New AAP Guidelines on Childhood Obesity

Emily Oster

11 min Read Emily Oster

Emily Oster

New AAP Guidelines on Childhood Obesity

What does the data tell us?

Emily Oster

11 min Read

Several weeks ago, the American Academy of Pediatrics released new guidelines for pediatricians on childhood obesity. These replace guidelines from 2007 that emphasized nutrition counseling and possible referrals outside of pediatricians’ offices. The new guidelines differ, in short, in arguing for a more aggressive approach to obesity in children and adolescents, up to and including medication and surgery. The guidelines still state that the most effective treatment is lifestyle and behavior changes, and that these new suggested measures are another tool in the toolbox.

Issuing guidelines like this is a huge lift, and I do not envy the amount of work that went into them by the committee. Especially since, to be frank, the reception has been decidedly cool, bordering on frigid. Criticism of the guidelines has come from all sides. Within the past week, I read fairly scathing criticism from both Vinay Prasad and Virginia Sole-Smith. To be clear, those two disagree vehemently with each other; what they can agree on is that the guidelines are problematic.

I have been considering why the reaction has been so negative. In doing so, I thought about the comparison to other guidelines. To be sure, the AAP has released other guidelines that commentators found problematic (here I am on its breastfeeding guidelines last year). But the organization also releases a lot of documents that are useful but not noteworthy.

For example: there are AAP guidelines on vision screening, which encourage doctors to be vigilant about screening for vision issues and to refer patients to specialists if necessary. Vision problems in children are treated in a variety of ways, ranging from eye drops to glasses to contact lenses. In a sense, these guidelines share a structure with the obesity guidelines: they recommend screening and treatment. The reaction is, of course, totally different.

The clearest reason for this difference is the way we, as a society, think about weight. Implicitly or explicitly, society has associated overweight and obesity with value. I am no expert on this; I’d point you to the work of Sole-Smith, Aubrey Gordon, and this excellent piece. These issues are often especially fraught in interactions with doctors. (Even the word obesity is uncomfortable for many people; I will use it here for precision, since it is the one used in the pediatric guidelines.)

So, stigma is one issue. However, in reflecting on the pediatric guidelines, I believe they would run into criticism even if we completely turned off these value judgements. Because from a data standpoint, there are at least two central conclusions on which these guidelines are based, and on which people disagree. Today, I want to unpack those data pieces.

Issue 1: Is childhood obesity a health concern?

Consider the vision guidelines and ask a parallel question — Is childhood myopia a health concern? — and the answer would clearly be yes. Not being able to see impacts the ability to do activities (see the blackboard at school, compete in many sports, etc.). It’s a concern for quality of life.

When we turn to weight, the AAP guidelines make clear that they are starting from the point that childhood obesity is a health concern. But not everyone agrees with this.

The disagreement is closely related to disagreements about the relationship between weight and health in adults. On one hand, it is clearly visible in the data that increased weight (holding height constant) is, on average, associated with worse health outcomes. People who have obesity are more likely to have other health issues — Type 2 diabetes, heart disease, stroke, cancer, sleep apnea, and others. In at least some of these cases, there is a lot of reason to think that these are mechanistically linked; that is, that obesity has an underlying relationship to the disease.

On the other hand, the link between weight, or body mass index, and health is by no means simple. BMI itself is just a ratio, and these “overweight” and “obese” cutoffs in medical definitions are arbitrary. And while it may be the case that, on average, people have more health issues at a BMI of 30 than a BMI of 24, this is definitely not true in all cases. Other health behaviors really, really matter. Someone with a BMI of 29 who jogs three miles five days a week is likely to have much better cardiovascular fitness than someone with a BMI of 22 who never exercises.

Attempting to summarize a full picture of health with a single number is misleading and counterproductive, on top of being judgmental.

The issues are even more complicated with children. There is a link between childhood obesity and adult obesity, but the predictive power is not 100%. About half of children with obesity go on to have obesity in adolescence, and about 70% of adolescents with obesity go on to have obesity at age 30. This could argue for lowering the focus on childhood and waiting to address health issues in adulthood. However, habit formation in childhood around food and exercise does carry over to adulthood, so it may be easier to intervene on these concerns with children. In addition, there is an argument that treating obesity directly in kids would make them less likely to develop conditions like Type 2 diabetes later. Better to treat obesity now than wait for other health problems later.

If you are in the camp of thinking childhood obesity is not a problem to be solved, then the entire premise of the AAP guidelines is flawed. As it turns out, though, even if we agree that there is a health concern, there is a second fundamental disagreement.

Issue 2: Is there anything effective to do about this problem?

Let’s return to childhood vision. There are a lot of effective interventions to treat myopia — glasses, contacts. Recommending that people do these things is uncontroversial. That is not true of obesity.

The AAP makes a number of recommendations. The first is that all children over the age of 2 with obesity should be referred to what is called intensive health behavior and lifestyle treatment (IHBLT). This involves family engagement with a high-intensity treatment program designed to change nutrition and physical activity. The gold-standard programs here deliver 26 or more hours of face-to-face contact over a 3- to 12-month period.

There are an enormous number of reasons why this recommendation is practically problematic. These programs are expensive and not widely available. They are typically not covered by insurance. They take huge amounts of time that families do not have. Attrition rates are high, perhaps 60% in many populations.

In addition, the impacts — even in experimental trials, which are likely to way overstate the population impacts — are small. This JAMA meta-analysis combines the randomized trials of this treatment. In commenting on the impact of trials with 26 to 51 contact hours, the authors say: “However, across all levels of contact, children in both groups showed a wide range of effects, as demonstrated by large SDs [standard deviations] relative to the mean change: some children in both groups showed fairly large reductions in excess weight, some showed no or modest changes, and some continued to gain excess weight.”

