PDF Summary:Cribsheet, by Emily Oster

Will breastfeeding your baby raise their IQ? When should you start potty training your toddler? Parents of young children often ask questions like these, as they’re eager to know the right way to parent. However, health economist Emily Oster argues in Cribsheet that there isn’t just one right way to parent a young child. What’s best for one family isn’t always best for another. She argues that you can discover the best parenting decisions for your family by consulting research and applying strategies from economics to your decision-making process.

In this guide, we’ll explore Oster’s advice on making research-based parenting decisions. We’ll also present her research on some of the most important and controversial topics in parenting, from breastfeeding to potty training. Throughout our guide, we’ll contextualize Oster’s findings by exploring how social and cultural norms and stigmas influence parenting decisions. Furthermore, we’ll supplement Oster’s recommendations with additional actionable advice, such as how to identify trustworthy data and how to reduce your child’s chance of having a peanut allergy.

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When considering what’s best for you, Oster emphasizes that what’s good for you is often good for your child, too. Therefore, it's important to consider your own desires, needs, and lifestyle when making a parenting decision. Oster claims that, unfortunately, many parents often choose what they believe is best for their child even when this choice would negatively impact them. Deprioritizing their own needs negatively impacts their mental or physical health, which harms them and their children.

(Shortform note: Research supports Oster’s claim that parents sometimes prioritize their children’s needs over their own. For example, many parents are too busy working and spending time with their children to invest in developing their own friendships. Furthermore, some economists argue that economic inequality has led parents to prioritize preparing their children for their future over attending to their own needs as parents.)

Below, we share a series of steps to take when you’ve examined the research on a topic and you’re ready to make an informed decision.

Step 1: List the Risks and Benefits

First, list each option’s risks and benefits for your child, you, and your budget. Brainstorm your own risks and benefits in addition to those revealed by the data. For instance, one risk of adopting a furry pet is that your baby is more likely to get bit and develop an infection. On the other hand, adopting a furry pet has benefits: It’ll bring you and your child joy.

(Shortform note: As you consider an option’s risks and benefits for your family, you may also want to also consider how an option affects your community. Some parents make decisions that they believe are best for their children and family, but they fail to consider how their decisions could contribute to social inequality. For instance, some white families perpetuate racial segregation when they choose to send their children to schools that enroll a higher proportion of white students.)

Step 2: Conduct a Risk Assessment

Second, consider how the risks you listed compare to the risks you regularly, automatically take. For example, research reveals that 10 to 20 people (predominantly children) die from animal bites every year in the US, but close to 1,000 US children die each year in car crashes. This comparison reveals that your child’s risk of death from an animal bite is significantly low relative to the risk of having them ride in a car. Next, ask yourself: Are there any ways I could minimize this risk? For instance, you could closely supervise your child and pet any time they’re together.

(Shortform note: As you conduct a risk assessment, resist the temptation to believe you and your family are an exception to the statistics you encounter. In Nudge, Richard Thaler and Cass Sunstein argue that people tend to possess an optimism bias that convinces them they’re less likely to suffer negative outcomes than other people.)

Step 3: Consider Opportunity Costs

Finally, for each option you’re considering, ask yourself: If I pursued this option, what benefits or opportunities would my family miss out on? For instance, if you don’t get a pet, you’ll never have to find a pet sitter. This might make it possible for your family to travel more often.

(Shortform note: As previously noted, considering opportunity costs can be overwhelming, and after you’ve made a decision, you may look back on the opportunity costs you considered and regret your choice. In The Paradox of Choice, Barry Schwartz claims you can avoid these scenarios by being a satisficer, not a maximizer. Satisficers spend less time on decisions because they’re satisfied with an option that’s good even if it’s not perfect. By contrast, maximizers take time to deeply consider every possibility until they find the best one. They’re more likely than satisficers to regret their decisions.)

