Latest / Wellness, Actually with Emily Oster & Perry Wilson, MD / It's A Podcast Anniversary Q&A! You asked, Emily answered

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It's A Podcast Anniversary Q&A! You asked, Emily answered · Wellness, Actually with Emily Oster & Perry Wilson, MD

• 0:00
  Speaker 1: I'm Emily Ost.
• 0:02
  Speaker 2: This is parent Data and today, well, today is a
• 0:08
  Speaker 2: special day.
• 0:10
  Speaker 3: Today is our potiversary pod Anniversary Podiversary, let's go with that.
• 0:17
  Speaker 3: We relaunched the new and improved parent Data podcast a
• 0:20
  Speaker 3: year ago.
• 0:20
  Speaker 4: Hey, Emily, Emily, Emily, Emily.
• 0:23
  Speaker 3: I'm Emily Oster and today parent Data the podcast. I'll
• 0:28
  Speaker 3: be interviewing experts to parse out fact from anecdote, causality
• 0:31
  Speaker 3: from correlation.
• 0:32
  Speaker 2: And it has been a great year.
• 0:35
  Speaker 3: We have had some incredibly smart educational guests.
• 0:39
  Speaker 5: Once you realize that we have to have unpaid labor
• 0:43
  Speaker 5: done by women for society to function, you start to
• 0:46
  Speaker 5: understand everything that surrounds it.
• 0:48
  Speaker 6: Talking about sex is not correlated with a bad sex life.
• 0:50
  Speaker 7: Talking about sex is correlated with a spectacular, magnificent, optimal
• 0:55
  Speaker 7: sexual experience.
• 0:56
  Speaker 8: One of the criticisms of this developmental story that we're
• 0:59
  Speaker 8: talking about here is, oh, so you're blaming the boys.
• 1:01
  Speaker 8: Actually the opposite, that the education system has inadvertently kind
• 1:06
  Speaker 8: of defaulted to more of the kind of female standard.
• 1:08
  Speaker 3: Could you please tell me how to solve my baby?
• 1:12
  Speaker 9: Well, salting and swaddling were part of an idea that
• 1:16
  Speaker 9: helpsway for quite a while that a baby would not
• 1:20
  Speaker 9: acquire human form unless it was imposed on that baby.
• 1:25
  Speaker 3: We've had fun late night panic Googles. Hello, Mandy Moore,
• 1:29
  Speaker 3: Hello has Reclined, Hello Abby, Philip, Jackie Ashray.
• 1:32
  Speaker 2: Thank you for joining me. Hello Emily as And here's
• 1:36
  Speaker 2: what I've learned.
• 1:38
  Speaker 3: It's hard to interview other people, but it's also really fun,
• 1:42
  Speaker 3: and it's a really interesting way to get more intimate
• 1:47
  Speaker 3: and to really connect with people who are going through
• 1:52
  Speaker 3: the same things that I'm going through or different things,
• 1:54
  Speaker 3: and where our shared experiences come out more than I
• 2:00
  Speaker 3: I would sometimes expect. So today we're going to see
• 2:06
  Speaker 3: how much I actually learned and how much I already know.
• 2:11
  Speaker 3: If you follow my Instagram at Pratt Family ask, you're
• 2:13
  Speaker 3: familiar with my Wednesday q and as. On those I
• 2:16
  Speaker 3: post a question box. People ask their questions and I
• 2:19
  Speaker 3: choose which one to answer. People sometimes ask me how
• 2:22
  Speaker 3: do I choose? And I try to choose things that
• 2:25
  Speaker 3: are entertaining or interesting or if everyone is already asking them.
• 2:30
  Speaker 3: So in the last couple of weeks we asked you
• 2:32
  Speaker 3: for your questions, and today I've got some answers and
• 2:37
  Speaker 3: some help.
• 2:38
  Speaker 2: I've invited my producer tomorrow to give me a hand.
• 2:41
  Speaker 2: Hi tomorrow, Hi Emily, So how are we doing this?
• 2:45
  Speaker 6: Okay, So, as you said, we solicited questions from all
• 2:50
  Speaker 6: over the place from your readers, your listeners, your Instagram followers.
• 2:54
  Speaker 6: Not unexpectedly, they really delivered. So I have taken the
• 2:58
  Speaker 6: questions that I think I've to borrow your model and
• 3:01
  Speaker 6: pick the ones that are interesting and different and actually
• 3:06
  Speaker 6: very common.
• 3:07
  Speaker 3: Follow the part of the model where I pick the
• 3:09
  Speaker 3: ones I know the answers to.
• 3:11
  Speaker 6: Well, that's the thing about somebody else picking them for you,
• 3:15
  Speaker 6: So put a pin in that for a second. Okay,
• 3:18
  Speaker 6: I've organized them by theme and I'm going to play
• 3:20
  Speaker 6: them for you, and you are going to answer them
• 3:23
  Speaker 6: in real time. So I can't stress this enough. You
• 3:26
  Speaker 6: have not heard these questions before. This is not going
• 3:29
  Speaker 6: to be like the magic of audio editing. This is
• 3:32
  Speaker 6: real life. This is what you do. Help is available, though,
• 3:36
  Speaker 6: so in true who wants to be a millionaire fashion?
• 3:39
  Speaker 6: We have a couple different options for any help that
• 3:42
  Speaker 6: you may need. We have searched the Internet and of
• 3:45
  Speaker 6: course not Google, but actually like you know, diving in yeah,
• 3:50
  Speaker 6: parent data Dewey, diving into those you know, Ivy League
• 3:55
  Speaker 6: economist research papers, that will help give you the answer.
• 3:59
  Speaker 2: That's not where I'm looking for help.
• 4:00
  Speaker 6: But okay, you can phone a friend and you can
• 4:04
  Speaker 6: pull the audience, so that will be some members of
• 4:07
  Speaker 6: your parent data team who might be able to help
• 4:10
  Speaker 6: out with answers that might be a little bit maybe
• 4:14
  Speaker 6: more anecdotal, but enough, you know, enough anecdotes become data.
• 4:17
  Speaker 2: It's not how it works, but okay, I like the idea.
• 4:20
  Speaker 2: I like the concept.
• 4:22
  Speaker 6: You can only pick each one once, so you have
• 4:25
  Speaker 6: to be strategic.
• 4:25
  Speaker 3: Okay, this seems hard. Okay, I'm ready, You're ready. Okay,
• 4:32
  Speaker 3: I'm ready.
• 4:32
  Speaker 6: Ish, all right, let's get started. Let's do it after
• 4:36
  Speaker 6: the break. So the first category is pregnancy and birth.
• 4:51
  Speaker 6: So let's start with the first question.
• 4:53
  Speaker 10: Hi, Emily, I am currently twenty one weeks pregnant and
• 4:57
  Speaker 10: I live in Canada.
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  Speaker 11: Access to great health care, very lucky for that.
• 5:01
  Speaker 2: I live in a big city.
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  Speaker 10: One thing that I'm just really noticing and have a
• 5:05
  Speaker 10: question about, is how far the pendulum really has swung,
• 5:09
  Speaker 10: you know, toward non intervention you know, quote unquote natural
• 5:13
  Speaker 10: birth or just non intervention birth. And look, it really
• 5:18
  Speaker 10: just to seem that the system has built in assumptions
• 5:21
  Speaker 10: now that nobody that everyone is trying to avoid interventions,
• 5:25
  Speaker 10: be it avoiding pain meds, be it avoiding induction, avoiding
• 5:28
  Speaker 10: sea section, all of the above. I'm wondering where it
• 5:31
  Speaker 10: comes from that like this assumption is so strong, and
• 5:34
  Speaker 10: if there is like.
• 5:34
  Speaker 2: A data basis. I know that there are obviously like risks.
• 5:39
  Speaker 10: Inherent and sy sections specifically, but just a bit of
• 5:43
  Speaker 10: h I'm trying to understand why my care providers seem
• 5:46
  Speaker 10: to just really assume at every turn that, like everything
• 5:52
  Speaker 10: that I'm going to prefer is to avoid interventions at
• 5:56
  Speaker 10: all costs. Frankly, I just want to have my baby
• 5:58
  Speaker 10: out safely, So I don't have any opinion about not
• 6:03
  Speaker 10: having a c section or having one if it's the
• 6:04
  Speaker 10: right thing being induced.
• 6:06
  Speaker 2: And I certainly would like payments.
• 6:08
  Speaker 10: So trying to understand this system that we're in a
• 6:11
  Speaker 10: little bit better, thank you.
• 6:13
  Speaker 3: So I think this question I would really separate in
• 6:16
  Speaker 3: a couple of different parts.
• 6:18
  Speaker 2: So one kind of intervention we would talk about.
• 6:21
  Speaker 3: Is a C section, and there are of course very
• 6:26
  Speaker 3: good reasons for a c section, and it can be
• 6:28
  Speaker 3: very life saving, but it's also true that that is
• 6:32
  Speaker 3: not the default method of birth. That most providers are
• 6:38
  Speaker 3: hoping for because the recovery is more significant, because that
• 6:42
  Speaker 3: is a major abnominal surgery and for most people it
• 6:49
  Speaker 3: is more likely to lead to complications if you want
• 6:51
  Speaker 3: a later child, you know again, sort of super safe,
• 6:55
  Speaker 3: not something to worry about, but also something we're not
• 6:58
  Speaker 3: hoping will be the default, which is why most providers
• 7:02
  Speaker 3: will not offer an electacy section unless there is a
• 7:05
  Speaker 3: reason to do that. I would pull out that as
• 7:09
  Speaker 3: sort of separate from the question of pain medication and
• 7:14
  Speaker 3: to some extent induction, where I do feel like we
• 7:17
  Speaker 3: have sometimes gotten into this idea of late that you know,
• 7:21
  Speaker 3: less is better that we would all be ideal if
• 7:24
  Speaker 3: we were like giving birth you know, alone under a tree,
• 7:29
  Speaker 3: like with no.
• 7:30
  Speaker 6: Help and pulling the baby out yourself.
• 7:33
  Speaker 2: Yeah, certainly that's not what we'd recommend.
• 7:35
  Speaker 3: But if you look at something like an epidaural and
• 7:38
  Speaker 3: you ask, you know, are there any doubts significant downsides
• 7:40
  Speaker 3: to pain relief, like absolutely those are. That is a
• 7:45
  Speaker 3: very safe and effective method of pain relief with tremendous benefits,
• 7:51
  Speaker 3: namely that it's quite painful to have a baby.
• 7:53
  Speaker 2: So I think this is you know again, like if you.
• 7:58
  Speaker 3: Asked why are people well, why do people talk about
• 8:01
  Speaker 3: this like it would be better to not do anything.
• 8:04
  Speaker 2: I'm not really sure.
• 8:05
  Speaker 3: I think it's part of this general culture of like
• 8:07
  Speaker 3: the more suffering we have as parents, the better. And
• 8:11
  Speaker 3: it's again one of the things I would say, you
• 8:14
  Speaker 3: have to decide what we should have. We should be
• 8:16
  Speaker 3: open to people deciding whatever space they want. You want
• 8:20
  Speaker 3: an induction, do you want a an epidural?
• 8:22
  Speaker 2: Do not want those things?
• 8:24
  Speaker 3: I think very reasonable people could choose both, and but
• 8:27
  Speaker 3: I do I would separate that from the C section question.