Basically, the impacts of these trials are really imprecise. Some show reductions, some do not. The effects are also small in magnitude, with the treatment groups mostly maintaining weight and the control group gaining 5 to 17 pounds on average. In the four trials that followed kids beyond 12 months, two of them showed continued impacts and two did not.

This isn’t to say that there isn’t some possible impact of these interventions, especially as you get into a range over 52 contact hours. But they aren’t some kind of magic panacea. And, again, they are pretty impractical as a public policy.

These results reflect a broad reality: weight loss through behavior change is extremely difficult to implement, especially long-term. There have been lots of kinds of interventions done with both children and adults, and behaviors are intractable. Diets usually do not have long-term impacts for the vast majority of people. Policies like “more gym time at school” also do not matter for weight.

Perhaps reflecting this reality, the AAP recommendations also suggest that pediatricians consider treatment with medication for children 12 and over, and bariatric surgery for children 13 and over with severe obesity.

The discussion of surgery in the document, while somewhat jarring (permanent, major surgery in kids who are 14 or 15 is hard to contemplate), is in a way fairly measured. They are clear that this is only one possible discussion in very extreme cases, with significant health-related complications. I do not think that this recommendation is likely to change practice in any meaningful way.

On the other hand, the medication discussion feels more meaningful — more like it might change how obesity is treated.

The guidelines discuss a large number of medications. For the most part, those don’t really work, or the side effects are prohibitive. For example, metformin (for which there is the most evidence) seems to have only marginal impacts on weight, along with substantial gastrointestinal side effects. Orlistat causes so much gas and “fecal urgency” that it isn’t widely used. Something called topiramate in principle suppresses appetite, but it causes cognitive slowing to the point of interfering with daily living, and the only trial of its use in children showed no impacts on weight.

I cannot imagine anyone prescribing any of these. There would be no reason!

However, there are new developments in weight-loss medication in the form of glucagon-like peptide-1 receptor agonists, like semaglutide, which suppress appetite. These are delivered through weekly injections and, in adults, seem to have significant impacts on weight (perhaps a 15% reduction). The idea is that these drugs would be taken continuously long-term to keep appetite suppressed.

Studies of these in kids are limited. A couple of tiny (like 12 kids) trials have shown BMI reductions. But these also have adverse effects (nausea, vomiting, possible increased risk of thyroid cancer).

Here is where we find ourselves. There is a broadly impractical recommendation for high-dose counseling interventions that, at best, are likely to have small impacts. There is at least one more extensively studied medication (metformin) that doesn’t work. And there’s an exciting new treatment with no real data in children, with no long-term follow-up in adults as an obesity treatment, that requires weekly injections, possibly forever, and has serious side effects.

Where to go from here

As I said, I’m glad I do not have to write these guidelines. I do not see some obvious solution. There are, however, two things that occur to me.

First: we need more evidence on what might work. There have been many efforts made — to improve school food, to increase access to fruits and vegetables, to change how food is marketed to kids, to create places for play, to educate about nutrition, and so on. All of these need more research dollars, along with a deeper dive on how we can improve nutrition in the household. Focusing on weight as a primary outcome misses the point. We’ve spent a lot of time focused on weight and relatively less time on trying to understand how households eat and what might nudge them to healthier eating.

The second is that there is not even close to enough discussion of the mental health impacts of these interventions on kids. Trials that look at weight loss tend not to consider either short- or long-term impacts on eating disorders in kids. This discussion is completely missing the possibility that by trying to address one issue, you may actually create another, potentially worse, one.

I listened to an interview about these guidelines in which someone suggested that, basically, we need to intervene extensively with kids because kids are bullied for their weight. That strikes me as an absolutely terrible argument. Rather than trying to address the problem of bullying, or help kids be resilient, we’re going to tell them that if they were just thinner, that wouldn’t happen? Or, effectively, bully them through the medical system? This is hardly a solution, and, plausibly, it would make things worse.

This seems to me the fundamental conflict with the entire AAP document. It argues that there is a problem, but the solutions presented are ultimately not compelling. It is a very hard problem; to go back to the vision comparison, we are about as far from “slap a pair of glasses on your face and you will be able to see” as you can get. In the end, hard problems will require work to solve — work that we should do but haven’t done enough of yet.

A medical exam table is seen with a folded hospital gown and paper sheet.

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We are better writers than influencers, I promise. Thanks to our kids for filming our unboxing videos. People make this look way too easy. 

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We are better writers than influencers, I promise. Thanks to our kids for filming our unboxing videos. People make this look way too easy.

Only two weeks until our book “The Unexpected” is here! Preorder at the link in my bio. 💙
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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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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.

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

#cribsheet #emilyoster #parentdata #languagedevelopment #firstwords
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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. ...

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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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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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!

#swimlessons #watersafety #kidsswimminglessons #poolsafety #emilyoster #parentdata

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!

#swimlessons #watersafety #kidsswimminglessons #poolsafety #emilyoster #parentdata
...

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.

 #emilyoster #parentdata #childnutrition #babynutrition #foodforkids

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.

#emilyoster #parentdata #childnutrition #babynutrition #foodforkids
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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

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
...

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!

#funnytweets #bedtime #nightimeroutine #parentinghumor #parentingmemes
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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.

#parentingquotes #decisionmaking #nosecretoptionc #parentingadvice #emilyoster #parentdata

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.

#parentingquotes #decisionmaking #nosecretoptionc #parentingadvice #emilyoster #parentdata
...

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.

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