Emily Oster

5 min Read Emily Oster

Emily Oster

Pregnant with a Toddler

Emily Oster

5 min Read

Many weeks ago, I wrote a very long piece on a decision process for many things in COVID-19, notably grandparents and child care. It included a 5 point “decision framework”:

  1. Frame the Question
  2. Mitigate Risk
  3. Evaluate Risk
  4. Evaluate Benefits
  5. Decide

I thought it might be useful to revisit this, briefly, today in the context of the question I get by far the most. It is a version of: “I am pregnant, due in October, and I’m trying to decide whether my two year old should go back to day care.”

Frame The Question

Should I sent my toddler back to day care or…what? In many cases, especially with a newborn at home, the alternative is to keep the toddler at home in whatever child care solution the newborn has. But your choice may be slightly different. If the newborn is planning to be in out of home child care, this probably changes the calculation.

Mitigate Risk

Just two notes on risk mitigation. First, make sure the child care solution you choose has some simple symptom monitoring and case reporting. This will go a long way to lowering the risk of in-care transmission.

Second, totally independent of COVID-19, you should be careful about having your toddler interact with your infant before the have their first shots. Infants are more susceptible to (non-COVID) illnesses and they will need more intensive treatment if they, say, get a fever. So it’s always worth being careful of these interactions in the first month or two. (I talk about this some in Cribsheet, in the non-COVID world).

Evaluate Risk

The key question I think people are grappling with here is how risky is this? This combines a few pieces: how likely is my toddler to get COVID-19 in child care, how likely are they to transmit to the family (either pregnant person or infant), and how likely is it that serious illness will result in anyone in this chain?

One piece of this relates to the prevalence around you, so I’d probably start everything by going to Johns Hopkins and checking out the situation in your area. There is no hard and fast rule about what is a “low” prevalence, but at least you can get some sense of the chance of exposure.

Of course, what you really want to know is the risk of your child getting infected at child care, and our data on that is poor. What we do have generally suggests pretty low risk — you can see some data from crowd-sourcing here, and all the data that we could find on state-level outbreaks here. There have been some cases in child care centers but the fact is that this risk is low.

You can refer above to the information on the chance of your child getting very sick. In terms of in-household transmission, the best evidence we have is probably from this South Korea study which showed very limited transmission from younger children within the household. So that is also reassuring.

What if you do get COVID-19? COVID-Explained has some resources here on COVID in pregnancy, most of which is very reassuring. A few weeks ago everyone panicked when the CDC said pregnant women were more likely to be hospitalized with COVID-19 than non-pregnant, but what most coverage failed to note is that this included hospitalizations to give birth. Sigh. Infants do seem to be at slightly higher risk than older children but, still, very low.

How do we aggregate all of this? There is a low probability of infection, and then a low chance of transmission and then a very low chance of serious infection. Small times small times small equals small.

It may actually be more helpful to refer to the flu information above. If you send your toddler to child care they are more likely to get seriously ill from the flu than from COVID-19. This flu would also be much more dangerous for you and your infant. The fact that you probably wouldn’t be having this conversation in flu season suggests something about your risk tolerance (not something bad! These risks are also small!). But I think it puts this all in some context.

Evaluate Benefits

You do not need me for this. What is the value to your family? How much do you think your toddler needs socialization? Are there other (less risky) social opportunities? How difficult would it be to have the toddler home during parental leave (if you have it)? Do you have other help?

Don’t ignore the mental health benefits here. I think we too frequently forget that parental happiness and sanity should be valued in these choices.

Decide…

…and then move on. You’ll never really know if the decision was right ex ante. This is part of what makes this especially hard here. There is so much uncertainty, so much fear, that it is difficult to ever really feel “happy” with your choice. What you can feel happy about is the choice process. So make that the goal.

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👉Comment “Link” for a DM to an article that summarizes all of the best potty training advice we collected. 

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#emilyoster #parentdata #pottytraining #pottytrainingtips #toddlertips

Looking for Memorial Day Weekend plans? Might be the perfect time to give potty training a shot. Potty training is notoriously difficult, and we unfortunately don’t have a lot of evidence-based guidance on what works best. So I asked the ParentData community to fill out a survey and share their knowledge — about 6,000 people responded.

👉Comment “Link” for a DM to an article that summarizes all of the best potty training advice we collected.

Remember, you are not alone in the potty training struggle! It can be incredibly challenging, so please give yourself some grace.

#emilyoster #parentdata #pottytraining #pottytrainingtips #toddlertips
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Do you brand things a certain way to get your kid to accept it? Like calling carrots “rabbit popsicles”? Or telling them to put on their “super speed socks” in the morning? Share your rebrands in the comments below! You never know who you might be helping out 👇

#emilyoster #funnytweets #relatabletweets #parentingjokes #kidssaythedarndestthings
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Listen and subscribe to ParentData with Emily Oster in your favorite podcast app 🎧

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Today is the first episode of a new biweekly series on my podcast: Late-Night Panic Google. On these mini-episodes, you’ll hear from some familiar names about the questions keeping them up at night, and how data can help. First up: @claireholt!

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

#parentdata #emilyoster #claireholt #parentingstruggles #parentingtips #latenightpanicgoogle
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☀️ Most importantly, limit their time out in hot weather. (They get hotter than you do!)
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☀️ If you want to add a little sunscreen on their hands and feet? Go for it! But be mindful as baby skin tends to more prone to irritation.

Comment “Link” for a DM to an article on the data around sun and heat exposure for babies.