Goal 3: Refrain From Harsh Self-Judgment

Finally, Oster urges you to refrain from harsh self-judgment any time you make a decision that defies conventional wisdom or that other parents are likely to judge as “wrong.” Others’ judgments, which you may internalize as self-judgment, are based on the false idea that there’s only one right way to parent. Instead, reassure yourself that you’ve made an informed, thoughtful decision that’s right for you, your child, and your budget.

(Shortform note: Harsh self-judgments may take the form of an “inner critic.” One psychologist recommends you counteract your inner critic’s judgments using this strategy: Write down what the inner critic “says,” and then write back with a more realistic, generous opinion about yourself. For example, imagine you decide to breastfeed your baby in public, an act that some people judge as inappropriate. Your inner critic may reflect this stigma, telling you it’s indecent to breastfeed in public. Respond in writing by reminding yourself why you decided to do it. For instance: “Breastfeeding in public is legal where I live, and I find it more convenient than seeking out a private space to breastfeed. Besides, I want to help destigmatize public breastfeeding.”)

Data to Inform Your Parenting Decisions

In this section, we present Oster’s research-based recommendations on several of the most important and controversial issues that crop up during a child’s first three years. Oster reviewed hundreds of studies and claims she based these recommendations on the most trustworthy, actionable research (usually randomized trials). We’ll begin this section with three topics that are relevant to the months following your baby’s birth: childbirth recovery, sleep, and feeding. Then, we’ll cover two topics that relate to supporting your toddler’s independence: potty training and discipline.

(Shortform note: There’s a topic that Oster doesn’t consider in her research that another economist argues is the most important parenting decision: where parents raise their kid(s). Specifically, he cites evidence that children who grow up in neighborhoods with positive role models are more successful than children who don’t. He defines positive role models as people who are smart, are family-oriented, have successful careers, and are committed to their community.)

Recovery From Childbirth

Emotional Recovery After Childbirth

According to Oster, research reveals that postpartum depression is a serious, common, and treatable condition that you should seek support for as soon as symptoms show up. Symptoms include feeling anxious, having trouble sleeping, having thoughts of self-harm, and deriving less joy from activities you once loved. Either or both parents can experience postpartum depression after their baby’s birth.

Because postpartum depression can make parenting feel harder, it’s best to treat it early. Doctors typically provide you with a survey to screen for depression at your six-week postpartum appointment. If you’re concerned you or your partner have postpartum depression earlier than this, call your doctor to get screened and treated earlier. Treatment typically includes talk therapy, and in more serious cases, your doctor may also recommend you take antidepressants.

(Shortform note: Although Oster focuses on describing and treating signs of postpartum depression after the baby’s birth, recent research shows that early signs of postpartum depression can appear during a person’s pregnancy. For instance, people who experience mood changes and depression during pregnancy are more likely to also experience postpartum depression. This research suggests that you may be able to seek treatment even before your baby is born.)

Physical Recovery After Childbirth

According to Oster, the period of physical recovery after childbirth varies in length, depending on how much trauma the birth did to your body. If you deliver by cesarean section, you’ll have a longer recovery than if you deliver vaginally. Birth complications, such as vaginal tearing, also prolong your recovery time.

(Shortform note: Recent research reveals that people who experience longer periods of recovery after childbirth can make that time more bearable by engaging in postpartum physical therapy. One randomized trial found that physical therapy reduces post-cesarean delivery pain. Another randomized trial reveals that people who experienced third-degree tearing during delivery felt that pelvic floor therapy improved their quality of life.)

Here, we share Oster’s answers to two common questions about physical recovery after childbirth:

When can I resume having sex? People often say you should wait until six weeks postpartum, but there’s no data to support this. Instead, determine for yourself when or if to resume having sex based on when you want it and when you feel physically ready (with no discomfort or pain).

