How to Protect Against Illness This Holiday Season

Emily Oster

8 min Read Emily Oster

Emily Oster

How to Protect Against Illness This Holiday Season

Safety Turducken for 2022 and beyond

Emily Oster

8 min Read

I first wrote about COVID Thanksgiving in October of 2020, when I discussed the idea of the “Safety Turducken”: basically, how to put layers of protection in if you were going to see your family. I wrote about it again in October of 2021, when things were better but still complicated.

In this moment, I am still getting a lot of questions about illness and seeing family. I will note, however, they are mostly not about COVID. People — especially those with young kids — are more worried about flu and RSV. These concerns are going to be evergreen. The pandemic isn’t over, but it’s reached a place for most people where COVID is part of a broader landscape of illness. The turducken we build this year for Thanksgiving is going to be one we consider keeping indefinitely; it’s one we could have had in earlier, pre-COVID years, except we were not thinking about it.

The pitch here is: You’re going to see your extended family, or friends, for Thanksgiving, and get-togethers like this are always a risk for illness. How can you lower these risks, both for your individual family, for the extended group, and for broader society?

I’m going to divide this into two sets of actions. The first are ones you can take as an individual family unit, without anyone else participating. The second are ones your broader group could consider taking. Finally, I’ll talk about how to make a plan (hint: be the first to read this so you can propose the plan!).

Individual family precautions

There are some actions your family can take to protect yourselves against illness (in general and in these gatherings). By “individual family,” I’m thinking of people whose actions you influence or control. That could be broader than people who live in your house! But I want to draw a distinction between actions or choices you can definitely make and those that require other people to comply.

Actions for everyone

Flu shots. Flu shots are a good idea for everyone, including kids, adults, older adults, all the people. It was a bad flu season in the other hemisphere, which portends a bad one for us. Flu vaccines are not perfectly protective, but they lower the risk of infection and tend to make it milder when people are infected. Flu poses a particular risk to children, so they should be included in vaccines.

General hygiene: hand washing, etc. COVID is airborne, making hand washing less effective. But many illnesses — hand, foot, and mouth; norovirus; flu; RSV — really benefit from hand washing. This isn’t so much about Thanksgiving, but it’s a good time to reinforce for kids that hands should be washed fairly well. Like, with soap.

Special considerations: older adults or immunocompromised individuals

COVID boosters. The bivalent boosters seem to be performing similarly to existing boosters; they’re especially effective at lowering the risk of serious illness. This serious illness is a significant risk in older people, especially those over 65. If you have an older adult in your family, they should get the bivalent booster to protect themselves. For younger people without immunocompromise, a result of the booster is likely to be some short-term reduction in the risk of getting COVID. This group should consider it, but the most important vaccination group is the older one.

Special considerations: newborns

If you have an infant under six months, and especially one under three months, illness is often worse. RSV is dangerous for this age group, and, for infants under two months, any fever is likely to necessitate a hospital visit. There is more imperative to keep them healthy. A 3-year-old who picks up a runny nose is annoying, but a one-month-old who does is scary. What can you do?

Limit Contact, no face kissing. The simplest way to protect your infant is to limit their physical exposure to others. Keep them somewhat distant from their toddler cousins. Do not let the toddlers get right in their faces. Ensure that any adults who hold them have washed their hands first.

Not Go. Not going to a holiday has serious downsides, but it is also the clearest way to avoid exposure.  A hard question is how to weigh these two sides of the coin. One line you might consider is the two month mark, when the interventions for a slightly sick baby start to get less stringent. Four month old illness is different from one month old illness, both in terms of risks and in terms of how the medical system would react.

In order to implement either of these, you are going to need to set some boundaries, which may be uncomfortable. Boundaries are always uncomfortable, and probably some people will be mad. That’s okay. Think about your boundaries: What are you comfortable with? Then share those boundaries up front. And when people push back in the moment, remember why you set them. To protect your baby.

Special considerations: pregnancy

Being sick during pregnancy is unpleasant, but most illnesses (including RSV) are not more dangerous during pregnancy. The most significant disease risk for pregnant women is likely CMV, which is unfortunately difficult to avoid since it’s often asymptomatic. However: good hand hygiene can go a long way.

Group precautions

Let’s turn to the harder part: What might we consider as a group to lower the risk of the gathering?

