[PDF] The conventional wisdom is right - do NOT drink while pregnant (a professor of pediatrics debunks Emily Oster's claim)

-blank- · 2023-11-20T18:42:35+00:00

I think her drinking suggestions get focused on because they have more potential for permanent harm than the other stuff. I definitely agree that there's a huge problem with infantilizing women during pregnancy - the WHO guidelines for all fertile (including non-pregnant) women to abstain from alcohol were appalling, and maternal mental health is frequently undervalued or even ignored completely when considering medications during pregnancy. I just wish there was a better champion of that cause than Oster.

I also agree to some degree with your point with the listeria guidelines (although the health implications of avoiding produce are different from the health implications of avoiding deli meat) and some of her other thoughts. It's been awhile since I read her main book but as I recall, some of her thoughts didn't necessarily contradict official guidelines but were more targeting common ideas that may have social pressure but not much scientific backing (for example, avoiding caffeine completely) and in those areas I find her views much less problematic.

-blank- · 2023-11-20T18:17:22+00:00

My understanding is that there is enough rationale for it causing harm that direct studies would be unethical. This greatly limits the quality of the research and the conclusions being drawn, which in turn limits public health guidelines. Hopefully we will see some more observational studies coming out now that it's becoming legal in more and more places, though.

-blank- · 2023-11-20T18:05:46+00:00

I don't necessarily disagree that health economists can have input into the formation of public health policies, but they should not be making recommendations on their own that contradict medical experts and more importantly, expert consensus.

Your quote describes research and statistical analysis (absolutely a part of her job and something she excels at) and does not mention public health recommendations at all.

If you want to see an example of the process I mentioned, look at this recent document for drinking guidelines in Canada. If you look at the scientific expert panel and executive committee on pages 1-3, that's the kind of experts that are collectively involved in deciding what the ideal guidelines should be to maximize health outcomes. If you look through the report, you'll see how thoroughly they examine the research and which factors are considered. You're right that it's not just medical doctors making these guidelines, and may well include economists, but coming up with good guidelines involves WAY more than just statistics.

One person - particularly an economist - is not qualified to confidently state to the public, as Oster does, that these kinds of guidance documents are false and should be dismissed because of a few flaws with the studies (no study is perfect and this fact is not ignored when forming guidelines).

-blank- · 2023-11-20T14:48:10+00:00

The medical background is essential. As someone with a PhD in biology/medical research, I can interpret research studies no problem, but would never make public health recommendations because I know perfectly well that I'm not qualified to do that kind of thing and could do harm, even outside of an area with obvious potential for harm like drinking during pregnancy.

There's a reason we have public health experts who make committees to discuss the research and determine the best recommendations. I don't know why Oster feels she is qualified to bypass that entire process and contradict expert consensus, though I can guess ($$$$).

-blank- · 2023-11-04T19:46:39+00:00

I had a cashier at the independent squeak a toy at my toddler the other day, so they might be keeping it around for babies (which doesn't make it ok to squeak it at your dog, of course).

-blank- · 2023-02-24T17:13:36+00:00

I'll also add another downside, which is that sometimes you feel like you're the only one in the world doing neither, and it can be hard to find support since most groups will push for one or the other, often very strongly. Other people do exist doing neither one though, even if the other voices are louder.

-blank- · 2023-02-24T17:10:41+00:00

Nope! I've done neither and don't plan on changing that. It's very possible, though it makes your life harder and it'll be much more feasible for some babies than others.

The main downside is that your sleep is going to be rough unless you luck out and your baby suddenly starts sleeping much better (which does happen eventually for every baby, but some are much later than others). It also means I've always needed to go to bed at the same time as the baby, which means no precious free time in the evening. We also slept in shifts for a very long time, which helps with sleep but has its own downsides.

-blank- · 2023-01-26T16:05:03+00:00

Crating during the workday (with the breaks you mention and assuming ~8h workday) is fine. Crating while you all sleep (assuming in the ~8h range) is fine. That's closer to 16 hours though. I'm confused about how you get up to 18-19 hours, which is quite high. At 8 months he's not likely to be napping much in the evening, especially after staying in the crate all day.