(Shortform note: Research reveals that couples tend to have less sex after their child is born, but their levels of sexual activity typically return to normal levels after a year. One factor that contributes to this reduction in sex is fatigue: Parenting is tiring, and couples are less likely to engage in sex when they’re tired. Additionally, when you’re busy caring for a child, it’s harder to pursue your urge for sex when it arises, as it’s less common for both parents to be free to spontaneously follow their impulses. According to experts, if you’re looking to carve out more time for sex postpartum, it helps to schedule regular “sex dates.” Ask a family member or friend to watch your child at their home so you and your partner can enjoy some alone time.)

When can I resume exercise? Exercise as soon as you’re physically able to, since it can help reduce symptoms of postpartum depression. Start with less intense exercise, then gradually increase the intensity. If you had a cesarean section, you can typically begin going on walks two weeks postpartum and resume your normal exercise routine after six weeks. If you had a vaginal delivery without tearing, you can exercise as early as one week after childbirth.

(Shortform note: What are the best ways to ease back into an exercise routine after having a baby? Experts recommend beginning with stretching, walking, pelvic floor exercises, and movements that focus on your core, such as lying down on your back and repeatedly lifting and lowering your pelvis off the floor.)

Sleep

Room Sharing

The American Academy of Pediatrics (AAP) recommends that you share a room with your baby for the first six to 12 months postpartum. Contrary to this, Oster cites evidence that sharing a room with your baby has benefits for only the first four months. It’s a good idea to share a room with your baby for the first four months because this is when the risk of SIDS (sudden infant death syndrome) is highest. SIDS is the unexpected death of an otherwise healthy infant. Sharing a room with your baby when their risk of SIDS is highest allows you to closely monitor them. After this, transition them to their own room. Research reveals that babies older than four months sleep better in their own rooms because it’s quieter.

(Shortform note: While Oster claims that room sharing has benefits for only the baby’s first four months of life (the main benefit being the reduced risk of SIDS), one expert claims that room sharing until your baby is six months old makes it easier to breastfeed them. During a baby’s first six months, they need to be breastfed overnight, and this is easier to manage when your baby is in the same room as you).

Co-Sleeping

The AAP also recommends you avoid co-sleeping (sharing a bed with your baby) because it increases the baby’s risk of suffocation as well as their risk of SIDS. Oster shares the counterpoint that according to research, the risks of co-sleeping are low.

(Shortform note: Oster mainly focuses on describing the low risks of co-sleeping, but research reveals that co-sleeping also provides several benefits for parents and infants. First, parents who share a bed with their baby sleep for longer durations because they don’t spend time getting in and out of bed to feed their babies and respond to their cries. Second, babies who share a bed with their parents sleep more lightly, and light sleep is associated with synaptogenesis (the formation of connections among neurons in their brain).)

Furthermore, Oster argues that co-sleeping is safe if you minimize its risks. One way to minimize risks is to avoid drinking and smoking: SIDS deaths are significantly higher when parents drink or smoke before co-sleeping. A second way to minimize risk is to remove the pillows and blankets from your bed, as soft items increase an infant’s risk of SIDS and suffocation.

(Shortform note: Experts note that SIDS has many risk factors, including those that Oster highlights here (parental drinking, parental smoking, and the presence of soft items in bed). According to research, an additional way you can minimize the risks of co-sleeping is to avoid taking sedating medications (such as certain pain relievers and antidepressants) before sharing a bed with your baby. Because these medications deepen your sleep, they reduce your ability to notice and respond to signs that your baby is suffocating or that you should adjust their sleeping position.)

Sleep Position

Although infants sleep more deeply on their stomachs, Oster cites evidence that infants who sleep on their stomachs are eight times more likely to die of SIDS compared to infants who sleep on their backs. This is because stomach sleeping is associated with deeper sleep, and deep sleep is linked to an increased risk of SIDS.

(Shortform note: Parents may worry that back-sleeping could increase an infant’s risk of choking if they spit up while sleeping. Fortunately, experts claim that back sleepers are at a lower risk of choking than stomach sleepers. This is because when babies sleep on their stomachs, there’s a risk that anything they spit up will block the opening of their trachea.)