• 8:31
  Speaker 6: Yeah, I think too. I found going through my own
• 8:34
  Speaker 6: pregnancies that it's something that feels like it should be
• 8:39
  Speaker 6: very natural, and right off the bat feels like it's
• 8:42
  Speaker 6: it becomes medicalized. You know, as soon as you as
• 8:46
  Speaker 6: soon as you find out you're pregnant, you book a
• 8:47
  Speaker 6: doctor's appointment, and it's like one thing after another where
• 8:51
  Speaker 6: you're continually putting, your putting something that you know, your
• 8:55
  Speaker 6: quote unquote your body is built to do in the
• 8:57
  Speaker 6: hands of doctors. And I think that there is this
• 9:01
  Speaker 6: trend now to kind of take the medicalization out, but
• 9:07
  Speaker 6: it does seem like a trend.
• 9:10
  Speaker 3: It's interesting, is part of what I like about midwif
• 9:13
  Speaker 3: frey care, which has grown in the US. And when
• 9:17
  Speaker 3: you talk about that in the context for the US,
• 9:18
  Speaker 3: people think about home birds, but actually most midwift berths.
• 9:21
  Speaker 2: Are are in hospitals.
• 9:24
  Speaker 3: But there is a model associated with with midwif.
• 9:27
  Speaker 2: Frey care different from from you know, care with.
• 9:30
  Speaker 3: An ob where it is a little bit more kind
• 9:35
  Speaker 3: of coming at it from the default idea of like,
• 9:38
  Speaker 3: this is something that you know, where it like is
• 9:42
  Speaker 3: expected that that is a normal part of a thing
• 9:47
  Speaker 3: that happens in life, and and that of course there
• 9:50
  Speaker 3: are reasons why we might need medical intervention at a
• 9:53
  Speaker 3: more serious level, but that the default is kind of
• 9:56
  Speaker 3: you are going to your body is sort of going
• 9:58
  Speaker 3: to do this, and that talking to midwives about this,
• 10:02
  Speaker 3: it's it. You will get a picture that's somewhere in
• 10:07
  Speaker 3: the middle, I would say, which I kind of like.
• 10:10
  Speaker 12: Okay, So speaking of c sections, Hi, my name is
• 10:13
  Speaker 12: Kristen and my question is related to trying to conceive
• 10:17
  Speaker 12: over forty This would be a fifth scheduled C section,
• 10:21
  Speaker 12: and I've been told I have a thin uterus already
• 10:24
  Speaker 12: due to the priority sections.
• 10:26
  Speaker 1: So I was wondering the concern.
• 10:29
  Speaker 12: Once you go beyond four s sections obviously, this being
• 10:32
  Speaker 12: the fifth and the thin uterus combined, and the age
• 10:36
  Speaker 12: of forty four as well.
• 10:38
  Speaker 1: Thank you for any advice. Bye.
• 10:40
  Speaker 2: Mar think we're gonna I think we're gonna phone a
• 10:42
  Speaker 2: friend on this. Yeah, let's call Nate.
• 10:45
  Speaker 6: Okay, So this is doctor Nate Fox obg y n
• 10:48
  Speaker 6: friend of the podcast and your co author for the Unexpected,
• 10:52
  Speaker 6: and we've got them queued up.
• 10:57
  Speaker 11: Hi.
• 10:57
  Speaker 13: Hello, Emily, how you doing, Nate?
• 11:00
  Speaker 2: I'm calling you.
• 11:01
  Speaker 3: I'm phoning a friend on this because you're a doctor
• 11:05
  Speaker 3: and I.
• 11:05
  Speaker 2: Trust you and I think you're the best doctor.
• 11:08
  Speaker 13: Oh God, that's so nice.
• 11:10
  Speaker 2: Can you help answer this person's question?
• 11:13
  Speaker 13: I'm sure, anything for a friend.
• 11:17
  Speaker 2: So what's the answer?
• 11:19
  Speaker 13: So, yeah, great question. It's a long answer for her specifically,
• 11:27
  Speaker 13: and this is something I usually see people and talk
• 11:31
  Speaker 13: to them for at least an hour about. But in
• 11:33
  Speaker 13: terms of the high points of the question, it seems
• 11:36
  Speaker 13: to be there's three. Number one is getting pregnant over
• 11:41
  Speaker 13: the age of forty Number two is getting pregnant with
• 11:45
  Speaker 13: having four prior caesareans, and number three getting pregnant with
• 11:50
  Speaker 13: having a thin lower uterine segments or a thin wall.
• 11:55
  Speaker 13: The uterus and so high level in terms of getting
• 11:58
  Speaker 13: pregnant after forty. You know, I definitely do not discourage
• 12:02
  Speaker 13: people from getting pregnant after forty. I encourage it. But
• 12:06
  Speaker 13: there are some things that can sometimes be challenging for people.
• 12:10
  Speaker 13: The likeli of infertility goes up, the likely of miscarriage
• 12:13
  Speaker 13: goes up. But assuming that doesn't happen, either you get
• 12:16
  Speaker 13: pregnant on your own, or you do IVF and you
• 12:19
  Speaker 13: get pregnant and there's no miscarriage, the pregnancy itself tends
• 12:22
  Speaker 13: to go well. There's an increased risk of some complications
• 12:26
  Speaker 13: at the end of pregnancy, like preclamsy or justestational diabetes,
• 12:30
  Speaker 13: and that's something where I typically would watch someone closer
• 12:33
  Speaker 13: for those things, but again, most of the complications tend
• 12:36
  Speaker 13: to be on the front end of pregnancy. One of
• 12:40
  Speaker 13: the complications that not complications, but one of the things
• 12:44
  Speaker 13: that's more likely as you get older is the risk
• 12:46
  Speaker 13: of caesarean, which is true for anyone who's getting pregnant
• 12:50
  Speaker 13: over forty, but certainly for your follower specifically who's already
• 12:55
  Speaker 13: had four C sections. So that's number two. So getting
• 12:59
  Speaker 13: pregnate after four sea sections does not tend to be
• 13:02
  Speaker 13: an issue again with getting pregnant or the pregnancy itself.
• 13:06
  Speaker 13: That's really just related to delivery because you're going to
• 13:11
  Speaker 13: need a sea section for your fifth delivery. As far
• 13:13
  Speaker 13: as we know, it's not safe to labor after four
• 13:15
  Speaker 13: prior sea sections, and so you're going to have to
• 13:18
  Speaker 13: be scheduled for a sea section, and then there's some
• 13:21
  Speaker 13: questions about the timing of it, when should that be done,
• 13:24
  Speaker 13: sort of is it going to be complicated is it not?
• 13:27
  Speaker 13: And one of the biggest variables on that is whether
• 13:30
  Speaker 13: you end up having a placenta previa or not, where
• 13:33
  Speaker 13: the placenta covers the cervix, which seems to be pure luck.
• 13:37
  Speaker 13: It's about a five percent chance. And if you are
• 13:40
  Speaker 13: someone who has four prior sea sections and you also
• 13:44
  Speaker 13: coincidentally have a percenta previa, then there's a very high
• 13:48
  Speaker 13: chance of something called percenta a creta where the placenta
• 13:52
  Speaker 13: gets stuck to the uterus and likely you would need
• 13:55
  Speaker 13: a hysterectomy at the time of delivery. So that's a
• 13:59
  Speaker 13: conversation that needs to be had for anyone who's getting
• 14:02
  Speaker 13: pregnant with several prior sea sections, that this is a
• 14:06
  Speaker 13: possibility for you. Doesn't mean it'll happen, obviously, but that
• 14:09
  Speaker 13: is a possibility. The third thing, which is more unique,
• 14:13
  Speaker 13: and this is something we're seeing more and more of nowadays,
• 14:16
  Speaker 13: is this idea of a thin lower part of the uterus.
• 14:19
  Speaker 13: So what is that. Basically, when we do a sea section,
• 14:21
  Speaker 13: we open the uterus and then we close it obviously,
• 14:24
  Speaker 13: and that scar and the uterus has to heal and
• 14:27
  Speaker 13: then if you look at it an ultrasound or you
• 14:30
  Speaker 13: look at it maybe the time of the next sea section,
• 14:33
  Speaker 13: that scar could heal and the muscle can be very thick,
• 14:36
  Speaker 13: like it healed perfectly. It looks like a normal muscle,
• 14:39
  Speaker 13: or sometimes it heals, but it's very very thin, and
• 14:43
  Speaker 13: there isn't a lot of sort of muscle attached to
• 14:47
  Speaker 13: the other part of the muscle anymore. So it's not
• 14:49
  Speaker 13: that it's open, it's not that it's ruptured, but it
• 14:51
  Speaker 13: just seems to be thin. And there's two concerns with that.
• 14:54
  Speaker 13: One concern is that if you have that and you're
• 14:57
  Speaker 13: pregnant and you go into labor, you have a higher
• 15:00
  Speaker 13: risk potentially of that thin lower segment rupturing as opposed
• 15:05
  Speaker 13: to if it were nice and thick, which just makes
• 15:07
  Speaker 13: sense to people for the physics of it. So that's
• 15:10
  Speaker 13: one problem. And so when people do have a history
• 15:12
  Speaker 13: of a thin lower uterine segment, we tend to deliver
• 15:15
  Speaker 13: them earlier because we don't want them to go into labor.
• 15:18
  Speaker 13: So instead of delivering them let's say thirty nine weeks
• 15:21
  Speaker 13: or thirty eight, sometimes we do it at thirty seven
• 15:23
  Speaker 13: or thirty six, prior to them going into labor. The
• 15:27
  Speaker 13: second issue potentially with a thin lower uterine segment is
• 15:32
  Speaker 13: if the pregnancy early on implants in that scar where
• 15:38
  Speaker 13: the where it's supposed to be a nice thick muscle,
• 15:41
  Speaker 13: but instead it's thin in this sort of like an
• 15:43
  Speaker 13: area that's chewed out. We sometimes call that a niche
• 15:46
  Speaker 13: and icche. If the pregnancy happens to implant in there,
• 15:50
  Speaker 13: that could be a very very dangerous pregnancy. So ultimately,
• 15:55
  Speaker 13: to go back to the original question, if I were
• 15:57
  Speaker 13: to meet with someone who's over forty and has four
• 15:59
  Speaker 13: prior sections and has a thin lower segment, it does
• 16:03
  Speaker 13: not mean I would tell the person not to get pregnant.
• 16:05
  Speaker 13: There are some who would. There's definitely doctors who say,
• 16:08
  Speaker 13: you know, enough is enough, no more babies. Don't get
• 16:10
  Speaker 13: pregnant too high risk. That's not how I typically address these.
• 16:13
  Speaker 13: As you go over each of these individually, try to
• 16:16
  Speaker 13: personalize it and individualize and just explain what are the risks,
• 16:19
  Speaker 13: what are the things we're looking for, and how might
• 16:21
  Speaker 13: we follow for those?
• 16:23
  Speaker 2: Best of luck. That's a good.
• 16:26
  Speaker 1: Answer, Nate, Wow, great answer.
• 16:29
  Speaker 6: Okay, So with that we say goodbye to doctor Nate
• 16:33
  Speaker 6: and hello to the next question.
• 16:35
  Speaker 14: Hey, Emily Oster, I've got a question for you. Is
• 16:39
  Speaker 14: it okay to take melatonin? What pregnant to combat that
• 16:42
  Speaker 14: pesky pregnancy insomnia? The internet is a posed because of
• 16:47
  Speaker 14: the lack of data, but my pregnancy app says I
• 16:50
  Speaker 14: can and I have horrible insomnia.
• 16:54
  Speaker 1: Let me know.