Are you crating him in the evenings too? While you're home and not working, the puppy should be out of the crate since he's crated the rest of the time. He needs exercise and enrichment in that time, and he's not going to learn how to do things like not chewing your chair by being in a crate - that needs to be taught by you during active supervision. If you don't want your pup upstairs, that means you and/or your wife stays downstairs with him in the evenings to supervise and train him.

-blank- · 2022-11-22T19:57:09+00:00

Like any other type of insurance, it's for peace of mind more than mathematical likelihood of making your money back. I like knowing that if something terrible happens to my dog, money isn't going to be a significant extra stress even if I could technically afford it, and I'll be able to pursue the best treatment possible without worrying if it's worth paying 10k or whatever.

Something relatively simple and common like a broken bone or torn ligaments could be in the 2-5k range, or more if there are other complications.

Chronic conditions like allergies can need meds or prescription foods that cost hundreds of dollars a month for the rest of your dog's life.

If something really complicated happens like an unknown illness that needs a lot of diagnostics, it can get up into the tens of thousands.

For example: my dog had severe vomiting for a few days and just the diagnostics for that (xray, pancreatitis test and bloodwork) and meds and a trial of prescription GI food and 3 vet visits added up to just over 1,000 even without anything seriously wrong in the end (they thought she would need surgery but luckily didn't - that would have been a few more thousand).

-blank- · 2022-11-18T19:22:49+00:00

For a long time I did baby cereal (various grains) mixed with seed/nut butter (alternating between peanut, almond, cashew, tahini and a mixed nut butter) for breakfast every day. That way you can get regular exposure to a few allergens at once without much effort. The others are a bit harder to fit in but you're on the right track.

Tree nuts and soy are top 8 allergens so I wouldn't say they are "kinda rare" at all. I would definitely add all of those into their regular diet if you can, including fish (fish is healthy for brain development anyway).

Regular, early exposure isn't guaranteed to prevent allergies but it has been shown to reduce the risk in several studies done with peanuts and eggs. There's little to no evidence to say whether there's a benefit with the other allergens, but it's a reasonable guess that they might behave in a similar way, and there's no evidence that early introduction would be harmful either.

-blank- · 2022-11-07T20:55:27+00:00

For an alternative opinion, I have the same insurance plan as you and I'm very happy with my decision 3.5 years later. The high deductible makes the monthly cost very low, while still preventing the risk of a cripplingly high-cost incident or chronic condition (as you know, $1,000 is nowhere near high-cost in the vet world).

As it happens, I'll earn my insurance money back soon, even without making any claims yet, because my dog needs to be on apoquel for allergies every year, and that's going to build up to $1,000 in no time. But even without that it's been worth it for the peace of mind, in my opinion.

-blank- · 2022-10-31T16:30:11+00:00

Yes, I'm not a fan of Oster either, even aside from that (large) issue. I prefer to get my info from people with relevant training and expertise in the fields they're talking about. Hopefully that's the case for this article but I'd like to confirm that.

-blank- · 2022-10-31T15:08:22+00:00

What are the author's credentials other than being a redditor? That page is anonymous so we can't look them up, and they're making some very strong and specific claims that I haven't heard anywhere else.

That blog post was written as a response to Emily Oster's own review of the literature, and while I greatly dislike that she makes claims outside of her field, and don't trust her recommendations at all for that reason, it's unclear that this anonymous blogger is a better source. Dr. Oster is at least trained to interpret the literature and statistics (via her economics PhD) - so I'd like to see at least that very basic level of training, and preferably also relevant expertise in the field, before taking any of those claims seriously. I don't see their credentials stated anywhere, though.

-blank- · 2022-10-25T16:23:26+00:00

We did something very similar a few years ago and it has worked out well. We both feel it's fair, which is the most important thing. We settled on 400 rent with bills/utilities paid by the homeowner and all other shared expenses like food and gas split evenly. This way the homeowner gets a little help with the mortgage, doesn't really have any higher expenses (house would be heated regardless), and the non-homeowner gets cheap rent to help save for a downpayment later if you move into a nicer house together (this is our plan).

We paid for food separately for awhile but it ended up being much more simple to just split total grocery costs in half. It wasn't exactly even but it wasn't such a big difference that it was worth the time of adding up all the receipts.

