60 pages • 2 hours read
Emily OsterCribsheet: A Data-Driven Guide to Better, More Relaxed Parenting, from Birth to Preschool
Nonfiction | Book | Adult | Published in 2019A modern alternative to SparkNotes and CliffsNotes, SuperSummary offers high-quality Study Guides with detailed chapter summaries and analysis of major themes, characters, and more.
Part 2, Chapters 4-7Chapter Summaries & Analyses
Part 2: “The First Year”
Part 2, Chapter 4 Summary: “Breast Is Best? Breast Is Better? Breast Is About the Same?”
Oster delves into the challenging topic of breastfeeding, sharing her personal experience and emphasizing that it can be a difficult journey for many women, contrary to the idealized image often presented. She discusses the various struggles she faced, such as supplementing with formula, using elaborate feeding setups, and the challenge of getting her baby to latch.
Oster then presents a comprehensive list of the claimed benefits of breastfeeding. She critically examines the challenges of conducting studies on breastfeeding due to inherent biases, such as more educated and wealthier women being more likely to breastfeed. Oster introduces readers to a variety of research methods, emphasizing the importance of randomized controlled trials in providing stronger evidence. She discusses the Promotion of Breastfeeding Intervention Trial (PROBIT) in Belarus, highlighting its findings on the impact of breastfeeding on gastrointestinal infections, eczema, and other health outcomes.
The author explores the relationship between breastfeeding and Sudden Infant Death Syndrome (SIDS), shedding light on the challenges of studying this rare but devastating occurrence and expressing caution about drawing definitive conclusions from existing data.
Moreover, Oster highlights that while many people claim breastfeeding leads to long-term advantages such as increased intelligence and reduced risk of obesity, the evidence supporting these assertions is not compelling. She discusses again the results of the PROBIT study, which followed children in Belarus who were part of a hospital initiative to promote breastfeeding. The study monitored the children until the age of seven, finding no significant long-term health impacts, including allergies, asthma, cavities, height, blood pressure, weight, or indicators for being overweight or obese.
Oster particularly questions the widely held belief that breastfeeding enhances IQ, emphasizing that the causal link is tenuous, as sibling comparison studies show no significant impact. Additionally, she explores subjective benefits for mothers, acknowledging that while some find breastfeeding empowering and convenient, others may experience discomfort and stress.
Oster expresses her critique of the societal pressure placed on mothers to breastfeed. She argues: “[T]he pressure on moms to breastfeed can be immense. The rhetoric makes it seem like this is the most important thing you can—and need—to do to set your child up for success. Breastfeeding is magic! Milk is liquid gold! This just isn’t right” (86). Oster challenges this narrative, asserting that such pressure is unwarranted. She acknowledges the potential benefits of breastfeeding while emphasizing that it is never the deciding factor in a child’s future success and that it often comes with substantial costs for the mother.
Part 2, Chapter 5 Summary: “Breastfeeding: A How-To Guide”
Oster reflects on her personal challenges with breastfeeding her daughter Penelope and addresses common parenting anxieties such as latching problems, supply concerns, and the use of breast pumps, emphasizing the isolating and frustrating nature of early breastfeeding experiences.
Oster explores the significance of skin-to-skin contact in improving breastfeeding rates and the positive impact of breastfeeding support from healthcare professionals or lactation consultants. She also delves into the crucial aspect of latching on, offering insights into the difficulties infants may face and potential solutions, such as nipple shields or addressing tongue tie through a surgical procedure.
Oster notes that nipple pain is quite common during breastfeeding, and she provides evidence-based suggestions for relief. She dispels the myth that pacifiers and bottles confuse babies and cause them to struggle with breastfeeding, citing randomized trials that contradict these longstanding beliefs. Oster delves into the biological mechanisms linking feeding breastfeeding frequency to milk production and highlights the challenges women may face, such as delayed onset of milk production. Oster explains that factors like smoking during pregnancy, obesity, and certain medical interventions can contribute to delayed onset. She also addresses the issues of insufficient or excessive milk supply, offering suggestions like pumping, herbal remedies, and pharmaceutical options to address supply concerns.
Furthermore, Oster dispels myths about dietary restrictions for breastfeeding mothers, assuring readers that, except for high-mercury fish, there are minimal food restrictions. She debunks myths about alcohol consumption during breastfeeding, emphasizing that moderate alcohol intake does not necessitate “pumping and dumping” (104).