• 16:55
  Speaker 3: So this falls in the category of things during pregnancy
• 17:00
  Speaker 3: where I wish we had better data and we don't,
• 17:02
  Speaker 3: because it absolutely is the case that many people have
• 17:06
  Speaker 3: insomnia during pregnancy, and melatonin is a naturally occurring hormone,
• 17:11
  Speaker 3: so it's not it would not be crazy to imagine
• 17:15
  Speaker 3: that this was safe, and indeed we have a reasonable
• 17:20
  Speaker 3: amount of reassuring evidence, and in fact, there are actually
• 17:27
  Speaker 3: some complications in pregnancy which are associated with problematic melatonin.
• 17:33
  Speaker 3: So actually some people have suggested that supplementation with melatonin
• 17:36
  Speaker 3: might actually improve some things like preterm birth or preclamsya.
• 17:40
  Speaker 3: That's not something that has shown up in the trials yet,
• 17:43
  Speaker 3: but that could be true in theory. But we also
• 17:48
  Speaker 3: know that melatonin is transmitted to the fetus melatonin from supplements, melatonin.
• 17:54
  Speaker 2: Then occurs naturally.
• 17:55
  Speaker 3: And it's like you land in this complicated space, which
• 17:59
  Speaker 3: is basically like, there's no absolutely no reason to think
• 18:02
  Speaker 3: that we would be concerned, but also nothing where you
• 18:05
  Speaker 3: can say, here's a large randomized trial that is like
• 18:08
  Speaker 3: going to prove to you that there's no possible issue.
• 18:13
  Speaker 3: Many people do take low doses of melatone and during
• 18:16
  Speaker 3: pregnancy if there were significant risks, we would obviously know
• 18:19
  Speaker 3: about that. And so that is that for me, I
• 18:22
  Speaker 3: think is pretty reassuring. And you know, sleep is sleep is.
• 18:26
  Speaker 2: Important for your health.
• 18:29
  Speaker 3: But I mean, I guess my more general point here
• 18:30
  Speaker 3: is like, sometimes the reason for conflicting advice is that
• 18:34
  Speaker 3: the answer is like, we don't have perfect evidence, and
• 18:37
  Speaker 3: so the conflict is how do you read the limited
• 18:41
  Speaker 3: evidence that we have, not that people have different evidence,
• 18:44
  Speaker 3: And that's probably useful to keep in mind when you
• 18:46
  Speaker 3: read these conflicting recommendations.
• 18:48
  Speaker 6: Yeah, I read a thing that said that your baby
• 18:51
  Speaker 6: will sleep better if you've taken melotone and during pregnancy.
• 18:54
  Speaker 6: So that's that's reason enough for me.
• 18:56
  Speaker 2: Definitely no evidence of that too, you know.
• 18:59
  Speaker 6: Oh well, oh well, you got to cling to what.
• 19:02
  Speaker 2: You can give.
• 19:02
  Speaker 3: It's a bourbon too, you know that that's a no,
• 19:05
  Speaker 3: don't do that.
• 19:07
  Speaker 6: A little bourbon sp Okay, well, you just mentioned preclamsia,
• 19:13
  Speaker 6: so let's click on the next question.
• 19:16
  Speaker 11: Hi, my name is Abby.
• 19:17
  Speaker 15: I'm thirty years old, and I had my first baby
• 19:20
  Speaker 15: in June, and it was a little bit eventful. I
• 19:23
  Speaker 15: lost about twelve hundred secies of blood after delivery, and
• 19:27
  Speaker 15: then I also developed postpartum preclampsia about four days after
• 19:31
  Speaker 15: getting home.
• 19:32
  Speaker 11: And I have two sisters.
• 19:34
  Speaker 15: One of them experienced postpartum hemorrhage and another one experienced
• 19:39
  Speaker 15: pre clamsia and pre term birth.
• 19:42
  Speaker 11: And so my question is, what.
• 19:44
  Speaker 15: Is the likelihood of either or both of these events
• 19:48
  Speaker 15: happening again in a future pregnancy and a future birth.
• 19:53
  Speaker 11: Should I be worried about getting pregnant again?
• 19:55
  Speaker 15: My doctors think it's fine if I just wait a year,
• 19:58
  Speaker 15: but I'd love to know what the day that says,
• 20:00
  Speaker 15: thank you so much.
• 20:02
  Speaker 3: So for preclamcy in particular, we can we have a
• 20:07
  Speaker 3: fair amount of very good data on recurrence risk because
• 20:10
  Speaker 3: it's actually a fairly common complication and it's not that
• 20:15
  Speaker 3: hard in the data to learn about the risk of
• 20:17
  Speaker 3: recurrence of something like that, because you can use these
• 20:20
  Speaker 3: like very large data sets from Europe.
• 20:21
  Speaker 2: Where you can see link people over over time.
• 20:25
  Speaker 3: So what we see out of that is that the
• 20:27
  Speaker 3: recurrence risk varies quite a lot based on when the
• 20:31
  Speaker 3: preclamsia appeared, and so if your preclamsia appeared early in pregnancy,
• 20:37
  Speaker 3: which is often associated with pre term birth, the recurrence
• 20:40
  Speaker 3: risk is very high. As it gets later in pregnancy,
• 20:43
  Speaker 3: we get to lower recurrence risks. So people who develop
• 20:45
  Speaker 3: preclamsia at term or in this case after term, the
• 20:48
  Speaker 3: recurrence risk is only in the range of ten percent,
• 20:51
  Speaker 3: so higher than the chance that you would have it
• 20:54
  Speaker 3: kind of at baseline, but not certainly not one hundred percent,
• 20:58
  Speaker 3: and still actually fairly low.
• 21:00
  Speaker 2: Preclamsia is also something.
• 21:02
  Speaker 3: Where we have some treatment options. In particular, dosing with
• 21:06
  Speaker 3: baby aspirin is actually quite effective at reducing the risk
• 21:11
  Speaker 3: of pre eclamsia, So surely that is an intervention your
• 21:14
  Speaker 3: doctor would encourage in a second pregnancy. And because you
• 21:18
  Speaker 3: know about this risk, and because it was post birth,
• 21:22
  Speaker 3: it's something where the monitoring would likely be much better
• 21:25
  Speaker 3: in a later pregnancy. So there's a lot of reasons
• 21:28
  Speaker 3: to think that the experience of this might be both
• 21:31
  Speaker 3: there's a lower risk than you would have had before
• 21:35
  Speaker 3: and that the experience would be different because you know
• 21:37
  Speaker 3: it's a risk for postpartum hemorrhage. Again, some of the
• 21:42
  Speaker 3: reasons for that are things which could recur, but it's
• 21:45
  Speaker 3: also true that it's not anywhere near like one hundred percent,
• 21:50
  Speaker 3: And in fact, because there are again are treatments higher
• 21:54
  Speaker 3: doses of potocin after a birth that can lock up
• 21:59
  Speaker 3: the uterus that's not a technical term, but can can
• 22:03
  Speaker 3: sort of reduce the risk of bleeding. That's something that
• 22:06
  Speaker 3: they can do that they probably didn't know to do before,
• 22:08
  Speaker 3: but they.
• 22:08
  Speaker 2: Would know to do in a repeat pregnancy.
• 22:11
  Speaker 3: So I think the short answer is, like, you're going
• 22:12
  Speaker 3: to want to be careful about all these things in
• 22:14
  Speaker 3: a leader pregnancy, but there's tremendous reason to think that
• 22:17
  Speaker 3: the outcome would be better in a second time around.
• 22:21
  Speaker 6: It's amazing how psychological it is. You have one pregnancy
• 22:24
  Speaker 6: and you think the next one is just going to
• 22:26
  Speaker 6: be exactly the same, because that's how you know pregnancy
• 22:29
  Speaker 6: to be, and then any change is just it's an earthquake.
• 22:33
  Speaker 6: An earthquake, although I guess in this case it would
• 22:36
  Speaker 6: be a that would be a great pod. Yeah it's sunshine. Okay,
• 22:41
  Speaker 6: this next question is tailor made for you, not for me,
• 22:45
  Speaker 6: but for you.
• 22:46
  Speaker 16: Several months ago I registered for a marathon. It's in December,
• 22:50
  Speaker 16: but since then I have found out that I'm pregnant.
• 22:53
  Speaker 16: I'll be about six months pregnant at the time of
• 22:55
  Speaker 16: the marathon. I just started training a few weeks ago,
• 22:58
  Speaker 16: and I'm all so getting towards the end of my
• 23:02
  Speaker 16: first trimester. I've been more exhausted this trimester than I
• 23:06
  Speaker 16: think I've ever been in my entire life, probably because
• 23:09
  Speaker 16: I also have a toddler at home and starting to
• 23:13
  Speaker 16: train has just made me even more tired. Will it
• 23:16
  Speaker 16: get better in the second trimester? With my first It did,
• 23:21
  Speaker 16: But it's hard to see the light at the ends
• 23:23
  Speaker 16: of the tunnel at the moment, and I want to
• 23:26
  Speaker 16: know if this is doable or if running a marathon
• 23:29
  Speaker 16: it's six months pregnant is the dumbest thing you've ever heard.
• 23:33
  Speaker 3: Definitely, not that it's I don't I belleve support this,
• 23:37
  Speaker 3: but let's talk about whether it's realistic. So, most people
• 23:42
  Speaker 3: feel better after their first trimester, so most people are
• 23:44
  Speaker 3: less tired.
• 23:45
  Speaker 2: So if you had to pick like.
• 23:47
  Speaker 3: An optimal time to train for a marathon within pregnancy,
• 23:50
  Speaker 3: it probably is the second. It is the second trimester,
• 23:54
  Speaker 3: you are going to be more tired than you would
• 23:57
  Speaker 3: be otherwise non pregnategnant, because you're making a person.
• 24:03
  Speaker 2: Is it doable to run a marathon it's six months pregnant?
• 24:05
  Speaker 3: Absolutely, you can do it, and in fact it's not.
• 24:09
  Speaker 3: If the worry is like, is this dangerous?
• 24:11
  Speaker 2: Is there? Am I putting the baby at risk?
• 24:14
  Speaker 17: No?
• 24:15
  Speaker 3: From your own personal standpoint, the injury risk is actually
• 24:19
  Speaker 3: going to be a bit higher just because your ligaments
• 24:21
  Speaker 3: loosen up a little bit, So you want to be
• 24:22
  Speaker 3: more cautious about the.
• 24:24
  Speaker 2: Like twinges that occur as you run.
• 24:27
  Speaker 3: This is unlikely to be the source of your pr
• 24:31
  Speaker 3: So if that's what you were hoping for, this is.
• 24:33
  Speaker 2: Probably not your race. But I would not discourage someone from.
• 24:38
  Speaker 3: Doing this to be honest, as long as you feel
• 24:41
  Speaker 3: like it is making you happy and not stressed out.
• 24:44
  Speaker 3: If it's a thing where it's like I can't believe
• 24:46
  Speaker 3: I have to go do this, like I'm not ready
• 24:48
  Speaker 3: to run twenty two miles today, then you may want
• 24:52
  Speaker 3: to rethink it.
• 24:53
  Speaker 2: But if it's like that would be great. I'd love
• 24:54
  Speaker 2: to get.
• 24:54
  Speaker 3: Away from my child there for three hours and just
• 24:57
  Speaker 3: you know, enjoy myself out on the trails, then you
• 25:00
  Speaker 3: should you should do that.
• 25:03
  Speaker 2: Tomorrow.
