Another unremarkable reaction to vaccinations

My friend and fellow Evidence-Based Parenting blogger, Tara Haelle shared her story of her son’s unremarkable reaction to his childhood vaccinations, here.  She also dissected a recent study from Pediatrics, the journal of the American Association of Pediatricians, on the impact of religious exemptions on  pertussis rates.  You can read Tara’s post here.  You can also join the Evidence-Based Parenting community on Facebook and discuss it, share your stories, here.

I’ve written before about the importance of vaccinations.  I’ve even written about a case of measles that hit WAY to close to home for me, here.  In light of that, the study which Tara wrote about is concerning to me.  The crux of that paper from Pediatrics?  “Counties with higher exemption rates had higher rates of reported pertussis among exempted and vaccinated children when compared with the low-exemption counties.” (Source).

If you think that choosing NOT to vaccinate your child doesn’t impact anyone else in your community, you are WRONG!

Parents are lying about their religious beliefs to score immunization waivers on the basis of a religious objection.  Those lies, that failure to vaccinate is having real and measurable impacts on their communities, in the form of increased cases of pertussis.  Vaccination is important.  Vaccines save lives.  We all have to do our part to keep our communities safe and healthy.

Today, I’ll join Tara and I’ll add my voice to the chorus of vaccine stories.

I have two children, Mable is 3.5 and Nemo just turned one.  Both children have been vaccinated according to the standard schedule recommended by the CDC, AAP, AMA, etc.

While I have done a lot of reading on the topic of childhood vaccinations, we relied heavily on the decades of schooling and practice that our pediatricians and nurse practitioners had, in deciding how to vaccinate our kids.

Both of my remarkable children have had only unremarkable reactions to their vaccinations.

Just last week Nemo recieved his first dose of the MMR vaccine and the Varicella vaccine.

I could not even tell you what happened after each and every vaccination.  I have a recollection of Mabel sleeping through the night for the first time after getting several vaccinations at her 8 week well child visit.  I have a recollection of Nemo having a slight fever after some shots- I don’t remember which ones or how old he was.

My experience has been completely unremarkable.  Other than expected tenderness at the injection site or being sleepier than usual, maybe a fever, neither of my kids have had any reactions.  And, as is clear from my inability to recall details, those reactions aren’t even memorable enough for me to recall.

That’s my unremarkable vaccine reaction story.  What’s yours?  Share it here or with other Evidence-Based Parents on Facebook.

Transition to New Parenthood/Evidence Based Parenting Discussion Storified

Earlier this week I posted my contribution to this month’s Evidence-Based Parenting Blog Carnival about the transition to motherhood.

Today, several of the contributors, all evidence-based parents (many scientists, science communicators, and researchers- all parents), got together on Twitter for a live discussion of some of the issues brought up in the Carnival.  We used the hashtag #parentscience and discussed issues ranging from sleep to swaddling to pain management and bonding.

If you missed the live discussion, don’t worry.  My fellow Carnival of Evidence-Based Parenting (CEBP) contributor, Matt Shipman Storified it!

You can catch up on what you missed here.  And you can contribute to the ongoing discussion on the CEBP Facebook page here (recent topics include the debatable happiness of new parents and the difficulties facing doctors and parents when caring for interest infants).

If you are ready to trade the parenting hype for the some legit, evidence-based parenting, read up!

The Transition to New Motherhood

This month’s Evidence-Based Parenting Blog Carnival is discussing the transition to motherhood/fatherhood, inspired by Mother’s Day.  Our host this month is evidence-based parent Jessica Smock whose blog, School of Smock, looks at parenting from the perspective of a mom with a young child and a research background.  Our topics in this month’s carnival are as varied as you might expect.  You can find them all here.  You can also follow the discussion on Twitter with the hashtag #parentscience and on our Facebook page.  Also, tune in on Twitter this Friday (5/17/13) from 1 to 2pm for a Twitter party with all of our bloggers for a live discussion with the hashtag #parentscience.

Last Mother’s Day was my due date with Nemo, my second offspring.  I was somewhat impatiently awaiting his arrival.  I must say, the transition from one kid to two was a lot easier than the transition to being a new mom.  Some of that was due to a more difficult delivery with my first and some of it was due to the amount of help I had with my second (Mac was home with me).  However, I think largely it was due to the fact that childcare was already routine.  I was used to being woken up in the night.  I was used to breast feeding.  I was used to diapers and swaddling and baby monitors and naps and sleep deprivation.  I’d been there, done that (or in some cases like diapers was still doing it with Mabel) when Nemo came along.  Caring for a baby wasn’t new, it was familiar.  It was habit.