#sunsafety #babysunscreen #babyhealth #parentdata #emilyoster

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☀️ Keep them in the shade as much as possible when you’re out.
☀️ Long-sleeve but lightweight clothing is your friend, especially on the beach, where even in the shade you can get sunlight reflecting off different surfaces.
☀️ If you want to add a little sunscreen on their hands and feet? Go for it! But be mindful as baby skin tends to more prone to irritation.

Comment “Link” for a DM to an article on the data around sun and heat exposure for babies.

#sunsafety #babysunscreen #babyhealth #parentdata #emilyoster
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#theunexpected #emilyoster #pregnancycomplications #pregnancystory

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OUT NOW: My new book “The Unexpected: Navigating Pregnancy During and After Complications” is available on April 30th. All of my other books came out of my own experiences. I wrote them to answer questions I had, as a pregnant woman and then as a new parent. “The Unexpected” is a book not to answer my own questions but to answer yours. Specifically, to answer the thousands of questions I’ve gotten over the past decade from people whose pregnancies were more complicated than they had expected. This is for you. 💛 Order now at my link in bio! ...

OUT NOW: My new book “The Unexpected: Navigating Pregnancy During and After Complications” is available on April 30th. All of my other books came out of my own experiences. I wrote them to answer questions I had, as a pregnant woman and then as a new parent. “The Unexpected” is a book not to answer my own questions but to answer yours. Specifically, to answer the thousands of questions I’ve gotten over the past decade from people whose pregnancies were more complicated than they had expected. This is for you. 💛 Order now at my link in bio!

OUT NOW: My new book “The Unexpected: Navigating Pregnancy During and After Complications” is available on April 30th. All of my other books came out of my own experiences. I wrote them to answer questions I had, as a pregnant woman and then as a new parent. “The Unexpected” is a book not to answer my own questions but to answer yours. Specifically, to answer the thousands of questions I’ve gotten over the past decade from people whose pregnancies were more complicated than they had expected. This is for you. 💛 Order now at my link in bio! ...

OUT NOW: My new book “The Unexpected: Navigating Pregnancy During and After Complications” is available on April 30th. All of my other books came out of my own experiences. I wrote them to answer questions I had, as a pregnant woman and then as a new parent. “The Unexpected” is a book not to answer my own questions but to answer yours. Specifically, to answer the thousands of questions I’ve gotten over the past decade from people whose pregnancies were more complicated than they had expected. This is for you. 💛 Order now at my link in bio!

OUT NOW: My new book “The Unexpected: Navigating Pregnancy During and After Complications” is available on April 30th. All of my other books came out of my own experiences. I wrote them to answer questions I had, as a pregnant woman and then as a new parent. “The Unexpected” is a book not to answer my own questions but to answer yours. Specifically, to answer the thousands of questions I’ve gotten over the past decade from people whose pregnancies were more complicated than they had expected. This is for you. 💛 Order now at my link in bio! ...

Is side sleeping important during pregnancy? Comment “Link” for a DM to an article on whether sleep position affects pregnancy outcomes.

Being pregnant makes you tired, and as time goes by, it gets increasingly hard to get comfortable. You were probably instructed to sleep on your side and not your back, but it turns out that advice is not based on very good data.

We now have much better data on this, and the bulk of the evidence seems to reject the link between sleep position and stillbirth or other negative outcomes. So go ahead and get some sleep however you are most comfortable. 💤

Sources:
📖 #ExpectingBetter pp. 160-163
📈 Robert M. Silver et al., “Prospective Evaluation of Maternal Sleep Position Through 30 Weeks of Gestation and Adverse Pregnancy Outcomes,” Obstetrics and Gynecology 134, no. 4 (2019): 667–76. 

#emilyoster #pregnancy #pregnancytips #sleepingposition #pregnantlife

Is side sleeping important during pregnancy? Comment “Link” for a DM to an article on whether sleep position affects pregnancy outcomes.

Being pregnant makes you tired, and as time goes by, it gets increasingly hard to get comfortable. You were probably instructed to sleep on your side and not your back, but it turns out that advice is not based on very good data.

We now have much better data on this, and the bulk of the evidence seems to reject the link between sleep position and stillbirth or other negative outcomes. So go ahead and get some sleep however you are most comfortable. 💤

Sources:
📖 #ExpectingBetter pp. 160-163
📈 Robert M. Silver et al., “Prospective Evaluation of Maternal Sleep Position Through 30 Weeks of Gestation and Adverse Pregnancy Outcomes,” Obstetrics and Gynecology 134, no. 4 (2019): 667–76.

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#pregnancy #pregnancycomplications #pregnancyjourney #preeclampsiaawareness #postpartumjourney #emilyoster

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I co-wrote #TheUnexpected with my friend and maternal fetal medicine specialist, Dr. Nathan Fox. The unfortunate reality is that about half of pregnancies include complications such as preeclampsia, miscarriage, preterm birth, and postpartum depression. Because these are things not talked about enough, it can not only be an isolating experience, but it can also make treatment harder to access.

The book lays out the data on recurrence and delves into treatment options shown to lower risk for these conditions in subsequent pregnancies. It also guides you through how to have productive conversations and make shared decisions with your doctor. I hope none of you need this book, but if you do, it’ll be here for you 💛

#pregnancy #pregnancycomplications #pregnancyjourney #preeclampsiaawareness #postpartumjourney #emilyoster
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Only two weeks until our book “The Unexpected” is here! Preorder at the link in my bio. 💙

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