Oster briefly touches on painkillers, antidepressants, and caffeine use during breastfeeding. The chapter concludes with insights into the challenges of pumping, discussing innovations, reasons for pumping, and the difficulties women face, especially when returning to work. Oster acknowledges the need for better pumping technology and briefly mentions exclusive pumping as an option for some women who struggle with latching.
Part 2, Chapter 6 Summary: “Sleep Position and Location”
Oster addresses the challenges surrounding infant sleep practices, focusing particularly on fears around the rare and poorly understood phenomenon known as Sudden Infant Death Syndrome (SIDS). She discusses guidelines by the American Academy of Pediatrics (AAP) advocating that “your child’s crib should be empty, with no toys, no bumpers, no blankets or pillows. Nothing” (124). The AAP recommends placing infants on their backs in a crib without any soft items. Oster delves into the historical shift from stomach to back sleeping: Until the early 1990s, it was recommended that infants sleep on their stomachs, as back sleeping could cause deformation of the skull. As doctors and scientists became aware of the correlation between stomach sleeping and SIDS, the recommendation shifted.
Oster delves into the risks associated with blankets and crib bumpers, highlighting concerns about suffocation. While acknowledging the potential purpose of bumpers in preventing limb entrapment, Oster cites a 2016 study in the Journal of Pediatrics revealing 48 US deaths attributed to bumpers between 1985 and 2012. However, she contextualizes this risk, indicating that eliminating bumpers would have only a minimal impact on reducing overall infant mortality—preventing approximately 0.007% of deaths (or 1 in 13,500)—compared to more impactful interventions like the “Back to Sleep” campaign.
Oster then addresses the complexities of sleep choices, weighing the risks and benefits of bed sharing, room sharing, and independent sleep. Oster reviews data on room sharing, questioning the AAP’s recommendation for room sharing throughout the first year, citing potential negative impacts on infant and parental sleep. Additionally, she highlights the substantial risk of infant deaths when sharing a sofa, urging against this practice.
She stresses the significance of avoiding smoking and drinking if bed sharing and considering the baseline risk of SIDS, particularly for premature or low-birth-weight infants. Oster encourages parents to confront the idea of risk, minimize it where possible, and make informed decisions based on their family’s needs.
Part 2, Chapter 7 Summary: “Organize Your Baby”
Oster challenges the popular advice of immediately imposing a schedule on newborns, as advocated by various parenting books and philosophies. Drawing from her personal experiences with her two children, Penelope and Finn, Oster emphasizes the challenges of determining when and how to transition a baby into a structured sleep routine.
She critiques conflicting recommendations from renowned sleep experts Dr. Richard Ferber and Dr. Marc Weissbluth, who provide differing opinions on the optimal amount of sleep for infants. Ferber suggests that, at six months, a baby should sleep approximately 13 hours, with 9.25 hours at night and two 1- to 2-hour naps during the day. In contrast, Weissbluth proposes that a six-month-old should sleep around 14 hours, but with a greater emphasis on nighttime sleep—12 hours at night and two 1-hour naps.
The stark disparity in their suggestions, particularly the three-hour difference in recommended nighttime sleep, underscores the lack of consensus in the field. Weissbluth also suggests that insufficient sleep, such as only nine hours at night, may lead to behavioral issues, including increased fussiness and a potential link to becoming overweight.
Oster concludes that while certain aspects of scheduling may be child-specific, wake-up times show less variation. She offers insights into managing bedtimes and highlights the eventual predictability of sleep schedules, particularly with the arrival of a second child. The chapter addresses the complexities of organizing a baby’s sleep and reassures parents that, despite the initial unpredictability, a more stable sleep routine will eventually emerge, helping them navigate parenting choices and challenges effectively.
Part 2, Chapters 4-7 Analysis
In this part, Oster refers to the critical decisions faced by new parents during the first year of their child’s life, on topics including breastfeeding, sleep training, and organizing a baby’s sleep schedule. The central theme revolves around Navigating Changing Guidelines, and Oster emphasizes The Value of Data in Parenting throughout.