Meeting Mabel face to face for the first time.

My practical advice to new moms, based on empirical evidence of having been one myself, consists of two things:

1.  Keep your expectations low.  (That includes expectations of yourself, your baby, and your partner.)

2.  Give it about a month before anything feels normal again.

I’ve written about #1 before, here.  In all truth, in the early days of parenting, it’s completely necessary and sufficient to just get by.  Your house doesn’t have to be clean.  Your clothes don’t have to be clean.  Your hair doesn’t have to be clean.  This study would indicate that you are not alone- 40% of women reported at 1 month postpartum that there were days they did not get dressed.  This was my experience too.  You can extrapolate from there.

At first, you just get by.  When it’s a struggle to just get all living beings in your household fed and clothed, you need to keep your priorities in order.  Now having had baby #2, I look back to how I did things with Mabel (#1) and feel like I need to apologize for my ineptitude.  We really were just getting by.  Learning as we bumbled along.

Why are these early days so hard?  I know my fellow EBBs (Evidence-based bloggers) are covering some of that.  There’s the sleep deprivation.  There might be postpartum depression.  You may be learning to breastfeed or struggling to breastfeed.  Bonding with the new baby.

I’ve written before about my recoveries (I had a C-section with both kids) in the past.  It’s definitely a transition physically, emotionally, and psychologically.

Meeting Nemo face to face for the first time.

When I had my first child, Mabel, I didn’t feel myself for weeks.  I felt kind of out of place and on edge.  Crawling into bed at night wasn’t a welcome rest, merely a short reprieve.  I couldn’t relax and enjoy the rest because I knew, at any moment, it would be interrupted by a crying baby.  That getting into/out of bed or rolling over was still painful and I was waking up drenched in sweat each night didn’t add to any sense of rest or relaxation.

My experience is pretty typical if you look at the data.  Maloni et al looked at the postpartum symptoms reported by 106 postpartum women who had a singleton high-risk pregnancy and were treated with antepartum (before giving birth) bed rest.  At 6 weeks postpartum, at least 40% of the women were still reporting symptoms like fatigue, mood changes, tenseness, and difficulty concentrating.  In this particular study, the authors didn’t include any kind of “control” group of women (i.e. those who had not been on bed rest, those that had low risk pregnancies, etc.).  If they had included such a group, I would not be surprised if the results were similar. My own anecdotal evidence would indicate that fatigue, mood changes, tenseness, and difficulty concentrating are pretty universal for women after giving birth.

I kind of trudged through the days (and nights) like a zombie- lack of sleep, lack of food (it was hard to find time to eat while caring for a newborn solo), C-section pain, pain medication- the combo wasn’t conducive to coherent thought.  Watching the 2010 Winter Olympics is how I kept from slumping over while nursing in the dead of night (perk- I actually got to watch some of it live).

It also didn’t really help that during that time Mabel was lacking in the personality department.  It was kind of like caring for a slobbery, leaky, screaming sack of sugar.  Her first smile- right around the one month mark was kind of a turning point.  She was interactive and that helped with nurturing and caring for her.  Also, I think we kind of found our groove.  After a month of muddling along, I figured out how to live as a mom, and she figured out how to live outside of my womb.

First family photo a few hours after Nemo was born.

Have you ever heard somebody say it takes 30 days to make a new behavior into a habit? Well, it turns out that there is some science to back up that notion- that it takes time for new behaviors to become habits, to become acclimated to new situations.

So is 30 days some kind of magic threshold?  I don’t think so.

By that one month mark, I was able to feel more relaxed at bed time, it no longer felt like there was a stranger in my house, I felt much less tense and on edge.  I still wasn’t ‘normal’- the house was still messy, I still spent days in my PJs, but they felt more like a lazy Saturday than futile struggle for self-care.

A few years ago, a group at the University College London, led by Phillipippa Lally studied 96 people who wanted to form a new habit (the article is behind a paywall, but you can find the abstract here).  Lally et al looked at how long it took individuals to report that the new behavior had become automatic- basically, had become habit.  They found a wide range (from 18 to 254 days) with an average of 66 days.