Crying It Out

Oster explains that “crying it out” is having your baby sleep in their crib and leaving them alone even if they wake up and begin to cry. Some psychologists claim that this practice reduces infants’ attachment to their parents, and some people claim that parents who let their babies cry it out are cruel.

(Shortform note: Since the publication of Cribsheet in 2019, new research has suggested that these claims are incorrect. A 2020 study found that leaving your baby to cry it out doesn’t impact their attachment or development. Furthermore, this study suggests that leaving your baby to cry it out may help them develop an ability to comfort themselves, causing them to cry for shorter periods of time. Therefore, you could argue that letting your baby cry it out isn’t cruel: It’s a loving way to support their self-control. This research supports Oster’s position in favor of crying it out, which we’ll discuss next.)

Contrary to claims that letting your baby cry it out is cruel and reduces their attachment to you, Oster argues that crying it out benefits both children and parents:

First, children who cried it out as babies experience long-term benefits: higher levels of attachment to their parents and better behavior.

(Shortform note: Here, Oster emphasizes the long-term benefits of letting your baby cry it out, but reaching these benefits may require you to resist your biological instinct to respond to your crying baby. Research shows that the sound of a baby’s cry activates a primitive part of your brain, immediately compelling you to pay attention to it.)

Second, babies who cry it out sleep for longer durations. This is because when they learn that no one responds to their crying, they stop crying and fall back asleep sooner.

Third, parents who have their children cry it out sleep better. This is because they don’t disrupt their sleep to comfort their baby and because their baby eventually cries less. Because these parents sleep better, they also experience higher rates of marital satisfaction and lower rates of depression and stress.

(Shortform note: Whether you’re a baby or an adult, good sleep supports your health, and sleep deprivation harms it. In Why We Sleep, Matthew Walker claims that sleep supports your mental and emotional health: It improves your muscle memory and long-term memory, dulls the sting of painful memories, and boosts your problem-solving skills. In contrast, sleep deprivation reduces your capacity to regulate your attention and emotions and increases your risk of diseases such as diabetes and cancer.)

Eating: Breastfeeding and Introducing Solid Foods

Effects of Breastfeeding on Your Baby’s Health

People sometimes claim that breastmilk is a near-miraculous substance that will raise your baby’s IQ and boost their health. Oster argues that while there’s a correlation between some of these benefits and breastfeeding, there’s only evidence of causation for some of these benefits.

According to research, breastfeeding slightly lowers your baby’s risk of several minor health issues, including rashes, eczema, gastrointestinal issues, and ear infections. However, there’s no evidence that breastfeeding raises your baby’s IQ or reduces their risk of obesity, high blood pressure, respiratory infections, cavities, or SIDS.

Effects of Breastfeeding on Parents’ Emotional Health

Oster cites evidence that breastfeeding can positively or negatively impact your emotional health. Some parents who nurse feel happy, connected to their babies, and powerful. By contrast, some parents who nurse experience frustration, shame, and guilt when they’re unable to breastfeed or they choose not to breastfeed.

Social Stigmas Around Breastfeeding

Research shows that nursing parents face both pressure to breastfeed (often due to its positive effects, as outlined above) and a social stigma against breastfeeding. These conflicting messages may make the decision to breastfeed or not an emotionally fraught experience in itself. Let’s further explore these conflicting messages and consider possible solutions.

On the one hand, parents often feel social pressure to breastfeed, given its many reported health benefits for babies. Therefore, as Oster notes, parents who are unable to breastfeed, or choose not to for other reasons, sometimes feel ashamed. On the other hand, new parents may feel social pressure to not breastfeed: There’s a bias that breastfeeding mothers are less competent in the workplace, and the social stigma against nursing in public discourages some parents from breastfeeding.

To address these social stigmas, one expert claims that public health campaigns that focus on the benefits of breastfeeding should instead focus on promoting social policies that reduce stigma around decisions to breastfeed or not. Specifically, she claims that public health efforts should normalize how challenging it is to breastfeed and advocate for workplace policies that make it easier to breastfeed (such as having a private lactation space).