I want to start with something that I do not think is necessary, which is limiting the gathering to vaccinated people. The data we currently have suggests that vaccination remains excellent at protecting against serious illness but provides only transitory and partial protection against any infection. Although unvaccinated family members may, themselves, continue to have a higher risk of serious illness, they do not pose a significant additional risk to others.

In earlier writing on this, I also focused on quarantine. At this point, quarantine prior to a gathering is infeasible for most people. It could be effective, but it’s unlikely to be possible.

There are other precautions that we thought about in 2020 — eating outside, masking all the time — that aren’t long-term feasible and for most families are off the table at this point. The goal now is to think about precautions that will work forever.

Focusing on the possible, here are two key approaches:

Do not come if you are sick.

An initial line of defense against disease spread is to avoid the gathering if you are sick. This seems easy, but the challenge in negotiating with family is the question of “What is sick?” Up front, you need to decide what that means. Especially for a gathering that contains toddlers, who have a runny nose 98% of the time.

For a family setup with healthy adults and children who are not small babies, one option (which is what we use) is school/day-care rules: no fever or vomiting within 24 hours. This works for us because it’s easy to state and it’s got some outside validation to it.

If you have more-vulnerable individuals (older people, newborns), you might want to extend that period or set more stringent limits.

COVID testing.

The reality is that most people are not going to test for COVID prior to getting together this year. However, especially for gatherings with older individuals, it may still be a valuable line of defense. Some asymptomatic cases would be caught by this routine testing and avoid spreading.

An intermediate approach to “everyone tests” is “test if you’re at all sick, or have been within the past week.”

Make a plan

The situation is a lot simpler than last year, or the year before. There are really only two moving pieces.

First, the boundaries you want to set if you have a small baby. This plan only requires you, and your ability to hold the line. Discuss this, perhaps with your partner, make a decision, and then let people know your plans. These could include not going, or going for less time, or limiting contact in other ways. My suggestion is you tell people the boundaries in advance, but only a day or two, so there is less time for them to argue. Hold the line. It’s your decision.

Second, what guidance you want to have about not coming when sick and about COVID testing (and possibly any other restrictions that you’re considering that I do not have here). You can’t make these decisions unilaterally, but when coordinating with family, I find the first-mover advantage is extremely powerful. If you are the first one to broach a topic, you’re more likely to get your way. Hopefully, the rest of your family doesn’t read this newsletter, or they read it later in the morning and you can get your plan out to them first!

Craft an email with your specific thoughts. Hopefully, they’ll agree. To get you started, here’s mine (I like a good bullet-point list in my family emails).

Hey everyone:

Looking forward to seeing you all. Dad: Are you on top of the pies, or do you want me to contribute there too? I am ready with the cranberry sauce. In terms of illness precautions this year:

  • Can we say the usual “day-care/school” rules for illness (don’t come with a fever or vomiting within 24 hours)?
  • COVID test if you’re at all sick? We are happy to just test regardless if that makes people more comfortable.

Love,

Emily

Have a great, safe and (hopefully) healthy holiday!

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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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It was an absolute pleasure to be featured on the @tamronhallshow! We talked about all things data-driven parenting and, in this clip, what I call the plague of secret parenting. To balance having a career and having a family, we can’t hide the fact that we’re parents. If mothers and fathers at the top can speak more openly about child-care obligations, it will help us all set a new precedent.

Watch the full segment at the link in my bio 🔗

#tamronhall #tamronhallshow #emilyoster #parentingsupport #workingparents

It was an absolute pleasure to be featured on the @tamronhallshow! We talked about all things data-driven parenting and, in this clip, what I call the plague of secret parenting. To balance having a career and having a family, we can’t hide the fact that we’re parents. If mothers and fathers at the top can speak more openly about child-care obligations, it will help us all set a new precedent.

Watch the full segment at the link in my bio 🔗

#tamronhall #tamronhallshow #emilyoster #parentingsupport #workingparents
...

Invisible labor. It’s the work — in our households especially — that has to happen but that no one sees. It’s making the doctor’s appointment, ensuring birthday cards are purchased, remembering the milk.

My guest on this episode, @everodsky, has come up with a solution here, or at least a way for us to recognize the problem and make our own solutions. I’ve wanted to speak with Eve for ages, since I read her book Fair Play. We had a great conversation about the division of household labor, one I think you’ll get a lot out of!