“When the researchers examined the different habits, many of the participants showed a curved relationship between practice and automaticity of the form depicted below (solid line). On average a plateau in automaticity was reached after 66 days. In other words it had become as much of a habit as it was ever going to become.” Source.

In a lot of ways, parenting becomes a habit.  Mac and I take turns getting up in the night, and a lot of times, in the morning, we can’t remember how often or what time or for which kid.  We’re on autopilot.  On the rare occasion we are childless, we still go to open the rear car door to extract a small child or still tiptoe up the stairs at nap time.

I think this force of habit is what made the transition to motherhood so challenging with my first child, and much less so when adding a second.  When transitioning to a new mom, I had to learn A LOT, adopt a whole new way of living, new skills, new routines, new patterns.  When transitioning to a mom of two, all of that was old hat, there was just one extra kid to juggle.

So, to those expectant and new parents, hang in there.  You can do it.  Give it time.  Cut yourself and each other lots of slack.  This too shall pass.  You’ll find your new normal.

What were your experiences becoming a new parent?  Adding another child to your family?  If you are expecting, what are you anticipating?

Read about the experiences of other evidence-based parents on School of Smock and follow our discussion on Twitter with the hashtag #parentscience and on our Facebook page.

Other posts I’ve done that might be useful for new and expecting parents:

My best parenting advice:  Keep you expectations low

The Science of Breastfeeding (already a little out of date)

My experience with a C-section birth

Recovering from a repeat C-section (and some info on my recovery from the first) and here

Recovering from late onset, pregnancy-induced hypertension

Introducing potentially allergenic solids

Baby-led weaning, and here

Picking a Pre-school

Note:  This post is part of the Evidenced-Based Parenting Blog Carnival.  This session’s host is Alice Callahan who blogs at scienceofmom.com.  You can find lots of other posts here, from bloggers/parents who turn to science for help with the parenting dilemmas we all face.  You can also follow the discussion on Twitter with the hashtag #parentscience.

_________________________________________________________________

I have to admit, when considering pre-school for Mabel, I didn’t put much thought into it.  I didn’t do a lot of research.  I didn’t visit lots of schools.  I didn’t fret about it.  I pretty much went with my gut.

Now, to be sure, it wasn’t an uninformed decision.  I generally keep current with parenting recommendations, so I was aware of the importance of preschool.  Mac and I knew Mabel was going to go to preschool, but the type of school and the timing were dictated more by circumstance than science.

The reason there was no question Mabel would attend preschool (aside from the fact that it gave Mac a break to have her out of the house 3hrs/3 days a week)?  The benefits are pretty firmly established.  This is a great article from The Washington Times that links to a lot of primary literature and data on many of the seminal studies on preschool education- where students were tracked well into adulthood, showing lasting benefit.  For even more in depth info and nuance of how this is studied, and we can tell if there is a benefit, see my fellow Evidence-Based Parenting Bloggers Jennifer Doverspike and Tara Haelle‘s posts.

Orientation Day at Mabel’s Preschool

A word to the wise, know your source.  Some of the data on preschool is ‘controversial’- I’m using quotes, because it’s only controversial if you look at certain, questionable, sources.  Public education costs money, and is funded by tax dollars, that means it’s politicized.  It’s not surprising that sources like the Wall Street Journal (which generally has a conservative slant), and places like the Cato Institute report that the benefits of preschool are short-lived, and thus should not be paid for with tax dollars.  Many of those arguments revolve around how much return is to be had from investing in children’s education, in a monetary sense.  Since I whole-heartedly dismiss the notion that the only value of education is to be measured monetarily, I find those arguments baseless.  However, if you turn to peer reviewed scientific sources, it’s quite clear that numerous studies, dating back decades, support the long-term benefits of preschool.

So, then the question turned to what kind of preschool? I should say straight out, that I don’t think where my kids go to preschool will determine whether or not they get into an Ivy League college.  There may be strong data that preschool forms a good foundation for future academic achievement, but let’s be reasonable- we’re talking about a 2 year old.  There are just too many variables to draw that kind of a causal relationship!

