Baby-Friendly Hospitals

Emily Oster

9 min Read Emily Oster

Emily Oster

Baby-Friendly Hospitals

Are they really better for babies? For breastfeeding?

Emily Oster

9 min Read

In 1991 the World Health Organization and Unicef launched a program — the Baby-Friendly Hospital Initiative (BFHI) — that was designed to increase breastfeeding rates worldwide. The BFHI has a chapter in the United States dedicated to this goal domestically. Within the U.S., Baby-Friendly USA evaluates hospitals to decide if they warrant the “baby-friendly” designation.

The goal of this initiative is to promote higher breastfeeding rates. The baby-friendly designation comes as a result of achieving a checklist of 10 items that are thought to increase breastfeeding. (Whether they do or not is the subject of most of the content below.)

I have never been a fan of the phrase “baby-friendly” in this context. The implication is that any hospital that doesn’t have this classification is unfriendly to babies. If we focus on the primary goal of breastfeeding, the natural conclusion is that a necessary condition for being friendly to babies is nursing. For moms, it can feel like saying, “If you’re not breastfeeding, you’re not your baby’s friend.”  

This isn’t the point of this post, but my broad view is that we put far too much emphasis on breastfeeding as some kind of metric of maternal success. I have written about this very extensively before (you can read the full chapter from Cribsheet on this topic), but my analysis of the literature is that many of the stated benefits of breastfeeding are not supported by the best data. There are some benefits! But they are smaller and shorter-term than much of what we hear. 

This doesn’t mean that we shouldn’t have programs that support and amplify breastfeeding. It just means that we want to be realistic about what might be achieved by alterations in this behavior and that we probably should shy away from implying that not breastfeeding is unfriendly. 

I’m leaving my soapbox now!

The primary goal of today’s post is to look at the evidence on whether baby-friendly hospitals increase breastfeeding rates. Before you ask: no, there isn’t any good data on other broader outcomes. The goal is breastfeeding rates, and that’s what the literature evaluates.  

Baby-friendly hospitals have to adhere to a checklist of 10 practices. One way to evaluate their success is to ask simply whether this package leads to higher breastfeeding rates. There are papers that do this, and I’ll talk about them first. A second way to evaluate it, though, is to look at what we know about the separate impact of each of these behaviors. This is valuable because it helps us think about whether the same impacts might be delivered with a more focused set of interventions. 


I need the short version today — take me to the bottom line!


Guidelines

To set the stage: In the service of increasing breastfeeding rates, there are 10 key things that baby-friendly hospitals must do. The first two of them are about recordkeeping and training. The last eight are specific to the way moms and babies are managed in the hospital. These eight are listed below.

  1. Discuss the importance and management of breastfeeding with pregnant women and their families.
  2. Facilitate immediate and uninterrupted skin-to-skin contact and support mothers to initiate breastfeeding as soon as possible after birth.
  3. Support mothers to initiate and maintain breastfeeding and manage common difficulties.
  4. Do not provide breastfed newborns any food or fluids other than breast milk, unless medically indicated.
  5. Enable mothers and their infants to remain together and to practice rooming-in 24 hours a day.
  6. Support mothers to recognize and respond to their infants’ cues for feeding.
  7. Counsel mothers on the use and risks of feeding bottles, artificial nipples (teats), and pacifiers.
  8. Coordinate discharge so that parents and their infants have timely access to ongoing support and care.

Evidence on broad impacts

To be designated as baby-friendly, a hospital must pass muster in all of the 10 key steps. Papers — of which there are a number — that evaluate the success of baby-friendly hospitals explore what happens when hospitals do all of these things together. These papers do not look separately at each behavior.

In evaluating the impact overall, there are multiple approaches.

The simplest analysis involves comparing breastfeeding rates at hospitals that have this designation with those that do not. This is not a good method, because there are important differences across those hospitals. (For example, this paper compares breastfeeding rates at baby-friendly hospitals with the national average in the U.S. The breastfeeding rates at the hospitals with the baby-friendly designation are higher, but that could be because of the difference in who seeks this designation, differences in the populations served, etc., etc. It’s nearly impossible to attribute this to the baby-friendly designation or to any of the behaviors associated with it.) 

Better evidence comes from variation over time. For example, at Boston Children’s Hospital, the breastfeeding initiation rate increased from 58% to 86% after the hospital’s designation changed. 