• 25:04
  Speaker 6: The look on your face, oh my god, Well pack
• 25:07
  Speaker 6: some extra gels, I guess. I mean, I'm so impressed
• 25:11
  Speaker 6: by anybody who's able to run a marathon. That's gonna
• 25:14
  Speaker 6: say sober. One of my friends not pregnant.
• 25:17
  Speaker 3: So one of my friends asked, like somebody in message
• 25:21
  Speaker 3: me on Instagram who's now become a friend after So
• 25:25
  Speaker 3: the context is she had like run Boston, the Boston Marathon,
• 25:28
  Speaker 3: and she had failed to qualify for the next Boston
• 25:31
  Speaker 3: because she was like four months pregnant. And the message
• 25:34
  Speaker 3: was like, I know I can do it. Should I
• 25:36
  Speaker 3: run another marathon three weeks so I can try to
• 25:39
  Speaker 3: get a BQ time? And there I wrote back and
• 25:42
  Speaker 3: I was like, definitely not.
• 25:44
  Speaker 2: This is a stupid idea.
• 25:46
  Speaker 3: And then it worked out great because then she had
• 25:48
  Speaker 3: her baby and after that she ran her here BQ
• 25:50
  Speaker 3: time and everything went great. But I would say two
• 25:55
  Speaker 3: marathons three weeks apart when you're like six months pregnant,
• 25:58
  Speaker 3: I am gonna I'm gonna call and no on that one.
• 26:01
  Speaker 6: I had a personal trainer years ago, like a decade ago,
• 26:05
  Speaker 6: and she was like, she was pregnant and just got
• 26:09
  Speaker 6: you know, cuter and cuter, you know, more and more,
• 26:12
  Speaker 6: like she had a basketball under her shirt, like that
• 26:14
  Speaker 6: kind of look, and she was doing at eight months pregnant.
• 26:17
  Speaker 6: She was doing one armed push ups. And here I
• 26:19
  Speaker 6: was not pregnant at all, not able to do one arm,
• 26:25
  Speaker 6: not able to do two armed push ups quite with
• 26:28
  Speaker 6: the same gusto.
• 26:29
  Speaker 3: So yeah, I ran until with my second kid, I
• 26:31
  Speaker 3: ran until like the very end, and then I got
• 26:33
  Speaker 3: a hamstring injury that I've never recovered from actually even
• 26:36
  Speaker 3: though he's not nine. So anyway, be careful of your hamstrings.
• 26:40
  Speaker 6: Good luck to this person. I am incredibly impressed.
• 26:44
  Speaker 2: I think you're going to do great.
• 26:46
  Speaker 6: Okay, this last question in this theme, I saved the
• 26:49
  Speaker 6: best for last yeah, go for it.
• 26:52
  Speaker 18: My question has to do with restless leg syndrome during pregnancy.
• 26:57
  Speaker 18: Everything that my obigui N recommended to me to help
• 27:00
  Speaker 18: with the symptoms didn't work. By accident, I found that
• 27:05
  Speaker 18: the only thing that made the symptoms go away was orgasm.
• 27:09
  Speaker 18: I did a little research and it looks like that
• 27:11
  Speaker 18: there is a study that says that potentially that is
• 27:15
  Speaker 18: the key question mark. Wondering what your thoughts are and
• 27:18
  Speaker 18: if you know of any research or connection between orgasm
• 27:22
  Speaker 18: and restless leg syndrome, thanks tomorrow.
• 27:25
  Speaker 2: I need the internet for this one.
• 27:27
  Speaker 6: Okay, I don't know.
• 27:28
  Speaker 2: I don't know the.
• 27:29
  Speaker 3: Answer to this one, although I do love the framing
• 27:32
  Speaker 3: of By accident, I found out that this worked, like oops.
• 27:36
  Speaker 6: Oops, okay, we'll wait. You go use the internet.
• 27:48
  Speaker 3: All right, So thanks for giving me the opportunity to
• 27:50
  Speaker 3: spend some time on the internet thinking about this and
• 27:54
  Speaker 3: researching it. And I want to be clear that even
• 27:56
  Speaker 3: though through the magic of podcasting this answer is coming immediately,
• 28:00
  Speaker 3: I actually spend a fair bit of time on this
• 28:03
  Speaker 3: trying very hard to find the data.
• 28:06
  Speaker 2: It's like God's work results.
• 28:07
  Speaker 3: Leg syndrome is not super well understood and the set
• 28:11
  Speaker 3: of treatments for it are also not you super codified.
• 28:15
  Speaker 3: I can find, however, nothing in the literature that suggests
• 28:19
  Speaker 3: that having orgasms would be helpful or not helpful with
• 28:25
  Speaker 3: this problem because it's related to your brain, and because
• 28:29
  Speaker 3: it might be related to dopamine. I don't think it's
• 28:32
  Speaker 3: an insane idea that they this might be related. But
• 28:36
  Speaker 3: it isn't something where say, there's a systematic randomized trial
• 28:39
  Speaker 3: where half the group gets a vibrator, half the group
• 28:40
  Speaker 3: doesn't get a vibrator.
• 28:41
  Speaker 2: And we like, see how their legs do.
• 28:44
  Speaker 3: Having said that, this is an example of something where
• 28:47
  Speaker 3: like who cares because this is a problem that's difficult
• 28:50
  Speaker 3: to treat, and you found a solution which has all
• 28:53
  Speaker 3: these other positive benefits.
• 28:55
  Speaker 2: So I would be.
• 28:56
  Speaker 3: Both to suggest that just because there's no systematic data
• 29:00
  Speaker 3: that you not enjoy orgasms and calm legs, which seems
• 29:03
  Speaker 3: like a total win to me.
• 29:06
  Speaker 6: So what are the chances of an actual systematic, double
• 29:10
  Speaker 6: blind randomized trial being conducted and can I sign up
• 29:14
  Speaker 6: for it?
• 29:16
  Speaker 3: Such a great question. I'm not optimistic, and I'm going
• 29:19
  Speaker 3: to tell you why.
• 29:20
  Speaker 2: It's because I don't see how to monetize it.
• 29:23
  Speaker 3: So it's expensive, somewhat expensive to run a randomized trial,
• 29:28
  Speaker 3: and it takes some time and work. And let's say
• 29:31
  Speaker 3: you learned this was a really good treatment, Like, how.
• 29:34
  Speaker 2: Can you get money from that? You cannot?
• 29:39
  Speaker 3: You know, the market for orgasms is very competitive. There's
• 29:44
  Speaker 3: many different ways to get it, and because one needs
• 29:50
  Speaker 3: money to finance research, usually we have a harder time
• 29:53
  Speaker 3: financing research if we cannot get money from it.
• 29:56
  Speaker 2: I'm sorry to.
• 29:57
  Speaker 6: Report, Okay, but as you said, still a win all around.
• 30:02
  Speaker 3: It's still yeah, I feel like it's you know, just
• 30:05
  Speaker 3: don't look for the evidence.
• 30:06
  Speaker 2: Look for the orgasm.
• 30:07
  Speaker 3: That's what we should see, like a tagline.
• 30:10
  Speaker 6: It's my new bumper sticker. Okay. So moving on. Now
• 30:16
  Speaker 6: that the legs are calm by any means necessary, and
• 30:20
  Speaker 6: the baby is out of the womb and into the world,
• 30:22
  Speaker 6: people have questions about the first year.
• 30:25
  Speaker 1: My question is about.
• 30:28
  Speaker 19: Just general risks with premature babies, because I'm reading all
• 30:32
  Speaker 19: over the place about increased risk for premies, for example,
• 30:37
  Speaker 19: like the risk of SIDS is increased if your baby's premature,
• 30:40
  Speaker 19: and I'm wondering when that stops applying. So, like, my
• 30:45
  Speaker 19: baby was six and a half weeks.
• 30:46
  Speaker 1: Early, but now he.
• 30:49
  Speaker 2: Is four weeks past his.
• 30:51
  Speaker 19: Duty and he's totally fine. He has no concerns relating
• 30:57
  Speaker 19: to his prematurity. But does that mean he's no longer
• 31:01
  Speaker 19: a premium or does he stay a premi forever?
• 31:05
  Speaker 1: When does that stop applying?
• 31:07
  Speaker 3: So your baby able to stay in the premature category forever.
• 31:12
  Speaker 3: So it's something that you will be part of his
• 31:15
  Speaker 3: medical history and will mean, you know, particularly for the
• 31:20
  Speaker 3: first couple of years.
• 31:22
  Speaker 2: They're likely to think.
• 31:23
  Speaker 3: About that when they're evaluating developmental milestones or thinking about say,
• 31:27
  Speaker 3: risks for something like RSV. So a baby who was
• 31:32
  Speaker 3: pre term is going to have longer eligibility for like
• 31:35
  Speaker 3: an RSV monocle immunization than another. So some of this
• 31:40
  Speaker 3: is just there's a category of premature which you're sort
• 31:43
  Speaker 3: of never gonna gonna leave. But when we talk about,
• 31:47
  Speaker 3: you know, there's an elevated risk of a whole host
• 31:50
  Speaker 3: of things. That's a really complicated question because it lumps
• 31:54
  Speaker 3: together a huge number of babies with very very different
• 31:59
  Speaker 3: risk profile. So six and a half weeks early, so
• 32:02
  Speaker 3: that's you know, something around say thirty four weeks is
• 32:07
  Speaker 3: quite different than thirty weeks is also quite different from
• 32:11
  Speaker 3: thirty six and a half weeks, which you know would
• 32:14
  Speaker 3: be would be lower risk, and so there's really like
• 32:18
  Speaker 3: a continuum, and in the literature there isn't as much
• 32:23
  Speaker 3: differentiation there as one might hope, nor is there much
• 32:28
  Speaker 3: differentiation that would have to do with the fact that, like,
• 32:30
  Speaker 3: you're not seeing any complications with your baby and things are,
• 32:34
  Speaker 3: you know, looking really great now four weeks after the
• 32:37
  Speaker 3: do dates. So all of these things kind of come
• 32:39
  Speaker 3: together to say that your individual situation is so much
• 32:44
  Speaker 3: more important than this one kind of definition. But in
• 32:48
  Speaker 3: terms of the definition, in terms of extra services, you
• 32:50
  Speaker 3: would get anything like that your baby is going to
• 32:52
  Speaker 3: be considered premature forever.
• 32:55
  Speaker 6: It can become a badge of honor after a while
• 32:59
  Speaker 6: it is.
• 32:59
  Speaker 3: And then the one thing people often ask in this
• 33:01
  Speaker 3: space is like, what do you expect about developmental milestones,
• 33:05
  Speaker 3: because they'll sort of you'll sort of talk about like
• 33:07
  Speaker 3: adjusted age for pre term babies. You know, you're four
• 33:11
  Speaker 3: weeks after your due date, so the baby was six
• 33:13
  Speaker 3: and a half weeks earlier, Like it's you know, he's
• 33:16
  Speaker 3: ten weeks old, but really like an adjusted age, he's
• 33:19
  Speaker 3: only four weeks old. And that influences when we expect
• 33:23
  Speaker 3: developmental milestones to happen. That crunches down and becomes less
• 33:27
  Speaker 3: important over time as we think about just the range
• 33:30
  Speaker 3: of heterogeneity.
• 33:31
  Speaker 2: Across kids and the fact that you know, basically a.
• 33:35
  Speaker 3: Four month old and a two month old are really different,
• 33:39
  Speaker 3: but a kid who's you know, four years and two
• 33:42
  Speaker 3: months versus four years and four months, those are actually
• 33:44
  Speaker 3: not very different. And so some of this like importance
• 33:47
  Speaker 3: of this stuff gets just.