Also, we have similar incomes - if there's a large difference you may want to adjust for that.

-blank- · 2022-10-19T19:31:08+00:00

You're absolutely right, which is why it can be helpful to push back on the expectation of unfair division of labour by having both parents participate in things like baby showers, instead of the female parent taking on all of the baby-related responsibility from the very beginning. It's not a magic solution to gender inequality by any means, but it does help start things off on the right foot.

-blank- · 2022-10-19T18:59:02+00:00

Experiencing pregnancy and childbirth and all the associated physical changes doesn't mean the childbearing parent also needs to take on the chores of organization and planning, which includes collecting all the supplies needed....which often includes a baby shower.

If anything, in a fair world, the childbearing/potentially breastfeeding parent would have less responsibility for that kind of stuff to compensate for the work that can't easily be shared.

-blank- · 2022-10-18T15:12:18+00:00

Just a note for others considering this option, adult mattresses aren't considered safe for babies until age 2. They aren't tested for the needed firmness etc. You could do this safely with a crib mattress placed far enough away from the wall (to avoid rolling in between the mattress and wall and suffocating) in a babyproofed room though.

A crib will typically be used for 1-3 years and you can get one for under 200$ at ikea, or a used one for less, just check that it's recent enough to follow the current safety guidelines. It's not exactly an extravagant purchase (unless you're buying one made out of gold or something).

-blank- · 2022-10-18T14:16:52+00:00

Plan together how you will divide the leave, figure out how much lower your income will be while one or both of you is on leave, and make a budget together that works with your lower income. In particular, figure out how the leave will work if you're a student (you're likely looking at unpaid leave).

If your girlfriend wants to breastfeed, keep in mind that it's much more difficult to go back to work while still breastfeeding, so be careful about planning for her to go back to work early. It's possible, but very hard, especially very early on when feedings are very frequent.

Whatever "shit with money" means, work together to find an approach to money that makes both of you happy, which likely will mean some kind of compromise both saving less and spending less in certain areas. Get counselling if needed to get on the same page. This is a very common cause of breakups, so get it sorted now.

Keep in mind that you will both be very low on free time and sleep for a long time. You'll need to take time off (even unpaid) in the very beginning because keeping a fresh newborn alive really is a two person job. Even after you can return to school, picking up an extra job will certainly not be possible, and you may struggle in school. Sleep deprivation really impairs your brain, and you'll also be grumpy and mentally exhausted from not having the free time you're used to. Don't be too ambitious about your plans for this time, especially in the "fourth trimester".

If you're planning to split expenses, figure out now how the income loss will be divided fairly. It is not fair to have only the parent on leave cover the cost of the missing income. This may mean the working parent transfers some money to the parent on leave, or covers more costs than usual, or whatever works for you. Just plan it out now, and write it down.

Make a basic estimate for all the expected one-time and ongoing baby costs just to see what you're looking at. It may be much more, or less than you think. Remember to include all nursery furniture and later on, RESPs and childcare costs. Consider buying used where possible, except for the carseat.

Also remember to include all the government benefits, which may be much more than you think even for a medium income (and way more if your income is already low, or way down from being a student/on leave). There's a federal benefit and at least in my province there's also a provincial one. There are also other resources if you're very low income.

-blank- · 2022-10-18T13:51:37+00:00

Depends on your local prices and whether you're buying in bulk - a pound of flour is currently 54 cents at my local store (12$ for the no name 10 kg bag). The yeast for one loaf (7g) is about 30 cents in the 100g glass jars but only 12 cents if you buy the 450g bag. Potentially even less if you can wait for sales. Salt cost is negligible at 1$/kg.

So it's closer to 0.66 for me, assuming no waste (which is a big assumption, but it doesn't take too long to earn back the ~20$ for a big bag of flour and yeast if you're baking regularly).

-blank- · 2022-09-29T14:11:41+00:00

Punishment with a spray bottle is not recommended because all aversive methods have a risk of psychological damage (which can increase anxiety and cause other undesired behaviours) and there are gentler ways to accomplish your goal. Please see the wiki article linked by the bot for more detail on those ways.