This is a huge impact, but other studies don’t show anything like this magnitude. A large study of WIC births in Maryland indicated no relationship between access to a baby-friendly hospital and breastfeeding behavior. A cross-state analysis using the same kind of variation also found no impact overall but a small increase among less-educated mothers. 

Overall: there is a big range in the results, but the studies with the largest amount of data seem to point to small, maybe not zero, impacts. These impacts are largely on breastfeeding initiation, which is something achievable in the hospital and which doesn’t always translate to continuation. 

Evidence on component impacts

Let’s turn now to the individual guidelines. One of the most frustrating aspects of this issue for me is that the baby-friendly guidelines combine some behaviors that are evidence-based and some that are not.  

The broad set of guidelines is informed by studies like this one that look at what behaviors are linked to breastfeeding success at an individual level. Things like not giving pacifiers, avoiding formula, and breastfeeding support are all correlated with breastfeeding success. But that does not imply they are causally related. 

In practice, the causal evidence for the particular behaviors varies.  

Several of the guidelines are common sense and, appropriately practiced, seem very likely to have some impact. Those include providing support in managing difficulties, recognizing infant cues, and coordinating post-discharge support.

There are four more specific recommendations: early skin-to-skin contact, avoiding pacifiers, avoiding formula supplementation, and encouraging rooming-in. We have a reasonable amount of data on the efficacy of these interventions at promoting breastfeeding, and the results are mixed. 

On the positive side: Early skin-to-skin contact has been shown to increase early breastfeeding success. There are a large number of other benefits of this practice — lower levels of bleeding, faster delivery of placenta, impacts on maternal stress — so it’s a great idea even putting aside nursing. 

The three other specific recommendations, though, show much less support in the data.

Rooming-in (versus nursery care) hasn’t been shown in either prospective data or randomized data to support longer durations of breastfeeding. 

The recommendation against supplementation is also unclear. Of course it is true that people who use formula in the hospital are less likely to breastfeed for extended periods. But that’s not a causal effect. And some studies (e.g. this one from 2013) have shown that limited in-hospital supplementation actually increases long-term breastfeeding success. 

In the case of pacifiers (recommendation #7 above), the data actively does not support this recommendation. Randomized data does not support the view that introducing a pacifier decreases breastfeeding success. And there are other benefits of pacifiers (soothing, possible SIDS reduction). A policy of discouraging the use of pacifiers loses these benefits without compensation.

Putting all this together, I find it unsurprising that we do not see obvious large impacts of this change in hospital policy, since most of the actions dictated are not actually well supported by data. Looking in a more negative light, these recommendations tie the hands of providers in ways that are not evidence-based. 

Telling people that pacifiers interfere with breastfeeding is misinformation, built into the policies. The goals are admirable here, but I see a need for more evidence-based decision-making.

Summary

Baby-friendly hospitals have a relatively narrow mandate — to increase breastfeeding rates — and for my taste they’d have a narrower name that better captured this mandate, something like “breastfeeding-encouragement hospitals.” Even for this outcome, the evidence suggests the impacts on breastfeeding rates may be relatively small. 

More concerning to me is that a number of the guidelines that make up the Baby-Friendly list have not been shown to actually have any impact on breastfeeding rates. This wouldn’t be such a big deal if they didn’t have negative impacts. But in some cases, they do. Many women and their babies benefit from supplementing with formula. Many women would like to have their infant spend some time in the nursery on the first night, so they can rest from labor. People like pacifiers — pacifiers soothe the baby and also prevent SIDS.  

By writing strict rules for behavior, you tie the hands of providers and may make it more difficult for them to serve the needs and preferences of their patients. There are situations in which we may want to do that — like with skin-to-skin, where the evidence strongly supports the value. But anytime we remove choice, we want to hold our evidence to a high standard. This does not meet that. 

Bottom line

  • “Baby-friendly” hospitals are designed to increase breastfeeding rates.
  • In the aggregate, they may have some small impact on breastfeeding, which is probably larger for groups with lower breastfeeding rates initially.
  • Some of the guidelines — notably, the prohibition on pacifiers — are not well supported by the data. 
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While doctors have long said Tylenol was safe, confusing studies, panic headlines, and even a lawsuit have continually stoked fears in parents. As a result, many pregnant women have chosen not to take it, even if it would help them.