• 33:49
  Speaker 2: Smaller over time.
• 33:51
  Speaker 6: My brother was was born premature. He was about four
• 33:54
  Speaker 6: weeks premature, and he was born in an Israeli hospital
• 33:57
  Speaker 6: in nineteen seventy three, and the you know, my mom
• 34:02
  Speaker 6: was was adjusting to this you know, very very tiny
• 34:05
  Speaker 6: baby who wasn't big enough to latch and this large
• 34:10
  Speaker 6: barrel chested is really male nurse came in and like
• 34:15
  Speaker 6: pointed to his chest and said, hey, don't worry about it.
• 34:17
  Speaker 6: I was I was a pre me too, and that
• 34:20
  Speaker 6: was very comforting to her at the time.
• 34:23
  Speaker 3: This is a space that has changed so much over time.
• 34:28
  Speaker 3: You know, there was one of John Kennedy's kids was born.
• 34:33
  Speaker 3: They had a baby born at thirty six weeks that died,
• 34:37
  Speaker 3: and that gestational age the survival now is like close
• 34:43
  Speaker 3: to what you'd see, very close to what you see
• 34:45
  Speaker 3: at full time, you know. It's that's like that we
• 34:48
  Speaker 3: sort of know how to deal with a baby at
• 34:49
  Speaker 3: thirty six weeks.
• 34:49
  Speaker 2: They might even not end up in the Nike.
• 34:51
  Speaker 3: You So, the whole range of kind of what is
• 34:54
  Speaker 3: possible and the outcomes from which ourn babies have gotten
• 34:57
  Speaker 3: so much better over the past decades and even over
• 35:00
  Speaker 3: the past you know, the past ten years.
• 35:02
  Speaker 2: So that's very encouraging.
• 35:06
  Speaker 6: Okay, So speaking of conventional wisdom, changing, next question.
• 35:10
  Speaker 20: Hey, Emily, I've heard that I can't give my baby honey,
• 35:14
  Speaker 20: especially from my mother in law.
• 35:16
  Speaker 9: Is this true?
• 35:18
  Speaker 3: I feel like honey and mother in laws just has
• 35:20
  Speaker 3: a total aside. But like most of the questions I
• 35:22
  Speaker 3: get about honey are about people's mother in laws, and
• 35:24
  Speaker 3: they're either my mother in law told me not to
• 35:26
  Speaker 3: do this, or it's like my mother in law gave
• 35:29
  Speaker 3: my kid a honey nut cheerio and I'm considering disowning
• 35:32
  Speaker 3: her my husband's lism overreacting like am I. So the
• 35:38
  Speaker 3: concern with honey is the possible link with botulism, which
• 35:44
  Speaker 3: is exposure to bochelism spores can give you an illness.
• 35:49
  Speaker 2: For adults and.
• 35:50
  Speaker 3: Older people, it's not typically a problem because you just
• 35:55
  Speaker 3: it doesn't cause any issues, but for infants it can.
• 35:58
  Speaker 3: It can be associated with illness and sort of short
• 36:02
  Speaker 3: term paralysis that it's quite scary, although all recoverable from.
• 36:07
  Speaker 3: And there was at some point a kind of idea
• 36:09
  Speaker 3: that this was linked to honey.
• 36:13
  Speaker 2: Actually, over time, it seems like that's not true.
• 36:18
  Speaker 3: You know, the kind of telling people not to give
• 36:20
  Speaker 3: their babies honey basically has had no impact on the
• 36:23
  Speaker 3: very small number of babies that get botulism over time.
• 36:25
  Speaker 3: So it just doesn't look like this was actually an
• 36:28
  Speaker 3: important source of botulism. And it's not something that you
• 36:31
  Speaker 3: can measure directly because if this happens, you are trying
• 36:35
  Speaker 3: to just figure out what are the range of things
• 36:37
  Speaker 3: that could have caused it, and honey is one that
• 36:39
  Speaker 3: had come up. But it just turns out x post
• 36:42
  Speaker 3: not to be an especially important, uh or really a
• 36:47
  Speaker 3: factor at all. So now does that mean you have
• 36:50
  Speaker 3: to that you should give your kid honey or they
• 36:53
  Speaker 3: need to enjoy honey?
• 36:54
  Speaker 2: Like, No, honey is not a central.
• 36:56
  Speaker 3: Food group for people, but I think it's an important
• 37:00
  Speaker 3: thing for me able to know, because for whatever reason,
• 37:02
  Speaker 3: a lot of parents freak out about this when it's
• 37:05
  Speaker 3: like accidentally their kid got a honey graham cracker, or
• 37:08
  Speaker 3: they had some honey nuturial's or somebody put honey in
• 37:10
  Speaker 3: the bread, Like this is just like fine, it's fine.
• 37:15
  Speaker 6: Is there any value to exposing them to honey? Like
• 37:18
  Speaker 6: going out of your way too?
• 37:19
  Speaker 2: It's not a common no.
• 37:20
  Speaker 3: I mean there's there are a bunch of foods that
• 37:22
  Speaker 3: are common allergens where you do want to be careful
• 37:24
  Speaker 3: to expose babies early, like peanuts and eggs and dairy wheat,
• 37:32
  Speaker 3: But honey is not a common allergen, so it's not
• 37:34
  Speaker 3: that you need to expose them to it.
• 37:36
  Speaker 2: It's just it's like, okay, if it.
• 37:37
  Speaker 6: Happens, okay, Well, if it does happen and those two
• 37:42
  Speaker 6: teeth are exposed to honey, click on the next question.
• 37:46
  Speaker 7: Oh, dear hi Emily, how important is it really that
• 37:51
  Speaker 7: I brush my fifteen month old's teeth twice a day?
• 37:55
  Speaker 1: They're gonna fall out anyway, right.
• 37:58
  Speaker 3: They are gonna fall at any Although your baby does
• 38:03
  Speaker 3: keep those teeth for a pretty long time, so you know,
• 38:06
  Speaker 3: keeping keeping them up to up to snuff is not
• 38:11
  Speaker 3: of no value. Generally, the links between you know, tooth
• 38:17
  Speaker 3: brushing and like tooth health are reasonably good.
• 38:21
  Speaker 2: But also it's hard to know how much of that is.
• 38:26
  Speaker 3: Like people who brush their kids teeth also do other
• 38:28
  Speaker 3: kinds of dental things and have other characteristics that are
• 38:31
  Speaker 3: that are important.
• 38:32
  Speaker 2: One thing we do know pretty consistently.
• 38:35
  Speaker 3: Is that as kids get a little older, having a
• 38:41
  Speaker 3: lot of the like a thing that is strongly associated
• 38:43
  Speaker 3: with cavities is drinking a lot of milk before sleep
• 38:47
  Speaker 3: and then not brushing.
• 38:48
  Speaker 2: Teeth because the milk sugars.
• 38:50
  Speaker 3: Stick around on the teeth and they like erode the enamel.
• 38:54
  Speaker 3: So it's worth thinking about the kind of brushing of
• 38:56
  Speaker 3: teeth right before bed. Be okay to do it twice
• 39:01
  Speaker 3: a day, sure, you could try, like try to do it.
• 39:05
  Speaker 3: Doing it once a day would be great. It's important
• 39:08
  Speaker 3: to develop a habit. I feel this is such a
• 39:11
  Speaker 3: hard thing because it's so challenging to brush your kids teeth,
• 39:14
  Speaker 3: like they hate it, and then you will get sold
• 39:17
  Speaker 3: these things like stick this mouthguard thing in it'll like
• 39:21
  Speaker 3: brush your kid's teeth for you.
• 39:23
  Speaker 2: Like, yeah, those don't work at all.
• 39:25
  Speaker 3: Actually, there's like there's like pretty good evidence they like
• 39:28
  Speaker 3: do it on like fake teeth.
• 39:29
  Speaker 2: It just like doesn't remove anything, you know.
• 39:32
  Speaker 6: So those instagram you've lied to me again.
• 39:35
  Speaker 2: Those are just a scam. So you really do need
• 39:38
  Speaker 2: to like brush your kids teeth.
• 39:39
  Speaker 3: But of course there's a there's a trade off between
• 39:41
  Speaker 3: like some small risk of additional cavities and the fact
• 39:44
  Speaker 3: that your kid is like screaming bloody murder and you're
• 39:46
  Speaker 3: like holding them down trying to get a toothbrush in
• 39:48
  Speaker 3: their mouth, which isn't good for your for your relationship.
• 39:50
  Speaker 3: So like, look, do you do your best? Do like
• 39:54
  Speaker 3: it's worth a try? Don't die doing, don't die in
• 39:56
  Speaker 3: the hill, try TV.
• 39:58
  Speaker 6: Can I actually ask a fall up on that? When
• 40:02
  Speaker 6: do you start taking your kid to the dentist regularly?
• 40:05
  Speaker 6: Because the dentist near us has a little blurb that says,
• 40:09
  Speaker 6: as soon as you see that first tooth, it's time
• 40:11
  Speaker 6: to go to the dentist, which seems insane to me.
• 40:14
  Speaker 3: Well, they're not to like get too deep into the
• 40:17
  Speaker 3: economics here, but you can imagine that their incentives would
• 40:21
  Speaker 3: be in.
• 40:21
  Speaker 2: The direction of see more dental time. You know, at
• 40:26
  Speaker 2: some point in the first few years your kids should
• 40:29
  Speaker 2: see a dentist once they have teeth. We don't actually
• 40:32
  Speaker 2: have a lot of good evidence in general.
• 40:34
  Speaker 3: About the value of dental visits. You know, clearly to
• 40:39
  Speaker 3: like have X rays and figure I cavities, Yes, but
• 40:42
  Speaker 3: in terms of like what's the value to cleaning is
• 40:44
  Speaker 3: actually not something that's like super well established in general,
• 40:49
  Speaker 3: And there's not anything in the data that would say,
• 40:52
  Speaker 3: you know, convincingly, like your kid has to go at
• 40:54
  Speaker 3: want or has to go at two.
• 40:56
  Speaker 6: The only thing our dentist office has accomplished so far
• 40:58
  Speaker 6: as introducing my son to cocomelon, which I'm not happy about.
• 41:02
  Speaker 2: So Cocomelon is great. I mean, it's I think you're
• 41:07
  Speaker 2: wrong there.
• 41:08
  Speaker 6: All right, Well we'll talk about this so we can
• 41:10
  Speaker 6: discuss that. Just going back actually to the marathon running
• 41:16
  Speaker 6: pregnant women, we had a write in that asked about exercise,
• 41:21
  Speaker 6: and I think it's pretty clear that this is pretty
• 41:25
  Speaker 6: high intensity exercise. Does that in any way deplete or
• 41:29
  Speaker 6: interfere with one's milk supply when you're breastfeeding.
• 41:32
  Speaker 3: I don't know of any systematic evidence that would point
• 41:36
  Speaker 3: to this. I would say one of our most poorly
• 41:39
  Speaker 3: understood things in this space is just what determines breast
• 41:46
  Speaker 3: milk supply. Other than the fact that we know if
• 41:50
  Speaker 3: you pump more, you nurse more, you get more supply.
• 41:52
  Speaker 3: There's like this clear sort of supply demand relationship, but
• 41:56
  Speaker 3: there's also a billion other things like out in the literature, hydration, pineapple,
• 42:01
  Speaker 3: this kind of cookie, that kind of cookie, this shake
• 42:03
  Speaker 3: that shakee do this that a Greek yeah, fannag right,
• 42:07
  Speaker 3: where like the data is just really either it's not
• 42:11
  Speaker 3: really there, it's quite poor generally, it's not super encouraging.