Listen and subscribe to ParentData with Emily Oster in your favorite podcast app 🎧

#emilyoster #parentdata #parentdatapodcast #parentingpodcast #householdtips #fairplay #invisiblelabor

Invisible labor. It’s the work — in our households especially — that has to happen but that no one sees. It’s making the doctor’s appointment, ensuring birthday cards are purchased, remembering the milk.

My guest on this episode, @everodsky, has come up with a solution here, or at least a way for us to recognize the problem and make our own solutions. I’ve wanted to speak with Eve for ages, since I read her book Fair Play. We had a great conversation about the division of household labor, one I think you’ll get a lot out of!

Listen and subscribe to ParentData with Emily Oster in your favorite podcast app 🎧

#emilyoster #parentdata #parentdatapodcast #parentingpodcast #householdtips #fairplay #invisiblelabor
...

Prenatal vitamins 💊 If there is any product that seems designed to prey on our fears, it’s this one. You’re newly pregnant and you want to do it right. Everyone agrees you need prenatal vitamins, so you get them. But do you want to be that person who just… buys the generic prenatal vitamins?

Good news: fancier vitamins are not better.  Folic acid is the most important prenatal ingredient. Iron (with vitamin C) and DHA are also nice to have. Other included ingredients have only weak or no evidence to support their use. (If you do not consume animal products, add B12, plus a few others depending on your diet.)

Vitamins are just vitamins. Any prenatal vitamin that contains these is enough. 

Comment “Link” for a DM to an article with everything you need to know about prenatal vitamins.

#emilyoster #parentdata #prenatalvitamins #pregnancydiet #pregnancytips

Prenatal vitamins 💊 If there is any product that seems designed to prey on our fears, it’s this one. You’re newly pregnant and you want to do it right. Everyone agrees you need prenatal vitamins, so you get them. But do you want to be that person who just… buys the generic prenatal vitamins?

Good news: fancier vitamins are not better. Folic acid is the most important prenatal ingredient. Iron (with vitamin C) and DHA are also nice to have. Other included ingredients have only weak or no evidence to support their use. (If you do not consume animal products, add B12, plus a few others depending on your diet.)

Vitamins are just vitamins. Any prenatal vitamin that contains these is enough.

Comment “Link” for a DM to an article with everything you need to know about prenatal vitamins.

#emilyoster #parentdata #prenatalvitamins #pregnancydiet #pregnancytips
...

When it comes to introducing your newborn to the world, timing matters. It’s a good idea to minimize germ exposure in the first 6-8 weeks; after that, it’s inevitable and, very likely, a good idea! This doesn’t mean you need to be trapped inside. The most significant exposure risks are from seeing other people at home — family, etc. These interactions are not infinitely risky, but they do pose more risk than a walk or a trip to the grocery store, since they involve closer interaction. Think simple and make sure everyone is washing their hands before holding the baby. 💛

#parentdata #emilyoster #newborncare #parentingadvice #parentingtips

When it comes to introducing your newborn to the world, timing matters. It’s a good idea to minimize germ exposure in the first 6-8 weeks; after that, it’s inevitable and, very likely, a good idea! This doesn’t mean you need to be trapped inside. The most significant exposure risks are from seeing other people at home — family, etc. These interactions are not infinitely risky, but they do pose more risk than a walk or a trip to the grocery store, since they involve closer interaction. Think simple and make sure everyone is washing their hands before holding the baby. 💛

#parentdata #emilyoster #newborncare #parentingadvice #parentingtips
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The first edition of Hot Flash is out now! Comment “Link” for a DM to learn more about the late-reproductive stage.

There are times when we expect hormonal shifts. Our reproductive lives are bookended by puberty and menopause. We discuss those changes often because they are definitive and dramatic — a first period is something many of us remember clearly. But between ages 13 and 53, our hormones are changing in more subtle ways. During the late-reproductive stage (in your 40s), you can expect a lot of changes in your menstrual cycle, including the length and symptoms you experience throughout. It’s an important time in our lives that is often overlooked!

🔥 Hot Flash from ParentData is a weekly newsletter on navigating your health and hormones in the post-reproductive years. Written by Dr. Gillian Goddard, Hot Flash provides all of the information you need to have a productive, evidence-based conversation about hormonal health with your doctor.