This is why good data is so important! When we can trust the data, we can trust our choices. And this study shows there is no blame to be placed on pregnant women here. So if you have a migraine or fever, please take your Tylenol.

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Exciting news! We have new, high-quality data that says it’s safe to take Tylenol during pregnancy and there is no link between Tylenol exposure and neurodevelopmental issues in kids. Comment “Link” for a DM to an article exploring this groundbreaking study.

While doctors have long said Tylenol was safe, confusing studies, panic headlines, and even a lawsuit have continually stoked fears in parents. As a result, many pregnant women have chosen not to take it, even if it would help them.

This is why good data is so important! When we can trust the data, we can trust our choices. And this study shows there is no blame to be placed on pregnant women here. So if you have a migraine or fever, please take your Tylenol.

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How many words should kids say — and when? Comment “Link” for a DM to an article about language development!

For this graph, researchers used a standardized measure of vocabulary size. Parents were given a survey and checked off all the words and sentences they have heard their child say.

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What’s valuable about this data is it can give us something beyond a general guideline about when to consider early intervention, and also provide reassurance that there is a significant range in this distribution at all young ages. 

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How many words should kids say — and when? Comment “Link” for a DM to an article about language development!

For this graph, researchers used a standardized measure of vocabulary size. Parents were given a survey and checked off all the words and sentences they have heard their child say.

They found that the average child—the 50th percentile line—at 24 months has about 300 words. A child at the 10th percentile—near the bottom of the distribution—has only about 50 words. On the other end, a child at the 90th percentile has close to 600 words. One main takeaway from these graphs is the explosion of language after fourteen or sixteen months.

What’s valuable about this data is it can give us something beyond a general guideline about when to consider early intervention, and also provide reassurance that there is a significant range in this distribution at all young ages.

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I saw this and literally laughed out loud 😂 Thank you @adamgrant for sharing this gem! Someone let me know who originally created this masterpiece so I can give them the proper credit.

I saw this and literally laughed out loud 😂 Thank you @adamgrant for sharing this gem! Someone let me know who originally created this masterpiece so I can give them the proper credit. ...

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Perimenopause comes with a whole host of symptoms, like brain fog, low sex drive, poor energy, and loss of muscle mass. These symptoms can be extremely bothersome and hard to treat. Could testosterone help? Comment “Link” for a DM to an article about the data on testosterone treatment for women in perimenopause.

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Summer is quickly approaching! You might be wondering if it’s the right time to have your kid start swim lessons. The AAP recommends starting between 1 and 4 years old. This is largely based on a randomized trial where young children were put into 8 or 12 weeks of swim lessons. They found that swimming ability and water safety reactions improve in both groups, and more so in the 12 weeks group.

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Most importantly, no matter how old your kid is or how good of a swimmer they are, adult supervision is always necessary!

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What age is best to start swim lessons? Comment “Link” for a DM to an article about water safety for children 💦

Summer is quickly approaching! You might be wondering if it’s the right time to have your kid start swim lessons. The AAP recommends starting between 1 and 4 years old. This is largely based on a randomized trial where young children were put into 8 or 12 weeks of swim lessons. They found that swimming ability and water safety reactions improve in both groups, and more so in the 12 weeks group.

Below this age range though, they are too young to actually learn how to swim. It’s fine to bring your baby into the pool (if you’re holding them) and they might like the water. But starting formal safety-oriented swim lessons before this age isn’t likely to be very helpful.

Most importantly, no matter how old your kid is or how good of a swimmer they are, adult supervision is always necessary!

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Like with most things, moderation is key! Avoid very salty chips or olives or saltines with your infant. But if you’re doing baby-led weaning, it’s okay for them to share your lightly salted meals. Your baby does not need their own, unsalted, chicken if you’re making yourself a roast. Just skip the super salty stuff.

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Can babies have salt? 🧂 While babies don’t need extra salt beyond what’s in breast milk or formula, the risks of salt toxicity from normal foods are minimal. There are concerns about higher blood pressure in the long term due to a higher salt diet in the first year, but the data on these is not super compelling and the differences are small.

Like with most things, moderation is key! Avoid very salty chips or olives or saltines with your infant. But if you’re doing baby-led weaning, it’s okay for them to share your lightly salted meals. Your baby does not need their own, unsalted, chicken if you’re making yourself a roast. Just skip the super salty stuff.