Effects of Breastfeeding on Parents’ Physical Health

According to Oster, breastfeeding can positively impact a nursing parent’s physical health. First, there’s strong evidence that breastfeeding significantly reduces your chance of getting breast cancer. Breastfeeding lowers your estrogen (which reduces your cancer risk) and modifies your breast cells (making them less vulnerable to carcinogens).

(Shortform note: If you choose not to breastfeed or you’re unable to, you may worry about missing out on this benefit. Fortunately, there are other ways to reduce your chances of developing breast cancer. The following behaviors are associated with lower risks of breast cancer: staying physically active, maintaining a healthy weight, and limiting alcohol consumption.)

Oster also cites evidence that breastfeeding can cause physical pain. Some people who nurse experience sore breasts and bleeding nipples. You can relieve breast pain by applying any of the following to your chest: cold packs, hot packs, and cold cabbage leaves (which soothe pain and conform to the shape of your breasts). Frenulum surgery can reduce nipple pain. This surgery cuts the baby’s frenulum (where their tongue connects to the floor of their mouth), making it easier for them to latch onto your nipples. If these or other remedies fail to reduce your pain, call your doctor to be evaluated for mastitis (a treatable infection).

(Shortform note: Many of the resources Oster recommends are accessible to most parents: Cold packs, hot packs, and cold cabbage leaves are inexpensive and easy to find. However, some of her recommendations may be prohibitively expensive for some families. Frenulum surgery (which can cost upwards of $350) and mastitis treatment (which can cost over $2,000) may not be covered by a family’s health insurance. Experts are seeking to address some of these gaps in access by offering programs that provide free nursing support.)

Alcohol Consumption

It’s common for people to claim that nursing parents should avoid drinking alcohol. According to Oster, research reveals that you don’t need to avoid alcohol entirely. Although your blood alcohol level determines your milk alcohol level, babies are only harmed when you consume more than four drinks prior to breastfeeding. If you want to err on the side of caution by ensuring no alcohol enters your milk, wait two hours per drink before pumping or breastfeeding.

(Shortform note: There’s a possible downside to nursing parents consuming even small amounts of alcohol that Oster doesn’t mention: Doing so disrupts infants’ sleep. One study conducted a trial that observed how well infants slept after consuming alcohol-free breastmilk and compared it to how well they slept after consuming breastmilk with low traces of alcohol. The researchers found that infants who consumed alcohol-containing breastmilk slept less deeply.)

Introducing Solid Food

When it’s time to wean your child off breastfeeding and transition them to solid food, two important and controversial topics are 1) pickiness and 2) exposure to peanuts, a top allergen.

Pickiness: According to Oster, research reveals that it’s possible to make your child a less picky eater. If your child doesn’t like a flavor, don’t pressure them to try it or offer them another option. Kids are more likely to refuse food when families engage in these practices. Instead, present your child with a diversity of flavors early on and reintroduce those flavors multiple times. Children tend to like a flavor more once they’ve tasted it on multiple occasions.

(Shortform note: Understanding why your child may be a picky eater in the first place could help you empathize with their fussiness and show patience as you encourage them to try new foods. Some children are picky eaters because they’re “super tasters” who taste bitterness more intensely than other children. Other children are picky eaters because of genetics: They inherit preferences for certain foods over others. These findings show that food pickiness may be rooted in biological factors beyond the child’s control.)

Peanut exposure: People typically claim that you should refrain from exposing your baby to peanuts. Contrary to this, Oster argues that this advice makes children more allergic to allergens rather than less allergic because early peanut exposure reduces children’s risk of becoming allergic.

(Shortform note: How can you safely expose your baby to peanuts? Experts advise that you carve out time to carefully observe how your child reacts to small amounts of peanuts. First, mix two teaspoons of peanut butter or peanut flour into several tablespoons of a food your child already likes (such as yogurt). If they experience a reaction (such as trouble breathing, vomiting, itching, a rash, or a swollen face), take them to an emergency room. If they don’t experience a reaction, you can continue to feed them the rest of the mixture. Continue observing them closely for the next two hours to notice any signs of a reaction. Following this, start your child on a diet in which they eat two grams of peanuts three times a week for at least three years.)