#emilyoster #parentdata #hotflash #perimenopause #womenshealth

The first edition of Hot Flash is out now! Comment “Link” for a DM to learn more about the late-reproductive stage.

There are times when we expect hormonal shifts. Our reproductive lives are bookended by puberty and menopause. We discuss those changes often because they are definitive and dramatic — a first period is something many of us remember clearly. But between ages 13 and 53, our hormones are changing in more subtle ways. During the late-reproductive stage (in your 40s), you can expect a lot of changes in your menstrual cycle, including the length and symptoms you experience throughout. It’s an important time in our lives that is often overlooked!

🔥 Hot Flash from ParentData is a weekly newsletter on navigating your health and hormones in the post-reproductive years. Written by Dr. Gillian Goddard, Hot Flash provides all of the information you need to have a productive, evidence-based conversation about hormonal health with your doctor.

#emilyoster #parentdata #hotflash #perimenopause #womenshealth
...

There are plenty of reels telling you how to parent. Plenty of panic headlines saying that “studies show” what’s best for your kid. Even good data, from a trusted source, can send us into a spiral of comparison. But I want you to remember that no one knows your kid better than you. It’s important to absorb the research, but only you will know the approach that works best for you and your child. 💙

Now tell me in the comments: what’s a parenting move you’ve made recently that feels right to you?

#parentingcommunity #parentingsupport #parentingquotes #emilyoster #parentdata

There are plenty of reels telling you how to parent. Plenty of panic headlines saying that “studies show” what’s best for your kid. Even good data, from a trusted source, can send us into a spiral of comparison. But I want you to remember that no one knows your kid better than you. It’s important to absorb the research, but only you will know the approach that works best for you and your child. 💙

Now tell me in the comments: what’s a parenting move you’ve made recently that feels right to you?

#parentingcommunity #parentingsupport #parentingquotes #emilyoster #parentdata
...

Let’s talk about sex (after) baby! Today on the podcast, I was lucky enough to speak with @enagoski about her new book on sexual connection in long-term relationships. Especially after having kids, this is something many people struggle with. Emily tells us to stop worrying about what’s “normal” and focus on pleasure in its many forms.

Listen and subscribe to ParentData with Emily Oster in your favorite podcast app 🎧

#parentdata #parentdatapodcast #emilyoster #emilynagoski #comeasyouare #cometogether #longtermrelationship #intimacy #relationships

Let’s talk about sex (after) baby! Today on the podcast, I was lucky enough to speak with @enagoski about her new book on sexual connection in long-term relationships. Especially after having kids, this is something many people struggle with. Emily tells us to stop worrying about what’s “normal” and focus on pleasure in its many forms.

Listen and subscribe to ParentData with Emily Oster in your favorite podcast app 🎧

#parentdata #parentdatapodcast #emilyoster #emilynagoski #comeasyouare #cometogether #longtermrelationship #intimacy #relationships
...

Ever wondered if you can safely use leftover baby formula? 🍼 The CDC says to throw out unused formula immediately because of the risk of bacterial growth. However, research suggests that bacterial concentrations do not appreciably increase after 3, 12, or even 24 hours at refrigerator temperatures. Good news! This means there’s not a strong data-based reason to throw out formula right away if you store it in the fridge.

Comment “Link” for a DM to an article on another common formula question: should you throw away old formula powder?

#emilyoster #parentdata #babyformula #babyfeeding #parentingstruggles

Ever wondered if you can safely use leftover baby formula? 🍼 The CDC says to throw out unused formula immediately because of the risk of bacterial growth. However, research suggests that bacterial concentrations do not appreciably increase after 3, 12, or even 24 hours at refrigerator temperatures. Good news! This means there’s not a strong data-based reason to throw out formula right away if you store it in the fridge.

Comment “Link” for a DM to an article on another common formula question: should you throw away old formula powder?

#emilyoster #parentdata #babyformula #babyfeeding #parentingstruggles
...

What’s the most important piece of advice for new parents? Here’s one answer, but I want to hear from you! Share your suggestions in the comments ⬇️

#emilyoster #parentdata #parentingtips #parentingadvice #newparents #parentingcommunity

What’s the most important piece of advice for new parents? Here’s one answer, but I want to hear from you! Share your suggestions in the comments ⬇️

#emilyoster #parentdata #parentingtips #parentingadvice #newparents #parentingcommunity
...