Oster mentions her personal journey with breastfeeding while delving into the scientifically contentious topic. She aims to dismantle the romanticized notion of breastfeeding by presenting a balanced view supported by rigorous research. In Chapter 4, she emphasizes the difficulty in attributing outcomes solely to breastfeeding due to the confounding variables associated with socioeconomic factors. By presenting a specific study on Scandinavian children, Oster illustrates how correlations between breastfeeding duration and higher IQ scores diminish when adjusting for maternal education and other characteristics. She addresses the societal pressure and guilt associated with the exaggerated claims of breastfeeding’s impact on a child’s intelligence, height, and weight. Her central argument is grounded in an analysis of the PROBIT study, emphasizing the lack of convincing evidence supporting these long-term benefits. She refers to studies with and without sibling comparisons to underscore the tenuous causal link between breastfeeding and higher intelligence. Oster’s intent is clear: to demystify the overstated claims surrounding breastfeeding by critically evaluating the research studies, urging readers to rely on robust evidence rather than anecdotal narratives or sensationalized media reports.
Oster provides practical insights into breastfeeding challenges and addresses The Anxiety of Parenting Very Young Children . She intends to bridge the gap between expert advice and real-world experiences related to breastfeeding. For example, in Chapter 5, she addresses painful and challenging aspects of breastfeeding, like cracked nipples and supply issues, and dismantles the idealized image of effortless breastfeeding. She discusses the mechanics of a good latch, dispelling common misconceptions. The emphasis on the physicality of the process—describing it as “jamming the kid on there” (92)—adds a touch of humor while underscoring the practical challenges faced by new mothers. By tackling issues like nipple pain, latching problems, and dietary restrictions, Oster encourages an in-depth understanding of breastfeeding, and presents more empathetic discourse around this often-stigmatized topic. She also touches upon external factors influencing breastfeeding, such as societal expectations, workplace challenges, and the pressure to succeed. By incorporating these broader contextual elements, Oster extends the conversation beyond individual struggles, encouraging readers to consider the societal and workplace support systems that impact breastfeeding experiences.
Oster observes the shifts in parenting recommendations, taking into account the research advancements that have occurred in this domain. In Chapter 6, she particularly refers to the shift from placing infants on their stomachs to the “Back to Sleep” campaign that began in 1992, recommending infants sleep on their backs to reduce the risk of SIDS. She cites a study published in the British Medical Journal in 1990, which focused on infants in the UK and found a strong association between stomach sleeping and an elevated risk of SIDS. By presenting historical data and research findings, Oster establishes a clear narrative on the dangers of stomach sleeping.
Oster emphasizes The Value of Data in Parenting. Guidelines tend to recommend any practice that may benefit young children, even when the evidence is tenuous and the benefit marginal, and regardless of the burden it places on parents. For instance, in Chapter 6, Oster questions the AAP’s recommendation for room-sharing extending to a year, pointing out the lack of substantial evidence supporting this guideline. Her aim is to empower parents to analyze the costs and benefits for themselves, rather than relying on authorities to tell them what they must do. She draws attention to a 2017 study suggesting potential negative effects on child sleep when room-sharing for an extended period, highlighting the importance of considering both short- and long-term implications. The incorporation of research findings and statistical data strengthens Oster’s argument for a balanced approach to sleep practices, and challenges rigid recommendations.
Oster employs irony along with data-driven insights to underscore the challenge of Navigating Changing Guidelines. In Chapter 7, Oster references conflicting advice from renowned sleep experts Richard Ferber and Marc Weissbluth, who differ in their recommendations for the duration and distribution of a baby’s sleep. The discrepancy in guidance raises questions about the lack of a one-size-fits-all solution for baby sleep, adding to the uncertainty faced by parents. Oster emphasizes the variability in sleep patterns, citing examples of babies sleeping as few as six hours or as many as 15 hours at night. She introduces a 2016 study published in the Journal of Sleep Research, which utilizes data from a Johnson & Johnson-sponsored app for recording infant sleep patterns.
The author employs statistical data and graphical representations to underscore the diversity in infant sleep, challenging the notion of a standardized sleep schedule. By referencing a meta-analysis of sleep duration studies, Oster presents general patterns in sleep development, such as the consolidation of nighttime sleep around two months of age. Oster’s writing style is characterized by a conversational tone, making complex research accessible to a broad audience. Her intent is not to dictate a specific parenting approach but to empower parents to make choices aligned with their values and circumstances.