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Among parenting topics, sleep training is one of the most divisive. Ultimately, it’s important to know that studies looking at the short- and long-term effects of sleep training show no evidence of harm. The data actually shows it can improve infant sleep and lower parental depression.

Even so, while sleep training can be a great option, it will not be for everyone. Just as people can feel judged for sleep training, they can feel judged for not doing it. Engaging in any parenting behavior because it’s what’s expected of you is not a good idea. You have to do what works best for your family! If that’s sleep training, make a plan and implement it. If not, that’s okay too.

What’s your experience with sleep training? Did you feel judged for your decision to do (or not do) it?

#sleeptraining #newparents #babysleep #emilyoster #parentdata

Is sleep training bad? Comment “Link” for a DM to an article breaking down the data on sleep training 😴

Among parenting topics, sleep training is one of the most divisive. Ultimately, it’s important to know that studies looking at the short- and long-term effects of sleep training show no evidence of harm. The data actually shows it can improve infant sleep and lower parental depression.

Even so, while sleep training can be a great option, it will not be for everyone. Just as people can feel judged for sleep training, they can feel judged for not doing it. Engaging in any parenting behavior because it’s what’s expected of you is not a good idea. You have to do what works best for your family! If that’s sleep training, make a plan and implement it. If not, that’s okay too.

What’s your experience with sleep training? Did you feel judged for your decision to do (or not do) it?

#sleeptraining #newparents #babysleep #emilyoster #parentdata
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Does your kid love to stall right before bedtime? 💤 Tell me more about their tactics in the comments below!

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Does your kid love to stall right before bedtime? 💤 Tell me more about their tactics in the comments below!

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Having this realization, accepting it, reminding ourselves of it, can help us make the hard decisions and accurately weigh the risks and benefits of our choices.

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Got a big decision to make? 🤔 Comment “Link” for a DM to read about my easy mantra for making hard choices.

When we face a complicated problem in pregnancy or parenting, and don’t like either option A or B, we often wait around for a secret third option to reveal itself. This magical thinking, as appealing as it is, gets in the way. We need a way to remind ourselves that we need to make an active choice, even if it is hard. The mantra I use for this: “There is no secret option C.”

Having this realization, accepting it, reminding ourselves of it, can help us make the hard decisions and accurately weigh the risks and benefits of our choices.

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Excuse the language, but I have such strong feelings about this subject! Sometimes, it feels like there’s no winning as a mother. People pressure you to breastfeed and, in the same breath, shame you for doing it in public. Which is it?!

So yes, they’re being completely unreasonable. You should be able to feed your baby in peace. What are some responses you can give to someone who tells you to cover up? Share in the comments below ⬇️

#breastfeeding #breastfeedinginpublic #breastfeedingmom #motherhood #emilyoster

Excuse the language, but I have such strong feelings about this subject! Sometimes, it feels like there’s no winning as a mother. People pressure you to breastfeed and, in the same breath, shame you for doing it in public. Which is it?!

So yes, they’re being completely unreasonable. You should be able to feed your baby in peace. What are some responses you can give to someone who tells you to cover up? Share in the comments below ⬇️

#breastfeeding #breastfeedinginpublic #breastfeedingmom #motherhood #emilyoster
...

Potty training can feel like a Mount Everest-size challenge, and sadly, our evidence-based guidance is poor. So, I created a survey to collate advice and feedback on success from about 6,000 participants.

How long does potty training take? We found that there is a strong basic pattern here: the later you wait to start, the shorter time it takes to potty train. On average, people who start at under 18 months report it takes them about 12 weeks for their child to be fully trained (using the toilet consistently for both peeing and pooping). For those who start between 3 and 3.5, it’s more like nine days. Keep in mind that for all of these age groups, there is a range of length of time from a few days to over a year. Sometimes parents are told that if you do it right, it only takes a few days. While that is true for some people, it is definitely not the norm.

If you’re in the throes of potty training, hang in there! 

#emilyoster #parentdata #pottytraining #pottytrainingtips #toddlerlife

Potty training can feel like a Mount Everest-size challenge, and sadly, our evidence-based guidance is poor. So, I created a survey to collate advice and feedback on success from about 6,000 participants.