• 42:14
  Speaker 3: Like I wouldn't say we there's no concrete evidence that
• 42:18
  Speaker 3: like oatmeal and cookies cause you to.
• 42:21
  Speaker 2: Have more more breastmulk supply.
• 42:23
  Speaker 3: What one thing we do know, which I think relates
• 42:25
  Speaker 3: to this question, is that the supply responds negatively to
• 42:29
  Speaker 3: stress so experiences, and I think you can this is
• 42:32
  Speaker 3: something breastfeeding people would reflect on. We'll remember like if
• 42:35
  Speaker 3: you're if you're having a very stressful almost like moment
• 42:39
  Speaker 3: or a stressful like incident, your supply drops. Like the
• 42:45
  Speaker 3: thing that I always comes to mind is when my
• 42:47
  Speaker 3: son was like three months old, I was nursing them
• 42:50
  Speaker 3: all the times. It's pumping all the time, and my
• 42:51
  Speaker 3: daughter got very sick and we were in the er
• 42:54
  Speaker 3: with her and.
• 42:55
  Speaker 2: She had like she was getting like ivy fluids.
• 42:58
  Speaker 3: She ended up being fine, she s had some virus,
• 42:59
  Speaker 3: but she had gotten super dehydrated, and they were like
• 43:01
  Speaker 3: very worried vombiting.
• 43:03
  Speaker 2: Its horrible, like like hold her down and get a
• 43:05
  Speaker 2: needle in her arm.
• 43:07
  Speaker 3: And then like as we're sitting there, I was like, oh,
• 43:08
  Speaker 3: I have to pump, and I was trying to pump
• 43:11
  Speaker 3: and like nothing, like it was just like there was
• 43:13
  Speaker 3: nothing coming out.
• 43:13
  Speaker 2: And I think that is a.
• 43:14
  Speaker 3: Very typical like sort of stress response that your body's
• 43:17
  Speaker 3: just like, you know what, we're not putting resources into
• 43:19
  Speaker 3: this right now, Like obviously we're trying to run from
• 43:20
  Speaker 3: a tiger and like, you know, put away the pump
• 43:24
  Speaker 3: because the tiger is coming, and like it's we can
• 43:26
  Speaker 3: deal with the breast milk later. I can imagine sort
• 43:29
  Speaker 3: of high intensity exercise having some of that, you know,
• 43:33
  Speaker 3: sort of short term effect.
• 43:34
  Speaker 2: Like if you said, like I did huge.
• 43:36
  Speaker 3: Workout and then like I tried to pump right after,
• 43:38
  Speaker 3: would you have less supply?
• 43:39
  Speaker 2: I can certainly imagine that being true.
• 43:41
  Speaker 3: I'm not sure that we have a lot of a
• 43:43
  Speaker 3: lot of good evidence and I do know many professional
• 43:47
  Speaker 3: marathon runners who have said like ahead of like I
• 43:50
  Speaker 3: pumped before and I pumped after, and like there's still milk.
• 43:52
  Speaker 3: You know there was like still milk.
• 43:55
  Speaker 21: So yeah, yeah, more parent data, including your questions about
• 44:09
  Speaker 21: older kids, the rule of grandparents, nakedness, that's not all
• 44:13
  Speaker 21: the same.
• 44:13
  Speaker 3: Question and rousing ask the audience comprised of members of
• 44:17
  Speaker 3: my own team after the break.
• 44:39
  Speaker 6: Okay, so that has exhausted our baby theme, and the
• 44:44
  Speaker 6: last segment here is older kids. And it's interesting the
• 44:49
  Speaker 6: way that the kind of like the texture of these
• 44:52
  Speaker 6: kinds of questions change because they become a little bit
• 44:55
  Speaker 6: more abstract, which I thought was interesting. So please go ahead.
• 45:01
  Speaker 22: Hi, Emily, I have a five year old son who
• 45:03
  Speaker 22: can sometimes act.
• 45:05
  Speaker 1: Very wild and distracted.
• 45:08
  Speaker 22: How much should I attribute to him being five? How
• 45:12
  Speaker 22: much should I attribute to him being a boy? And
• 45:15
  Speaker 22: how much should I get someone involved to see if
• 45:17
  Speaker 22: it's an issue?
• 45:19
  Speaker 3: So to say, like set stage first, five year olds
• 45:24
  Speaker 3: tend to be kind of wild and distractable on average,
• 45:29
  Speaker 3: boys have a harder time sitting still than girls, particularly
• 45:32
  Speaker 3: in this age group.
• 45:33
  Speaker 2: And those things are just true.
• 45:34
  Speaker 3: It's not that every five year old's one way or another.
• 45:37
  Speaker 3: Every boys want more one way or the other. But
• 45:39
  Speaker 3: like you know, this overlap in the distributions. But those
• 45:42
  Speaker 3: things are true on average, and there is a wide
• 45:48
  Speaker 3: range of of what we would consider like normal behaviors
• 45:52
  Speaker 3: or sort of typical behaviors that you would that you
• 45:55
  Speaker 3: would see in kids, in boys, in girls, in kids
• 45:58
  Speaker 3: of different ages, Like just the world, there's a rich
• 46:00
  Speaker 3: tapestry of everything and people's behavior or a difference.
• 46:05
  Speaker 2: There are of course.
• 46:06
  Speaker 3: Situations in which you want to talk to someone about whether,
• 46:11
  Speaker 3: like your kid is going to struggle to operate in school,
• 46:15
  Speaker 3: or whether there's something that you could be doing to
• 46:19
  Speaker 3: help scaffold and make their experience of.
• 46:22
  Speaker 2: The world easier. But the way that I.
• 46:25
  Speaker 3: Would ask yourself the question of should I get someone involved,
• 46:27
  Speaker 3: which is like a very common question that I get
• 46:30
  Speaker 3: I actually asked answer.
• 46:31
  Speaker 2: This question for someone in person literally yesterday, is what
• 46:36
  Speaker 2: are you what are you going to accomplish with that?
• 46:40
  Speaker 3: What is the possible set of decisions you would make
• 46:44
  Speaker 3: differently right?
• 46:45
  Speaker 2: And so in particular, one of the things that comes
• 46:48
  Speaker 2: up in this space is you know, we what do
• 46:50
  Speaker 2: we think about medication?
• 46:51
  Speaker 3: And a five year old is too young Basically, for
• 46:54
  Speaker 3: really most people to consider medication, we talk about medicating
• 46:58
  Speaker 3: kids for ADH tends to be starting in older ages
• 47:03
  Speaker 3: in which there's maybe more of an expectation in the
• 47:07
  Speaker 3: systems that they're in that they need to be able
• 47:09
  Speaker 3: to sit still for longer periods of time and less,
• 47:12
  Speaker 3: and it is also more atypical to be unable to
• 47:15
  Speaker 3: do that at five. Very few people would recommend that
• 47:20
  Speaker 3: kids be medicated for this, and so then the question is, well, what, okay,
• 47:24
  Speaker 3: so what are you hoping for if you went to
• 47:26
  Speaker 3: talk to somebody, is there actually anything you would get
• 47:29
  Speaker 3: out of that other than somebody else's opinion about, you know,
• 47:33
  Speaker 3: where your kid falls in the distribution, which is probably not.
• 47:36
  Speaker 2: That useful at this point.
• 47:38
  Speaker 3: If you're worried, it's always useful to talk to your
• 47:41
  Speaker 3: pediatrician about things and bring that up. But I really
• 47:44
  Speaker 3: would focus on the question of, like, what would I
• 47:47
  Speaker 3: get out of this, what would I learn from this,
• 47:48
  Speaker 3: what we actually would do.
• 47:49
  Speaker 2: Differently, rather than on just the question of.
• 47:52
  Speaker 3: Like where is my kid in the distribution, which could
• 47:55
  Speaker 3: be something of interest to you but is actually not
• 47:57
  Speaker 3: decision relevant.
• 48:00
  Speaker 7: Okay, next question, Hey, Emily, I've been hearing a lot
• 48:05
  Speaker 7: of conversations lately about childcare and how the US childcare
• 48:10
  Speaker 7: system is very broken and messed up, as we all know.
• 48:13
  Speaker 7: But one thing I feel like I never hear about
• 48:15
  Speaker 7: is the role of grandparents when it comes to childcare
• 48:20
  Speaker 7: because I feel like I know so many parents with
• 48:22
  Speaker 7: young kids where grandparents play a pretty major role in
• 48:26
  Speaker 7: their childcare setup. And then I also know many people
• 48:31
  Speaker 7: who don't have grandparents or active grandparents to help. So
• 48:36
  Speaker 7: how many people are actually relying on grandparents for their
• 48:39
  Speaker 7: childcare needs? And is this something that's sort of like
• 48:42
  Speaker 7: invisible when we look at kind of like the labor
• 48:47
  Speaker 7: and economic implications of childcare?
• 48:50
  Speaker 11: Thank you?
• 48:52
  Speaker 3: So this is super interesting question. So are there is
• 48:56
  Speaker 3: some data on this? So the ARP surveys old people
• 49:00
  Speaker 3: older excuse me, older of people, and about sixty percent
• 49:04
  Speaker 3: of them say that they provide some care for their grandchildren,
• 49:06
  Speaker 3: and about forty thirty five percent say that they provide
• 49:09
  Speaker 3: some regular childcare, and something like sort of other data
• 49:12
  Speaker 3: like a quarter of kids under the age of five
• 49:14
  Speaker 3: have grandparents as a core source of childcare. So usually
• 49:18
  Speaker 3: this is quite an important part of the childcare market.
• 49:23
  Speaker 3: It is also a place where I think people's experiences
• 49:28
  Speaker 3: can be amazing, they can be complicated, Like, there are
• 49:32
  Speaker 3: a lot of good ways to have childcare, of which
• 49:34
  Speaker 3: this is one of them. So I'd actually be curious,
• 49:37
  Speaker 3: like to pull the audience on this one and see
• 49:39
  Speaker 3: what people what people are actually doing with their grandparent time.
• 49:44
  Speaker 6: Okay, so we've got a quorum of your own team
• 49:47
  Speaker 6: here at parent Data to help you out. Everyone say
• 49:50
  Speaker 6: hi to Emily.
• 49:52
  Speaker 11: Emily.
• 49:53
  Speaker 2: All right, guys, I need some help. I put out
• 49:55
  Speaker 2: some numbers.
• 49:57
  Speaker 3: We have some numbers on the share of grandparents who
• 50:01
  Speaker 3: are helpful. But I would love to know how you
• 50:04
  Speaker 3: guys use your grandparents or don't use them, if the
• 50:08
  Speaker 3: case may be.
• 50:10
  Speaker 2: So let's go.
• 50:12
  Speaker 17: Yeah, So we have used our grandparents a few different ways.
• 50:16
  Speaker 17: The first was before I went back to work and
• 50:19
  Speaker 17: my husband went back to work. We kind of used
• 50:22
  Speaker 17: grandparents to bridge the gap before our nanny share began.
• 50:25
  Speaker 11: So my parents came for a few.
• 50:26
  Speaker 17: Weeks, and then my husband's parents watched her for a
• 50:29
  Speaker 17: few weeks also, but on a more regular basis.
• 50:33
  Speaker 11: She goes every week.
• 50:34
  Speaker 2: On Wednesdays to her grandparents once.