What's in the bag of a Vagina Economist? 👀 Someone please tell me this looks familiar to you.

What`s in the bag of a Vagina Economist? 👀 Someone please tell me this looks familiar to you. ...

Comment ”link” for a DM to learn more about tongue ties 🔗

Breastfeeding is often difficult, especially at the start. For babies with tongue ties, many infants (and their moms) struggle to get the hang of a good latch. This can lead to painful nipples and to inefficient feeding, and then low weight gain.

So what does the data say about the increasingly common practice of cutting tongue-ties in infants to improve breastfeeding success? Several weeks ago, @nytimes published a long and quite scary article on this topic.

After diving into the data, here is what I found. There is limited evidence that frenotomy procedures improve breastfeeding efficacy and the harms of the procedure are minimal. Many women do report that it alleviates pain and helps them with breastfeeding. However, it should not be a first-line treatment for breastfeeding problems.

#parentdata #emilyoster #tonguetie #tonguetiebabies #breastfeedingsupport

Comment ”link” for a DM to learn more about tongue ties 🔗

Breastfeeding is often difficult, especially at the start. For babies with tongue ties, many infants (and their moms) struggle to get the hang of a good latch. This can lead to painful nipples and to inefficient feeding, and then low weight gain.

So what does the data say about the increasingly common practice of cutting tongue-ties in infants to improve breastfeeding success? Several weeks ago, @nytimes published a long and quite scary article on this topic.

After diving into the data, here is what I found. There is limited evidence that frenotomy procedures improve breastfeeding efficacy and the harms of the procedure are minimal. Many women do report that it alleviates pain and helps them with breastfeeding. However, it should not be a first-line treatment for breastfeeding problems.

#parentdata #emilyoster #tonguetie #tonguetiebabies #breastfeedingsupport
...

Tag a friend who needs to hear this 💛 For many choices in parenting, there is no one right answer. We can use research and data to make informed decisions, but ultimately, it won’t tell you what to do. Only you can decide what will be best for your kids and your family.

I’m here to remind you to take a deep breath and trust yourself. I’ll be here to support you along the way. 

Thank you to everyone who submitted videos, including:
@sarah.consoli
@jess_lynn627
@nicolevandenwills
@thedrblair
@ncbenedict29
@haleycimini
@iamkellysnodgrass
@calesse_smith
@garnet__gordon
@jencoopgaiser87
@danigirl18c
@jamielundergreen
@carly_comber
@thecelebratingmama
@emilyannbynum
@eeliz413

#emilyoster #parentdata #parentingadvice #parentingsupport #parentingquotes

Tag a friend who needs to hear this 💛 For many choices in parenting, there is no one right answer. We can use research and data to make informed decisions, but ultimately, it won’t tell you what to do. Only you can decide what will be best for your kids and your family.

I’m here to remind you to take a deep breath and trust yourself. I’ll be here to support you along the way.

Thank you to everyone who submitted videos, including:
@sarah.consoli
@jess_lynn627
@nicolevandenwills
@thedrblair
@ncbenedict29
@haleycimini
@iamkellysnodgrass
@calesse_smith
@garnet__gordon
@jencoopgaiser87
@danigirl18c
@jamielundergreen
@carly_comber
@thecelebratingmama
@emilyannbynum
@eeliz413

#emilyoster #parentdata #parentingadvice #parentingsupport #parentingquotes
...

Congratulations on making it through another year of panic headlines! We’ve had some doozies this year, like aspartame causing cancer and the perils of white noise, but these headlines are very often based on poor data. Correlation does not equal causation. There will certainly be more panic headlines in 2024, but ParentData is here to debunk them for you.

#emilyoster #parentdata #happynewyear2024 #panicheadline #datadriven

Congratulations on making it through another year of panic headlines! We’ve had some doozies this year, like aspartame causing cancer and the perils of white noise, but these headlines are very often based on poor data. Correlation does not equal causation. There will certainly be more panic headlines in 2024, but ParentData is here to debunk them for you.

#emilyoster #parentdata #happynewyear2024 #panicheadline #datadriven
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