FOR NEW parents, it is a terrifying moment. The hospital doors close behind them, leaving them with a new and helpless human being. The baby’s survival into adulthood seems impossible. What if it will not eat? What if it is allergic to water? What if an owl carries it off? Probably, few parents wish at that moment for the help of an economist. But “Cribsheet”, a new book by Emily Oster of Brown University, shows that in the hectic haze of parenthood an economist’s perspective can prove surprisingly clarifying.
Ms Oster’s academic work relates to health and health policy. A recent paper, for example, studied how food-purchasing decisions change in response to being diagnosed with diabetes. Five years ago she published a book on pregnancy, drawing on her training as an economist and her own experience (her husband, Jesse Shapiro, with whom she has two children, is also an economist at Brown). “Cribsheet” tackles the next step in the journey from childfree person to parent. Deciding whether to have a child in the first place fairly obviously involves economic calculations, from the impact on the parents’ earning potential to the resources that must be set aside to pay for nappies, child care and university. The decisions that come in a torrent after the birth, in contrast, such as whether to breastfeed or how to manage sleeping arrangements, might not seem so amenable to such thinking. But Ms Oster’s new book shows that they are.
Parents generally try to maximise the welfare, present and future, of their children (and, secondarily, themselves) subject to constraints of money and time. That requires choices. Economics can help a parent judge these trade-offs. Good choices begin with good information. Before deciding whether breastfeeding is worth the time, trouble and physical toll, it helps to know the benefits compared with feeding with formula. Parents do as most people do when making a hard call: turn to experts, friends, family and the internet. But different sources provide wildly different answers—and often with an extraordinary intensity of belief. As Ms Oster notes, internet mums frequently write as though ignoring their advice is tantamount to abandoning a child to wolves.
The help she provides begins with sorting through published research and determining what is worth heeding. This involves more than identifying outright disinformation, of the sort published by anti-vaccination groups. The conclusions of serious research also need to be treated with care. Unless studies are well-designed, the results can be influenced by confounding factors. The purported benefits of breastfeeding, such as conferring a higher IQ on the child, can reflect the fact that women who are richer and better educated, and have higher IQs, are more likely to breastfeed. More reliable research attempts to take account of these factors. Whenever possible—and breastfeeding is a case where participants would almost certainly refuse to co-operate—researchers arrange randomised controlled trials, randomly dividing participants into “control” and “treatment” groups, only one of which engages in the behaviour under study, the better to isolate its effects.
Even when a study is well designed, it can require statistical sophistication to understand the size of any effect and the significance of the result. Non-economists may find “Cribsheet” interesting as a guide to understanding research findings, though harried parents may focus more on its concrete guidance. There is plenty of this. Breastfeeding, it turns out, provides short-term health benefits to babies (notably by making diarrhoea less common) and reduces the mother’s risk of developing breast cancer. But there is no hard evidence that breastfed babies enjoy long-term health or cognitive benefits compared with bottlefed ones.
Still, given the potential benefits, why not do it? Economic analyses include not only what is gained by a choice, but what is foregone. For example, putting an infant to sleep beside a parent in bed rather than alone in a cot is associated with a higher risk of sudden infant death. If there are no exacerbating factors (such as a mother who smokes or drinks), that increased risk is tiny: 22 deaths in 100,000, rather than eight. But why risk it? The answer may be that it is worth it. Sleeping side by side can make breastfeeding easier. More importantly, for some parents it is the only way to settle the baby (and hence to get some sleep themselves).
Prolonged sleep deprivation is horrible and makes it harder to be a good parent—or to function. Some mummy bloggers may find it unconscionable that a mother would expose her child to extra risks in order to treat herself to a few hours of sleep. Ms Oster suggests that, if well-informed parents make that choice, then it is reasonable: a welfare-enhancing balancing of benefits and costs.
A mother’s place is in the wrong
Economic reasoning can feel bloodless. But the calculations in Ms Oster’s book seem more human than “Mummy War” moralising, in their recognition that parental time and energy are finite. She reckons it is helpful to think about work-life balance in bluntly economic terms: “What is the optimal configuration of adult work hours for your household?” In the past, male economists like Gary Becker used such logic to argue that women should “specialise” in home-making. But Ms Oster points out that the benefits to a household of more income (often a necessity) should not be ignored—and neither should a mother’s preferences. Although research suggests that policies allowing a parent to stay home in an infant’s first months do benefit children, staying home for two years rather than one does not meaningfully alter a child’s prospects. Women who need or want to return to work should not be kept from doing so by guilt or others’ expectations, she writes.
Parenting can be fraught. “Cribsheet” aims to help parents do better. And in capturing how they struggle when beset by dubious information and emotional pressure from peers, it also holds lessons for economists. Welfare-maximising decisions are hard to make, and sometimes people need a little help.