How long does potty training take? We found that there is a strong basic pattern here: the later you wait to start, the shorter time it takes to potty train. On average, people who start at under 18 months report it takes them about 12 weeks for their child to be fully trained (using the toilet consistently for both peeing and pooping). For those who start between 3 and 3.5, it’s more like nine days. Keep in mind that for all of these age groups, there is a range of length of time from a few days to over a year. Sometimes parents are told that if you do it right, it only takes a few days. While that is true for some people, it is definitely not the norm.

If you’re in the throes of potty training, hang in there!

#emilyoster #parentdata #pottytraining #pottytrainingtips #toddlerlife
...

For children or adults with severe food allergies, they can be incredibly scary and restrictive. We may imagine that it’s easy to deal with a peanut allergy by, say, not eating peanut butter sandwiches. But for someone with a severe version of this allergy, they may never be able to go to a restaurant, for fear of a severe reaction to something in the air. Right now, there’s only one approved treatment for severe allergies like this and it’s limited to peanuts.

This is why the new medication Xolair is very exciting. It promises a second possible treatment avenue and one that works for other allergens. A new trail analyzed data from 177 children with severe food allergies. Two-thirds of the treatment group were able to tolerate the specified endpoint, versus just 7% of the placebo group. This is a very large treatment effect, and the authors found similarly large impacts on other allergens. 

There are some caveats: This treatment won’t work for everyone. (One-third of participants did not respond to it.) Additionally, this treatment is an injection given every two to four weeks, indefinitely. This may make it less palatable to children. 

Overall, even with caveats, this is life-changing news for many families!

#xolair #foodallergies #allergies #peanutallergy #emilyoster #parentdata

For children or adults with severe food allergies, they can be incredibly scary and restrictive. We may imagine that it’s easy to deal with a peanut allergy by, say, not eating peanut butter sandwiches. But for someone with a severe version of this allergy, they may never be able to go to a restaurant, for fear of a severe reaction to something in the air. Right now, there’s only one approved treatment for severe allergies like this and it’s limited to peanuts.

This is why the new medication Xolair is very exciting. It promises a second possible treatment avenue and one that works for other allergens. A new trail analyzed data from 177 children with severe food allergies. Two-thirds of the treatment group were able to tolerate the specified endpoint, versus just 7% of the placebo group. This is a very large treatment effect, and the authors found similarly large impacts on other allergens.

There are some caveats: This treatment won’t work for everyone. (One-third of participants did not respond to it.) Additionally, this treatment is an injection given every two to four weeks, indefinitely. This may make it less palatable to children.

Overall, even with caveats, this is life-changing news for many families!

#xolair #foodallergies #allergies #peanutallergy #emilyoster #parentdata
...

If you have a fever during pregnancy, you should take Tylenol, both because it will make you feel better and because of concerns about fever in pregnancy (although these are also overstated).

The evidence that suggests risks to Tylenol focuses largely on more extensive exposure — say, taking it for more than 28 days during pregnancy. There is no credible evidence, even correlational, to suggest that taking it occasionally for a fever or headache would be an issue.

People take Tylenol for a reason. For many people, the choice may be between debilitating weekly migraines and regular Tylenol usage. The impacts studies suggest are very small. In making this decision, we should weigh the real, known benefit against the suggestion of this possible risk. Perhaps not everyone will come out at the same place on this, but it is crucial we give people the tools to make the choice for themselves.

#emilyoster #parentdata #tylenol #pregnancy #pregnancytips

If you have a fever during pregnancy, you should take Tylenol, both because it will make you feel better and because of concerns about fever in pregnancy (although these are also overstated).

The evidence that suggests risks to Tylenol focuses largely on more extensive exposure — say, taking it for more than 28 days during pregnancy. There is no credible evidence, even correlational, to suggest that taking it occasionally for a fever or headache would be an issue.

People take Tylenol for a reason. For many people, the choice may be between debilitating weekly migraines and regular Tylenol usage. The impacts studies suggest are very small. In making this decision, we should weigh the real, known benefit against the suggestion of this possible risk. Perhaps not everyone will come out at the same place on this, but it is crucial we give people the tools to make the choice for themselves.

#emilyoster #parentdata #tylenol #pregnancy #pregnancytips
...

Parenting trends are like Cabbage Patch Kids: they’re usually only popular because a bunch of people are using them! Most of the time, these trends are not based on new scientific research, and even if they are, that new research doesn’t reflect all of what we’ve studied before.

In the future, before hopping onto the latest trend, check the data first. Unlike Cabbage Patch Kids, parenting trends can add a lot of unnecessary stress and challenges to your plate. What’s a recent trend that you’ve been wondering about?

