Comment by Fire-Dragon-DoL
2 years ago
When I was getting ready to turn dad for the first time, I read a few books on pregnancy, children and parenting. My trust on medicine dropped substantially when I discovered that doctors have poor notion of statistics, so they take for granted improper studies results.
I remember one classic one is the "no coffee when pregnant", the study says this causes problems, the test was performed on rats and by feeding them coffee in the amount of 3/4 of their body weight. We can agree that with this amount, it's reasonable it could cause problems. Very different from one cup of coffee though.
The other study that was done is about Amniocentesis, this one is more interesting the chance of miscarriage is considered 0.1% but this was before the operation was performed with a live ultrasound to look at the needle while performing it, which (probably) makes a big difference. Before, doctors performed an ultrasound and then went in blind.
There was also a serious bias towards a certain type of population. But of course doctors don't bring this up at all.
Last thing is sids, it's a terrible type of diagnosis that pushes parents against the instinct of sleeping with their children, even though this is commonly done in non-western cultures and can save a lot of pain to the parents and give a lot of security to the child. Do your research though, medical community reports risks and I'm no doctor, just a dad who read a few books.
Glad my children are healthy. Every time I read about some illness for children I feel an incredible weight on my heart
I think it's both funny and sad that you're doing the exact same thing as the "bad" doctors in TFA and then are on here commenting about it. A quick search on Google Scholar for "caffeine pregnancy" reveals a number of studies that show a non-trivial link in humans to increased miscarriage chances, at levels of consumption that realistically occur with heavy coffee drinkers. I.e. your conclusion is not so clear-cut and is based on one (admittedly bad science) thing you read. Example [1][2]
[1] https://www.sciencedirect.com/science/article/abs/pii/S00029...
[2] https://academic.oup.com/nutritionreviews/article/54/7/203/1...
I don't think that's fair toward me: the bad doctors never told me "do your research, form your opinion". They were always clear cut, they looked up on us for sleeping with our children and they "checked" the breastfeeding checkmark at the hospital even if my wife lamented pain during it and turned out my daughter had a really bad lip/tongue tie that took a month to be solved (with surgery). Notice that medical personnel even told her "you have to endure it, it's normal", as her breasts were cracking and she couldn't breastfeed anymore (had to pump).
I explicitly said, do your research at the end of the message.
P. S. The book might have been one of the following, I can't remember:
Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong--and What You Really Need to Know (The ParentData Series Book 1) from Emily Oyster
What to expect when you are expecting
I think it's the first one. I read many at the same time, so it's hard to remember which one had the information.
The problem that became very salient to me dealing with miscarriage is that women who have healthy pregnancies are also more likely to have problems with morning sickness, and are more likely to avoid things like coffee that are likely to make them feel even more nauseous. Women who have troubled pregnancies that are more likely to end in miscarriage are less likely to feel nauseous and therefore continue to drink and eat things as before.
So it's possible caffeine consumption is a sign of a troubled pregnancy rather than a cause of it. I'm sure there's a point where caffeine becomes problematic but that could be said of a lot of things.
There's a paper in NEJM or JAMA that pointed to this as a likely explanation but it's been a few years and don't have time to look for it now. I think they were looking at timing of caffeine consumption and nausea symptoms?
From your second link:
>The results of this literature review suggest that heavy caffeine use (≥ 300 mg per day) during pregnancy is associated with small reductions in infant birth weight that may be especially detrimental to premature or low-birth-weight infants. Some researchers also document an increased risk of spontaneous abortion associated with caffeine consumption prior to and during pregnancy. However, overwhelming evidence indicates that caffeine is not a human teratogen, and that caffeine appears to have no effect on preterm labor and delivery.
> I remember one classic one is the "no coffee when pregnant", the study says this causes problems, the test was performed on rats and by feeding them coffee in the amount of 3/4 of their body weight. We can agree that with this amount, it's reasonable it could cause problems. Very different from one cup of coffee though.
Honestly I don't know which study you're talking about, and I'm not trying to question what you're saying (such studies indeed often use exaggerated amounts because it's more likely to show effects, but it can skew the results of course) but I just found it interesting that depending on what "feeding them coffee in the amount of 3/4 of their body weight" means, well over a pregnancy it's easy to consume 3/4 of one's body weight in coffee.
It means about 150 mL coffee per day for a woman weighing 55 kg, over 9 months.
About SIDS and sleeping with the children in the same bed, if I remember correctly (it's been some time since I had to read about this) the very large majority of cases happened with parents who either smoke or are obese. I think I couldn't find precise stats just for non-smoking, non-obese parents but it seems like SIDS basically didn't happen in this case when co-sleeping. It also almost never happens with immigrant parents for some reason (even though they are statistically more likely to practice co-sleeping, here in Europe).
SIDS has all manner of interesting and unexpected demographic correlations. I’m not convinced anyone knows what to make of them.
That’s the problem with anything that is defined by the symptoms, rather than the cause. As soon as you find definitive evidence of what causes a subset of SIDS, it’s no longer really SIDS but “improper bed safety” or “undiagnosed genetic condition”.