• 50:37
  Speaker 17: A week, which helps us offset the cost a bit
• 50:40
  Speaker 17: of our nanny share. And then also gives her time
• 50:43
  Speaker 17: and them time to get to know each other.
• 50:45
  Speaker 5: So my grandparents' situation is a little different because we
• 50:49
  Speaker 5: don't live in the same state as either sets of grandparents,
• 50:52
  Speaker 5: so my dad has actually never met the girls, and
• 50:55
  Speaker 5: my mom comes every few months to visit. My husband's
• 51:00
  Speaker 5: parents live in a different state, and so we don't
• 51:02
  Speaker 5: really have that option, though it would be really nice
• 51:04
  Speaker 5: to have that to offset the cost of childcare, it's
• 51:08
  Speaker 5: just not something that's.
• 51:09
  Speaker 2: Available to us.
• 51:11
  Speaker 23: We do virtual and travel. My mom lives across the country,
• 51:14
  Speaker 23: but if I were going to go to weddings a lot,
• 51:17
  Speaker 23: and like recently went to California and we blew her out.
• 51:20
  Speaker 23: She's never been to California, so blew her out to
• 51:22
  Speaker 23: watch Ivy while we went to a wedding, and it's
• 51:24
  Speaker 23: like a family vacation, so like there's a treat for
• 51:26
  Speaker 23: her and like it's also a little bit of a
• 51:28
  Speaker 23: relief for us. But like, virtually, if I need a
• 51:31
  Speaker 23: second to myself, I set up the iPad and she
• 51:33
  Speaker 23: just talks to her grandma, which helps tremendously. And that's
• 51:36
  Speaker 23: like every day, sometimes three times a day.
• 51:38
  Speaker 6: It's nice.
• 51:39
  Speaker 3: Yeah, can I just interject and say, this is exactly
• 51:42
  Speaker 3: what my son does with his grandfather. He will like
• 51:46
  Speaker 3: get on the iPad FaceTime Grandpa also his cousin and
• 51:50
  Speaker 3: so it's like the two cousins and Grandpa like and
• 51:53
  Speaker 3: they'll just sit there for like forty five minutes just
• 51:57
  Speaker 3: like chatting.
• 51:58
  Speaker 2: Is it play roadblock? Yes, it's amazing.
• 52:02
  Speaker 24: So my parents are an hour and a half away,
• 52:04
  Speaker 24: and my husband's parents are three hours away, so we
• 52:07
  Speaker 24: don't have any sort of like regular childcare help from them,
• 52:11
  Speaker 24: but where they really come in handy as if we're
• 52:14
  Speaker 24: going on any sort of trip, they will either come
• 52:18
  Speaker 24: and stay at our house or we will take our
• 52:22
  Speaker 24: one in, our one year old to them for the
• 52:25
  Speaker 24: duration for the weekend or for the week and that's
• 52:29
  Speaker 24: been super helpful.
• 52:31
  Speaker 20: We love our grandparents. My mother in law, she's only
• 52:34
  Speaker 20: about fifteen minutes away and we don't rely on her
• 52:37
  Speaker 20: for regular childcare, but she's there if we need anything.
• 52:40
  Speaker 20: So if the nanty sick, she'll kind of pitch in.
• 52:44
  Speaker 20: And you know, she was there when I had my
• 52:46
  Speaker 20: second son. She watched the oldest for a couple of nights,
• 52:50
  Speaker 20: so it's great to have that support. And then my
• 52:53
  Speaker 20: parents are unfortunately in California, but we do lots of
• 52:56
  Speaker 20: virtual facetimes, and I know my mom would hop on
• 52:58
  Speaker 20: a plane in a second if I needed to, So
• 53:01
  Speaker 20: the support is great, although not regular childcare.
• 53:05
  Speaker 25: So we actually have a unique situation that I feel
• 53:08
  Speaker 25: like is not very typical where both sets of grandparents
• 53:11
  Speaker 25: live like fifteen minutes from us, but unfortunately, due to
• 53:17
  Speaker 25: like a number of different factors, including some health issues,
• 53:22
  Speaker 25: none of our parents can help with childcare. So it's
• 53:27
  Speaker 25: kind of a bittersweet situation where in theory it would
• 53:30
  Speaker 25: be really great to have them so close, but they
• 53:34
  Speaker 25: actually can't really help a lot. I will say, you know,
• 53:39
  Speaker 25: when we do need something in a pinch, if you
• 53:42
  Speaker 25: know there's something going on and we don't have our
• 53:45
  Speaker 25: regular childcare, certainly you know all parents would offer to help,
• 53:49
  Speaker 25: but it's not something that we can like safely rely on.
• 53:53
  Speaker 4: So my my husband is an orphan and does not
• 53:55
  Speaker 4: bring any grandparents to our situation, but my parents more
• 54:02
  Speaker 4: than make up for it. My mom drives from New
• 54:05
  Speaker 4: York City to Philadelphia every week. She arrives Tuesday morning
• 54:10
  Speaker 4: and time for breakfast, and spends the night and leaves
• 54:13
  Speaker 4: Wednesday around four o'clock.
• 54:17
  Speaker 2: She has.
• 54:19
  Speaker 4: She would fault me if I did not clarify that
• 54:21
  Speaker 4: she has not missed a week since Leanna was born.
• 54:25
  Speaker 4: My dad also recently retired and is more than willing
• 54:28
  Speaker 4: to hop on a train and be here whenever we
• 54:32
  Speaker 4: need him. In fact, this week, our nanny is going
• 54:35
  Speaker 4: away and my parents are kind of tag teaming days
• 54:39
  Speaker 4: of coverage. So while we do not live in the
• 54:42
  Speaker 4: same place, they are really rock stars.
• 54:47
  Speaker 6: What do you feel like grandparents bring to the mix
• 54:50
  Speaker 6: in terms of taking care of your kids that you
• 54:54
  Speaker 6: can't necessarily offer yourself chaos?
• 54:58
  Speaker 2: Oh sorry, it wasn't a question to me, Branna.
• 55:03
  Speaker 11: That is a good answer.
• 55:05
  Speaker 17: I would say, like a lightness and silliness. Honestly, I
• 55:13
  Speaker 17: also have FaceTime up a lot during dinner time, especially
• 55:16
  Speaker 17: when my husband's working nights. I'm getting dinner ready and
• 55:19
  Speaker 17: my daughter is facetiming with my parents, and she's very
• 55:23
  Speaker 17: playful with them, even through a screen, and they aren't
• 55:28
  Speaker 17: worried about all of the things that could go wrong
• 55:31
  Speaker 17: or trying to, you know, check a box of all
• 55:34
  Speaker 17: of the to do lists that I have that day,
• 55:37
  Speaker 17: and yeah, it's fun.
• 55:39
  Speaker 23: My mom is Querto Rican, so Spanish, she speaks more.
• 55:42
  Speaker 23: She's more fluent in it than I am. So my
• 55:44
  Speaker 23: husband and I are like my husband's Jewish white guy
• 55:47
  Speaker 23: bles us already tries, but we are trying so hard.
• 55:50
  Speaker 23: We have a books and stuff. But my mom is
• 55:52
  Speaker 23: like so fluent, like teaches her so much. She's teaching
• 55:54
  Speaker 23: her how to roll her r's and stuff. So that's
• 55:56
  Speaker 23: like clutch for for me.
• 55:58
  Speaker 24: This will be more developed as my child gets older.
• 56:02
  Speaker 24: But my parents live on a farm with horses and
• 56:06
  Speaker 24: like twelve cats, and they just acquired chickens and everything
• 56:11
  Speaker 24: they get. They say it's in anticipation of my son
• 56:15
  Speaker 24: spending more time there.
• 56:17
  Speaker 2: So it's I mean, we live, we live in.
• 56:20
  Speaker 24: A small city, so that's just a whole different lifestyle
• 56:24
  Speaker 24: for him to be able to go up there and
• 56:26
  Speaker 24: be in the grass and play with the chickens and
• 56:27
  Speaker 24: the horses.
• 56:28
  Speaker 4: I think my parents bring an attention spam that I lack.
• 56:34
  Speaker 4: They are both retired and don't really you know, they
• 56:39
  Speaker 4: don't have distractions. They're just like entirely focused on her
• 56:42
  Speaker 4: and I do not have that level of capacity that
• 56:48
  Speaker 4: they have. Should I say that again without a toddler.
• 56:53
  Speaker 2: No, that's perfect. So good a great Thanks team, amazing.
• 57:00
  Speaker 6: They're so great. Next question, Hi, this is Jessica.
• 57:05
  Speaker 26: I'm curious about what age is inappropriate to have children
• 57:08
  Speaker 26: of mixed genders being together. I'm also curious about when
• 57:12
  Speaker 26: parents just stop showering with their children of same gender
• 57:16
  Speaker 26: and different genders. Thanks so much.
• 57:19
  Speaker 3: This isn't something that is amenable to data. This is
• 57:21
  Speaker 3: really a very culturally oriented question. There are there are
• 57:25
  Speaker 3: cultures where everyone is naked together a lot. There are
• 57:29
  Speaker 3: cultures where people don't like to be naked. So in
• 57:31
  Speaker 3: the US people tend to be like less naked. In
• 57:34
  Speaker 3: Europe they're like more naked.
• 57:37
  Speaker 16: You know.
• 57:37
  Speaker 3: There are I have a friend where like he went
• 57:41
  Speaker 3: for like to live with the family.
• 57:43
  Speaker 2: Well whatever, I'm gonna tell the story. It's totally insane.
• 57:45
  Speaker 2: Scratch that. So there are cultures. There's a huge amounts
• 57:48
  Speaker 2: of variation in this.
• 57:50
  Speaker 3: The general advice is, like it is, being naked is
• 57:55
  Speaker 3: fine as long as everyone is comfortable with it, and
• 57:57
  Speaker 3: that means as long as you're comfortable with it, as
• 58:00
  Speaker 3: long as your kids are comfortable with it. Most people
• 58:01
  Speaker 3: will find as their kids age into puberty they will
• 58:05
  Speaker 3: become uncomfortable being naked around their parents, maybe more one
• 58:10
  Speaker 3: parent than another. Some parents will tell me, like I
• 58:13
  Speaker 3: don't want to be naked around my kids, and like
• 58:17
  Speaker 3: even in my household, like my husband would never be
• 58:19
  Speaker 3: naked around our kids, And I have no problem being
• 58:21
  Speaker 3: naked around anyone. And it's just like that, and you know,
• 58:24
  Speaker 3: but I also try to be sensitive to like whether
• 58:26
  Speaker 3: my kids are comfortable with it and so on. But
• 58:28
  Speaker 3: it's it's like totally personal in some ways, like totally
• 58:32
  Speaker 3: personal preference and just making sure that you're respecting your
• 58:36
  Speaker 3: kids and your own boundaries.
• 58:38
  Speaker 6: Yeah, I wish you'd told me that this was going
• 58:39
  Speaker 6: to be a topless podcast recording.
• 58:42
  Speaker 2: Well, look, Tamar, you know I can't tell you everything.
• 58:47
  Speaker 6: Okay, last question, And I saved this for last because
• 58:51
  Speaker 6: I feel like this this caller really understands what you do.
• 58:56
  Speaker 6: And I think this is a really good question to.
• 58:59
  Speaker 2: Being naked isn't about anything podcasting?
• 59:03
  Speaker 6: No, none of us knew about that.
• 59:05
  Speaker 2: That's a surprise.