#parentdata #emilyoster #parentingtips #parentingadvice #parentinghacks

Parenting trends are like Cabbage Patch Kids: they’re usually only popular because a bunch of people are using them! Most of the time, these trends are not based on new scientific research, and even if they are, that new research doesn’t reflect all of what we’ve studied before.

In the future, before hopping onto the latest trend, check the data first. Unlike Cabbage Patch Kids, parenting trends can add a lot of unnecessary stress and challenges to your plate. What’s a recent trend that you’ve been wondering about?

#parentdata #emilyoster #parentingtips #parentingadvice #parentinghacks
...

As of this week, 1 million copies of my books have been sold. This feels humbling and, frankly, unbelievable. I’m so thankful to those of you who’ve read and passed along your recommendations of the books.

When I wrote Expecting Better, I had no plan for all of this — I wrote that book because I felt compelled to write it, because it was the book I wanted to read. As I’ve come out with more books, and now ParentData, I am closer to seeing what I hope we can all create. That is: a world where everyone has access to reliable data, based on causal evidence, to make informed, confident decisions that work for their families.

I’m so grateful you’re all here as a part of this, and I want to thank you! If you’ve been waiting for the right moment to sign up for full access to ParentData, this is it. ⭐️ Comment “Link” for a DM with a discount code for 20% off of a new monthly or annual subscription to ParentData! 

Thank you again for being the best community of readers and internet-friends on the planet. I am so lucky to have you all here.

#parentdata #emilyoster #expectingbetter #cribsheet #familyfirm #parentingcommunity

As of this week, 1 million copies of my books have been sold. This feels humbling and, frankly, unbelievable. I’m so thankful to those of you who’ve read and passed along your recommendations of the books.

When I wrote Expecting Better, I had no plan for all of this — I wrote that book because I felt compelled to write it, because it was the book I wanted to read. As I’ve come out with more books, and now ParentData, I am closer to seeing what I hope we can all create. That is: a world where everyone has access to reliable data, based on causal evidence, to make informed, confident decisions that work for their families.

I’m so grateful you’re all here as a part of this, and I want to thank you! If you’ve been waiting for the right moment to sign up for full access to ParentData, this is it. ⭐️ Comment “Link” for a DM with a discount code for 20% off of a new monthly or annual subscription to ParentData!

Thank you again for being the best community of readers and internet-friends on the planet. I am so lucky to have you all here.

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Just eat your Cheerios and move on.

Just eat your Cheerios and move on. ...

The AAP’s guidelines recommend sleeping in the same room as your baby “ideally for the first six months.” However, the risk of SIDS is dramatically lower after four months, and the evidence in favor of the protective effect of room sharing is quite weak (both overall and even more so after four months). There is also growing evidence that infants who sleep in their own room by four months sleep better at four months, better at nine months, and even better at 30 months.

With this in mind, it’s worth asking why this recommendation continues at all — or at least why the AAP doesn’t push it back to four months. They say decreased arousals from sleep are linked to SIDS, which could mean that babies sleeping in their own room is risky. But this link is extremely indirect, and they do not show direct evidence to support it.

According to the data we have, parents should sleep in the same room as a baby for as long as it works for them! Sharing a room with a child may have negative impacts on both child and adult sleep. We should give families more help in navigating these trade-offs and making the decisions that work best for them.

#emilyoster #parentdata #roomsharing #sids #parentingguide

The AAP’s guidelines recommend sleeping in the same room as your baby “ideally for the first six months.” However, the risk of SIDS is dramatically lower after four months, and the evidence in favor of the protective effect of room sharing is quite weak (both overall and even more so after four months). There is also growing evidence that infants who sleep in their own room by four months sleep better at four months, better at nine months, and even better at 30 months.

With this in mind, it’s worth asking why this recommendation continues at all — or at least why the AAP doesn’t push it back to four months. They say decreased arousals from sleep are linked to SIDS, which could mean that babies sleeping in their own room is risky. But this link is extremely indirect, and they do not show direct evidence to support it.

According to the data we have, parents should sleep in the same room as a baby for as long as it works for them! Sharing a room with a child may have negative impacts on both child and adult sleep. We should give families more help in navigating these trade-offs and making the decisions that work best for them.

#emilyoster #parentdata #roomsharing #sids #parentingguide
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