The covariates are awkward and because they correspond so strongly with parental traits, the possibility exists that the kids are dying because of dysfunctional parental behaviors specifically.
I'm a light sleeper and I feel like I have an awareness of everything nearby when I'm asleep (like I used to fall asleep with an open laptop in bed during college without knocking into it). I have a feeling co-sleeping wouldn't be an issue for me, but with all the dire warnings I'm afraid to risk it.
My wife did exactly that because she is a light sleeper. She actually slept near the center of the bed with the baby on her chest, so she could perceive any movement. I got used to perceive baby movements too.
I would obviously suggest to be very honest with yourself, but if you are a light sleeper and don't roll (we didn't), the most you have to be careful of is heat. Otherwise, enjoy the cuddly night
> I'm a light sleeper and I feel like I have an awareness of everything nearby when I'm asleep
You absolutely don't have awareness of everything nearby when you're asleep. You are inherently incapable of even determining this because you're sleeping. I'm sure you react to some stimuli but that doesn't mean you can expect yourself to react to every potential stimuli that you would want to.
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It was intended in a day, not over the course of the pregnancy
You should see how the second hand smoke studies upon which all other second hand smoke studies were based were done - very similar methodology - cotton swabs were saturated with combustion residues from hundreds of cigarettes, making them into tarry masses, which were then applied to 100% of the bodies of infant rats, every day for several weeks - and they were then observed for developmental abnormalities. The discussion then explicitly states that this should not be taken as a human analogue, as the rats were seen to lick the residue off their bodies, thus consuming all of it, and that further research would be needed.
Further research was of course done - on rats - with much the same methodology.
Medicine is really prone to falling for this sort of thing - and it’s honestly no great shock, recalling the calibre of people at school who went on to become doctors. I studied physics, for Christ’s sake, and knew more about metabolic pathways than third year med students who I would help cram.
When my wife was pregnant 15 years ago, I did a lot of similar reading about various things. One was home vs hospital birth, and at that time at least, there was a strong vibe of "home birth is best birth" going around. Many people linked to a study (which I can no longer find!) in Norway maybe? It was a big study that "showed" that home birth was safer than hospital birth. However, if you dug into the study, you'd find one particular interesting nugget: if any of the home birth participants experience any negative medical event, even during delivery, they were removed from the study. It was preposterous. In the end, all the study said was, "home births that happened without incident were safer than hospital births", or, in other words, "safe births are safer than non-safe births".
The home birth obsession makes me so angry. My wife had a really bad postpartum hemorrhage when our daughter was born. Thankfully, we were in the hospital, so the obstetrics team was able to stop the bleeding and get her stabilized. She'd have likely died if it was a home birth.
What's even crazier is that in most of the US, midwives only need a high school diploma and a midwifery certificate - or in many states, no education is required at all as the title "midwife" is not protected. The vast majority of the rest of the developed world requires midwives to either be professional nurses with additional training in midwifery, or to have a special four year midwifery degree (eg: here in Canada, midwifery is a bachelor's degree). Many parents in the US who opt for a home birth are likely unaware of how underqualified many American midwives are compared to their international counterparts to respond to an obstetric emergency.
I'm glad we were given an option but only based on comfort level, not because of better safety. We wanted the hospital, in case you need a rushed c section.
Has SIDS been linked to co-sleeping? I thought the risks of co-sleeping were more around accidentally rolling on or suffocating the baby.
That is also what we were told after birth.
My personal opinion is that the advantages of co-sleeping far outweigh the risks. It is much less stressful for both the parents and the baby. My wife simply slept topless, turned (half-sleeping) to our baby whenever it was crying, and immediately fell back asleep.
Yeah, we coslept as well. We don't drink or do drugs, so we weren't in that risk group. Neither of us has been the type to fall out of bed (which would indicate lack of physical awareness during sleep). We put the baby between us, so she wouldn't roll off. We kept the room warm so there wouldn't be a risk of heavy quilts suffocating her.
And it was fantastic. No crying, no separation anxiety. Feeding was easy, so we all slept well.
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works for dad too
Newer research shows a good chunk of SIDS cases actually _are_ likely suffocation from various causes.
That’s why the SIDS reduction measures are mostly ‘sleep on the back, in an empty crib, with nothing soft around’.
But it’s much easier to tell a grieving parent that there’s nothing they could have done, than that their baby got unlucky and suffocated to death.
You are speaking facts, but it runs into the medical problem of “overdiagnosis” where the treatment can be worse than the disease.
Swaddling the baby and forcing it to sleep on its back, may have a tiny statistical benefit for SIDS, but it causes tons of problems at a time when people are taxed to the limit of their abilities.
We could reduce the incident of breast cancer by removing every woman’s breasts, but that would be an improper risk assessment.
The biggest factor linked to SIDS is poverty, and after that it’s stuff like going to bed while under the influence of drugs and smoking.
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The problem is that sids is vague, sometimes is used to protect the parents from murder accusation because overly tired