• 59:06
  Speaker 27: Okay, Hi there, I'm Catherine and Mama from Canada.
• 59:10
  Speaker 1: I have a toddler who is.
• 59:12
  Speaker 27: Joyfully exploring the world.
• 59:14
  Speaker 1: She loves to run and jump and climb.
• 59:17
  Speaker 27: I think of myself as being a little bit anxious.
• 59:20
  Speaker 1: And I know that Emily.
• 59:24
  Speaker 27: You've talked about risk that's really evident and visible, like
• 59:28
  Speaker 27: physical risk, and then all the other risks that are
• 59:30
  Speaker 27: harder to see. So like if I am helicoptering my
• 59:34
  Speaker 27: kiddo and we'll let her climb anything at the park
• 59:37
  Speaker 27: because I'm scared of the physical risk, there's other risks
• 59:39
  Speaker 27: to say, her independence and her self confidence. So my
• 59:43
  Speaker 27: question is about how do we as parents go about
• 59:49
  Speaker 27: making those decisions about what is healthy developmental risky play
• 59:55
  Speaker 27: where we talk about you know, water and heights and
• 59:59
  Speaker 27: distance from parents, things like that, versus what.
• 1:00:04
  Speaker 1: Is straight up dangerous.
• 1:00:07
  Speaker 27: I don't even know if this is answerable really because
• 1:00:10
  Speaker 27: there's so many different situations to think of, But I
• 1:00:13
  Speaker 27: find myself grappling with that all the time. What is
• 1:00:16
  Speaker 27: a healthy risk that I should allow my kiddo to
• 1:00:20
  Speaker 27: engage in and what is just straight up dangerous? And
• 1:00:23
  Speaker 27: how do I start to determine that so I can
• 1:00:25
  Speaker 27: give her the opportunity to engage in risky play but
• 1:00:29
  Speaker 27: also not be.
• 1:00:31
  Speaker 1: Uh, what's the word like negligent?
• 1:00:34
  Speaker 2: Maybe?
• 1:00:36
  Speaker 27: Thank you so much for all the work that you do.
• 1:00:39
  Speaker 27: You've been such a guiding light in preconception and conception
• 1:00:44
  Speaker 27: and pregnancy and my kiddo and beyond.
• 1:00:46
  Speaker 1: So thank you.
• 1:00:48
  Speaker 3: So I want to start with a couple of things,
• 1:00:50
  Speaker 3: which like when people ask like what are you worry about?
• 1:00:53
  Speaker 3: Like what is dangerous or probably worth saying? So there
• 1:00:56
  Speaker 3: are things in the world that are dangerous for kids,
• 1:00:58
  Speaker 3: cars and pools being kind of two central ones. It's
• 1:01:04
  Speaker 3: very difficult to think about the car risks because so
• 1:01:07
  Speaker 3: much of the risks we have with vehicles are just
• 1:01:09
  Speaker 3: when you're driving in a vehicle, it's it's risky. But
• 1:01:12
  Speaker 3: I would say, you know, making sure your kid is
• 1:01:14
  Speaker 3: not playing in a street full of like fast cars
• 1:01:17
  Speaker 3: is a sort of baseline, like not negligent pools are.
• 1:01:21
  Speaker 3: I think actually something where people or lakes or whatever
• 1:01:24
  Speaker 3: are is a place where we probably under in some
• 1:01:27
  Speaker 3: ways under supervise. Actually, like even for a kid who
• 1:01:31
  Speaker 3: can swim, they should really be there should be another person,
• 1:01:35
  Speaker 3: and certainly for a small child there should be supervision
• 1:01:37
  Speaker 3: all the time around sources of water because drowning actually
• 1:01:41
  Speaker 3: is very scary. So I think those are places where
• 1:01:44
  Speaker 3: I kind of put the guardrails and say, like I
• 1:01:46
  Speaker 3: definitely wouldn't say the way to introduce.
• 1:01:49
  Speaker 2: You know, independence for your kid is to have them
• 1:01:51
  Speaker 2: swim alone. That that's not it. On these other things.
• 1:01:56
  Speaker 3: I think it's it's very hard because the first step.
• 1:02:00
  Speaker 2: Always is going to feel risky.
• 1:02:02
  Speaker 3: So what I would tell people is like, if you
• 1:02:04
  Speaker 3: are at the playground and you feel like I am
• 1:02:07
  Speaker 3: over I am over doing it on how much I'm
• 1:02:12
  Speaker 3: in it with mikel which I think you can so
• 1:02:13
  Speaker 3: we can sort of you and be like I think,
• 1:02:15
  Speaker 3: I think maybe I want to dial it back. Just
• 1:02:17
  Speaker 3: try dialing it back once. Try dialing it back a
• 1:02:20
  Speaker 3: little bit, you know, do the like whatever is the
• 1:02:23
  Speaker 3: equivalent of stepping three steps back. Don't assume that your
• 1:02:27
  Speaker 3: first step here is going to be like telling your kid,
• 1:02:31
  Speaker 3: you know, hey, hang out of the park for a
• 1:02:32
  Speaker 3: few minutes. I'm going to get like an ice cream
• 1:02:34
  Speaker 3: over here. You know, that's not going to be the
• 1:02:36
  Speaker 3: first thing you can do. Maybe the first thing you
• 1:02:38
  Speaker 3: can do is sit on the bench a little more.
• 1:02:39
  Speaker 3: Maybe the second thing you can do is like bring
• 1:02:42
  Speaker 3: a book and read a book.
• 1:02:43
  Speaker 2: On the bench. Maybe the third thing you can do
• 1:02:44
  Speaker 2: is step a little bit further away. Whatever it is.
• 1:02:47
  Speaker 3: Because so much of giving our kids this more independence
• 1:02:51
  Speaker 3: and being comfortable with it is the experience.
• 1:02:54
  Speaker 2: Of doing it.
• 1:02:55
  Speaker 3: And this comes up when we talk about giving bigger
• 1:02:57
  Speaker 3: kids more independence. You know, almost everyone you talk to
• 1:03:00
  Speaker 3: who is like I wanted my kid to walk home
• 1:03:02
  Speaker 3: from school or go to walk to school themselves, they
• 1:03:04
  Speaker 3: will tell you the first time they did it, I
• 1:03:07
  Speaker 3: was terrified.
• 1:03:07
  Speaker 2: You know, even people.
• 1:03:09
  Speaker 3: Who are very much on the forefront of pushing this
• 1:03:12
  Speaker 3: out even the public conversation, will tell you the first
• 1:03:14
  Speaker 3: time I had my kid do this, I was like
• 1:03:17
  Speaker 3: panicked the entire time until I heard they were okay.
• 1:03:20
  Speaker 2: But by the third time it was fine. And I
• 1:03:22
  Speaker 2: think that's part of this adaptation that are our kind
• 1:03:25
  Speaker 2: of emotional selves need.
• 1:03:27
  Speaker 3: Even no matter how much data I can give you,
• 1:03:30
  Speaker 3: humans like experience and emotion, we learn from that more
• 1:03:35
  Speaker 3: than we can learn from data. And if you step
• 1:03:38
  Speaker 3: three steps back and your kid goes down the slide
• 1:03:42
  Speaker 3: by themselves or climbs up the rock wall by themselves
• 1:03:45
  Speaker 3: and nothing happens, which is the vast, vast, vast vast likelihood,
• 1:03:50
  Speaker 3: that's going to give you more confidence next time to
• 1:03:52
  Speaker 3: step a little bit further back. So I would say,
• 1:03:54
  Speaker 3: just you know, holding yourself to the standard of small
• 1:03:59
  Speaker 3: changes and giving yourself all the time is going to
• 1:04:03
  Speaker 3: help think about this and then also always supervise them
• 1:04:06
  Speaker 3: around pools.
• 1:04:08
  Speaker 6: Like we stop thinking that we can learn from our
• 1:04:11
  Speaker 6: own discomfort. Yeah, that if we're uncomfortable, then as parents,
• 1:04:16
  Speaker 6: then that must be telling us something really important. And
• 1:04:19
  Speaker 6: I think we take the wrong message away that that
• 1:04:22
  Speaker 6: discomfort is a part of that whole process of separating.
• 1:04:27
  Speaker 2: Totally, and it's like the hardest part. I mean it's like, really,
• 1:04:31
  Speaker 2: I don't know. I don't want my kid to be sad.
• 1:04:32
  Speaker 3: I don't want it, like I don't want I don't
• 1:04:35
  Speaker 3: want them to be scared.
• 1:04:36
  Speaker 2: I don't want anything to happen.
• 1:04:38
  Speaker 3: I think part of this is part of the realizing
• 1:04:40
  Speaker 3: the invisible risk is like something is happening if you're
• 1:04:43
  Speaker 3: not doing this, And I think that's because you can't
• 1:04:45
  Speaker 3: see it.
• 1:04:46
  Speaker 2: It's hard to see.
• 1:04:47
  Speaker 1: Yeah.
• 1:04:48
  Speaker 6: Throughout this whole conversation, I've been thinking about podcast episodes
• 1:04:52
  Speaker 6: that we've done. I mean, this is our our year
• 1:04:54
  Speaker 6: podversary look back, and the one that always comes to
• 1:04:58
  Speaker 6: mind actually to me, is conversation with Nate Fox about risk.
• 1:05:03
  Speaker 22: Yeah.
• 1:05:04
  Speaker 6: I think that that's something that is worthwhile for any
• 1:05:07
  Speaker 6: parent to go back and listen to and think about
• 1:05:10
  Speaker 6: just how poorly as human beings we can actually process risk.
• 1:05:14
  Speaker 6: I mean, that's what economists are for, and I think,
• 1:05:19
  Speaker 6: well to non economists. Yeah, and I think that that
• 1:05:24
  Speaker 6: taking a step back and you know, kind of letting
• 1:05:28
  Speaker 6: data calm you down and fill in that missing part
• 1:05:33
  Speaker 6: of our brain that is really good at processing risk.
• 1:05:37
  Speaker 6: I mean, I think that's why you have the audience
• 1:05:39
  Speaker 6: you do. Thanks for being here tomorrow, Thanks for having me, Emily.
• 1:05:48
  Speaker 1: Yeah.
• 1:05:48
  Speaker 3: I love answering questions. This is great fun. And thanks
• 1:05:51
  Speaker 3: everybody for asking such good questions.
• 1:05:53
  Speaker 2: Yeah, till next time tomorrow.
• 1:05:55
  Speaker 6: Till next time, Emily.
• 1:05:57
  Speaker 2: I think we.
• 1:05:57
  Speaker 3: Should do this before another year has passed, so hopefully
• 1:06:00
  Speaker 3: we get some more questions.
• 1:06:01
  Speaker 1: We'll do some more taking sounds great.
• 1:06:03
  Speaker 6: Bye bye.
• 1:06:14
  Speaker 3: Parent Data is produced by Tamar Avishai with support from
• 1:06:18
  Speaker 3: the parent Data team and PI Rex. If you have
• 1:06:21
  Speaker 3: thoughts on this episode, please join the conversation on my
• 1:06:23
  Speaker 3: Instagram at Prof Emily Oster, and if you want to
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• 1:06:30
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• 1:06:34
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• 1:06:36
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• 1:06:41
  Speaker 3: I do one of these q and a's every Wednesday
• 1:06:44
  Speaker 3: on my Instagram feed. So if you ask a question
• 1:06:47
  Speaker 3: they didn't get answered today, or if this episode inspired
• 1:06:50
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• 1:07:08
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• 1:07:19
  Speaker 2: We'll see you next time.