Supporting Your Toddler’s Independence

Potty Training

Many parents wonder when to start potty training their toddler. According to Oster, research reveals that most US children complete their potty training when they’re between 21 and 30 months old regardless of how early they start training. If you start potty training early (when a toddler is one and a half), you’ll use fewer diapers—but the entire process of training will take longer (close to 10 months). If you start potty training later (when a toddler is older than two), you’ll use more diapers—but the process will take less time (close to three months).

(Shortform note: Research on global potty-training practices reveals that many parents outside the US toilet train their children earlier than US parents do. This research underscores Oster’s overall claim in her book that there isn’t just one right way to make parenting decisions, and it adds the perspective that your cultural practices shape how you approach potty training. For instance, most toddlers living in rural China are potty-trained before they’re 24 months old, thanks to the help of pants that feature a split seam at the crotch. These pants make it easier for children to use the toilet because they don’t have to take time to remove their pants.)

Parents also wonder what’s the best approach to potty training. Oster argues that there’s no research indicating that parent-driven approaches are any more or less effective than child-driven approaches. Parent-driven approaches such as Oh Crap! Potty Training have you dictate the training timeline, such as when to stop using diapers and when to transition your child to the next phase of training. By contrast, child-driven approaches have the child indicate when they’re ready to start using the toilet and move through these phases. Given these data, Oster claims that the best you can do is strive for consistency: Pick an approach and commit to it.

(Shortform note: Although research provides no evidence that parent-driven approaches work any better or less than child-driven ones, experts claim that which approach you should choose may depend on your child’s personality. For instance, if your child is stubborn, a child-led approach may work best for them. This approach could help prevent your child from resisting your efforts to train them before they’re ready. By contrast, if your child seems eager to please and thrives on praise, a parent-driven approach may help move them through the potty-training process.)

Disciplining Your Child

According to research, approaches to disciplining your child are most effective when they 1) don’t involve corporal punishment; and 2) use consistent rewards and consequences. Let’s explore these two ideas further:

No corporal punishment: According to research, there’s no evidence that corporal punishment (such as spanking) improves children’s behavior, and there’s some evidence that it makes their behavior worse.

(Shortform note: Why do parents sometimes resort to corporal punishment, and why does this approach make children’s behavior worse? In No-Drama Discipline, Tina Payne Bryson and Daniel Siegel claim that parents sometimes use corporal punishment when they don’t have another plan for discipline in place. In the absence of a go-to plan, parents base their responses to misbehavior on their current emotions and resort to physical force when they feel angry or frustrated. Bryson and Siegel argue that spanking leads children to misbehave more because it makes them feel threatened. This threat activates the primitive parts of their brain rather than the parts that allow them to calm down and correct their behavior.)

Consistent rewards and consequences: Approaches such as 1-2-3 Magic recognize that when children misbehave, they don’t learn from long discussions about why their misbehavior was bad. Instead, their behavior improves when you reward them or provide them with consequences according to consistent rules.

For example, imagine you’re trying to teach your child to only run when they’re outside. If you ever catch them running, don’t give them a long speech about how running inside is dangerous. Instead, tell them you’ll be taking away five minutes from their outdoor play time (something they love). Any time your child runs indoors, give them this same consequence—even if it feels mean to reduce their outdoor playtime. You can also reward your child any day they refrain from running indoors by adding extra outdoor playtime.

(Shortform note: In No-Drama Discipline, Bryson and Siegel argue that understanding why your child misbehaves prepares you to deliver consistent consequences in a loving, caring way. They suggest that any time your child misbehaves, you should consider what goal or need they were trying to meet. This can help you see things from their perspective, respond more calmly, and implement a consequence that teaches them a lesson without depriving them of their physical or emotional needs.)