk as I could produce. The relief was staggering. My children thrived. Imagine doing something that hurts 12 X a day and feeling like a failure because others scold, hound and lecture and the doctors' offices have posters abjuring you to do this one thing, as if it were abusive not to.My early days as a mother were irreparably marred. Years later, I saw a young mother weeping in front of the formula shelf. Her hand kept reaching and falling back. I learned her circumstances were like mine and told her that choosing what was best for her and her baby wasn't shameful; I just wish someone had told me the same.

  194. I was/am a single mother of twins. Our first visit to the doctor, I was nervous. I really didn’t want to breastfeed and thought it would be easier to do formula to satisfy the needs of two babies. Pumping at work was completely unworkable for me. The doc asked tentatively if I was breastfeeding. I said no, expecting a lecture. She said “good,” and pointed out that making enough milk would probably be hard, and not even counting the difficulty of shuffling and feeding two babies alone. (With bottles, I would often sit them in carseats and/or prop them beside me and feed both of them at the same time.). Fast forward. My kids are thriving, tall for their age, perfectly healthy, excel in school, and are completely bonded with and love their mom. People have to make decisions that are best for them. As the doc pointed out, she grew up on formula and became a doctor. Thank god I had that kind of support early on. Oh, and I sleep trained too, after one kid wouldn’t sleep for a year. Turns out Mom is a whole lot happier and better for baby when she’s had some sleep!

  195. @AhBrightWings Of course it can be painful the first few weeks, that skin in very tender and never even sees the sun at the beach! Two of mine were born in July, so I actually found a place in the yard to get a bit of sun on them before the births and it helped a lot. The one born in December is lucky he was the “baby” because only long experience and a very strong will got me through the first three weeks of that one! In a way, I wish I’d had this data then, but I really liked the sheer convenience of breastfeeding.

  196. @AhBrightWings How wonderful of you to reach out to that mother in the formula aisle! "Breast is best" should not be the focus - "Fed is Best" is what we should strive for. Those who can't or won't breastfeed shouldn't be guilted or shamed.

  197. This is fantastic. As a health economist this speaks to my data driven mind as well as experience. I breast fed 3 of 4 kids, really no difference in school performance etc. I sleep trained all of them with varying degrees of success - they are all securely attached to me and others. And I held down a job that involved long hours and significant travel and each of them have told me they loved that I was happy at my job. They have told me I am a role model - my boys and my girls - and they are so proud of me. I think we need to be gentle with each other, respect and support each other. Motherhood is not a competition, it is a journey that is long, scary, wonderful and full of love.

  198. @Bismarck Indeed!

  199. This article is great, thank you! And being a data scientist, I did the same kind of research when I had kids. But I do worry that the bigger issue is being ignored. The vast majority of women do not have these choices to make, they bottle feed and sleep train because they have to. So, while I like this article, I hope the economist’s next article examines how many American women have these options. Until all women have the same rights, that’s where our energy should be.

  200. @Human Bean The lack of parental leave in the USA is a national disgrace.

  201. As a single working father of four, I’m regularly momterrupted and momsplained to about parenting issues- even though I’m the most experienced parent in almost any room. I appreciate your acknowledgement that there is limited real information on the “right” way to care for kids. More acknowledgement that female-parent focused parenting is just another parenting option would also be great.

  202. @Mark Shumate - I strongly agree. I was a stay at home dad for the first year and a half of my child's life and continue to do the majority of parenting with a more flexible work schedule. I got used to be shunned by mommy cabals on the playground. parties, etc. and momsplained (I love that) anytime I did anything with my kid that looked like I was struggling. Or, there were lots of judgmental comments about my wife who continued to work by choice. In general, from my experience, I found women mommy groups (and especially the white, over-educated affluent ones) to be the most cutthroat, obnoxious, unpleasant and judging people around. I'm glad I was able to help spare my wife having to be subjected to their misery. Oh, and my kid's doing just fine.

  203. @Bob Lob The sanctimommy groups like that will do the same to everyone who disagrees with them, doesn't follow their latest fad - male or female. They are horrible people to be around - mothers hate them as much as fathers do. Good mothers and fathers groups have no issue with male or female primary caregivers, and know that each parent has a unique situation as each child is different, each family is different. But santimommies and martyr mommies - they're rotten to everyone.

  204. @Mark Shumate Gotta say - momterrupted and momsplained happens to every parent ever - happens as much, quite possibly more, to women as men. There's nothing like having a guy (who is not a lactation consultant) tell you how to properly latch, the right way to breastfeed - unless it's all of society, men and women, telling you whether or not it's OK to feed your baby somewhere, and how a coverup solves everything.