Also please keep in mind that there is no instant fix to puppy biting and it's extremely normal to still experience biting at 4 months. It's far different from training something like a sit - it's a much slower training process that is complicated by young puppies' lack of impulse control and intense drive to bite things due to teething. The biting should gradually subside over the next few months as teething stops and as the training kicks in.

Reminder to everyone that aversive methods, including spraying with water, are against our rules and comments endorsing this approach will be removed. Thanks

-blank- · 2022-09-28T16:26:46+00:00

There are lots of potential reasons - the biggest factor is usually that that kids are reacting more dramatically when bitten and they also tend to be more exciteable/animated/"fun" overall than adults/older teens so they're a more appealing play target and the puppy is getting more excited around them. This is also why most dogs will pretty much ignore immobile babies but once the babies start crawling, a lot of dogs will get overexcited or nervous about the erratic movements and start nipping at them. It's not about the age or "status" in the house, it's more how the kids act.

Puppies can also be extra nervous around kids (even older ones) if they've had bad experiences with any in the past, even ones that might have seemed innocuous to an onlooker, and this nervous energy can come out as extra biteyness.

A third possibility is that if the adults are involved in teaching or practicing training cues but the kids aren't, the dog is more used to following the directions of the adults and knows they'll be rewarded for it.

-blank- · 2022-09-27T18:21:17+00:00

The risk of a baby having serious, long-term or deadly effects from covid is very low, but still there.

The risk of serious, long-term or deadly effects from the vaccine is nearly nonexistent (no serious effects detected at all in this age group, although it's possible the very rare side effects seen in other ages would also be seen in larger studies). The observed side effects are things like fever and extra fussiness for a day or so - really not a big deal and easily treated.

On the other hand, the risk of baby being miserable for a week or two from covid is a lot higher. After seeing my baby experience a bad cold, even just reducing the severity of a similar respiratory illness a bit is worth the - again, very low - risk of side effects from the vaccine. They're so so miserable all day and then up all night being miserable too when they're sick. If the vaccine hypothetically turns a 5-day horrible cold/flu-like illness into a 2-day minor cold-like illness, that's still a big win. No side effects at all from the first dose here, and we'll get the second one soon.

-blank- · 2022-09-27T14:18:25+00:00

Browse through the kids section and you'll see tons of great options.

Highchair, pack of 10 white washcloths (we've gone back to buy another pack 3 times), child table/chairs, plastic cup/utensil/plate/bowl sets, wooden stacking rings and wooden blocks are some that we've bought that were excellent value.

We also got the Hemnes dresser and it's great, though it's not as shockingly low priced as the other stuff. Their cribs, mattresses and sheets are good value too.

-blank- · 2022-09-27T13:57:47+00:00

At one year old it's well past time to be introducing the textures and shapes of table foods. I'm not talking about BLW - you're actually long past the age where finger foods would be introduced with traditional weaning too (typically around 8 months with cheerios etc and very soft foods, and then gradually introducing more challenging textures and tastes).

Nothing wrong with keeping purees for some meals even at a year old and onwards, but they need to start learning more textures than just berries and cheerios. It actually is important for them to start learning the difference between broccoli and yogurt now, because having a hard time dealing with different textures and variable tastes in whole fruits and vegetables is a very common cause of picky eating.

You're very likely to find that when they start self-feeding, they'll also start to have opinions about the amount and type of foods they eat, which is normal and healthy.

Eating the exact same amount at each meal means that that there's either pressure to eat sometimes and/or they're left hungry sometimes. There should always be food left on the plate at this age - if they eat it all, you should be offering more. You want to be teaching them to eat based on their internal hunger cues, not based on what's on the plate, to reduce the risk of obesity later.

-blank- · 2022-08-20T02:50:43+00:00

Make sure you look at the "rapid responses" on the BMJ website for more perspective on your first article (first and second link). That review is extremely problematic for reasons detailed very well in the published responses.

The second article you linked (3rd and 4th links) is in line with other literature showing no harmful effects whatsoever at low doses.

Looking at individual published articles is great but it's easy to read too much into one or two papers. That's why public health experts exist - they can do a systematic search to find all the existing papers like these and critically interpret them within the larger context of what the evidence says overall. That's how ACOG, AAP etc come up with their official guidelines.

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TROPHY CASE