I wanted Mabel to enjoy preschool, socialize, and give Mac a break from juggling two kids.  We didn’t need it to offer immersion in a foreign language (although that would be awesome), we didn’t need it to be anything elite or exceptional.  I wasn’t going to jump through hoops, I wasn’t going to pay an exorbitant tuition, I wasn’t going to kiss butts, fret over interviews (of Mabel or of Mac and I), I just didn’t think it was a big deal.  It was only preschool- and as Melinda Wenner Moyer points out in her Evidence-Based Parenting post, the fact that I’m even wondering probably means she doesn’t really need it anyway!

That said, we live in Westchester County, a suburb of Manhattan.  Even our bad schools are good (or my suspicion, maybe our ‘bad schools’ are just not white)- but few provide public pre-k.  Where we are, it wasn’t like I was settling for an inferior program because I wanted it to be nearby and inexpensive.

First day of preschool.

One of the admin assistants at my job lives near me.  Her kids are in elementary school, so just like I did when I was looking for a good bagel place, a guy to fix a flat tire, and a church, I asked her where I should look.  She gave me three names of schools that her kids had attended, or that she knew of and that was the starting point of my search.

The first was ruled out pretty quickly.  It was through a church, and included a religious education component which Mac wasn’t crazy about.  We kept an open mind and attempted to look into it.  However, the fact that we couldn’t get anyone on the phone and nobody would return any of our phone messages clinched it as a no-go.

The second place was a school I actually got to visit (hard to arrange visits when you are at work all day).  It was Montessori style (I guess technically modified Montessori).  One large room, took kids from 2.5-5yo, a lot of “play”, with a well-qualified teacher.  When we visited, Mabel joined right in on circle time and had a ball.  That my coworker’s son had graduated from there and both he and his fellow graduates were all kindergarten-ready was another plus.  However, being one large room, we wondered if Mabel would be distracted or not get enough attention in a room where she was the youngest (for an good look at the research on pros/cons of mixed-age classrooms, check out my fellow Evidence-Based Parenting Blogger Alice Callahan’s post).

The third I didn’t get to visit (work).  Mac reported it was run like a typical elementary school- and seemed to be a tight ship.  They say theirs is a literature-based program; however, we were both kind of taken aback that during certain times of the day, kids were allowed to watch TV!  I’m not paying for Mabel to watch TV!  I’m already paying through the nose for cable- if I wanted her to watch TV, I could just sit her on the couch and save the tuition money!  Mac did feel that this school would make the transition to kindergarten easy- since it was basically run as such.  However, he felt that Mabel was perhaps a little young for it.

Given that Mabel’s January birthday means she’ll be starting kindergarten at 5y8m and not 4y8m, if we started her in September as planned, when she was 2y8m, she’d have three years to spend in preschool.  How did we want her to spend that time?  In an elementary school setting or a Montessori setting?

Well, here is where research really pays off.  I’ve written about it before, more than once- kids are little scientists.  I am not alone in this (check out Fellow Evidence-Based Parenting Blogger Jeanne Garbarino’s post about her little scientists), and the data are pretty clear.  Just like big scientists, little scientists, need to experiment.  How do they do so?  By playing.

My little scientist showing off a 50ml conical tube she brought home from a visit to my lab.

A 2012 review article published in Science, “Scientific Thinking in Young Children:  Theoretical Advances, Empirical Research, and Policy Implications” does an awesome job of reviewing some of the seminal research in this area and distilling it.  It’s not a tough read if you want to check it out, otherwise, a brief and easy summary can be found here.

The thrust of the literature review can be gleaned from the abstract:

New theoretical ideas and empirical research show that very young children’s learning and thinking are strikingly similar to much learning and thinking in science. Preschoolers test hypotheses against data and make causal inferences; they learn from statistics and informal experimentation, and from watching and listening to others. The mathematical framework of probabilistic models and Bayesian inference can describe this learning in precise ways. These discoveries have implications for early childhood education and policy. In particular, they suggest both that early childhood experience is extremely important and that the trend toward more structured and academic early childhood programs is misguided.  Source: Alison Gopnik, Science

As you could tell from the posts I linked to above, this wasn’t exactly news to me.  Through a combination of benign neglect, encouragement, and laziness, Mac and I attempt to get Mabel to be as independent as possible- from washing her hands to playing with new toys, to figuring stuff out on her own.   (It’s no wonder that when my mom said she didn’t know how to work the car radio, from the back seat Mabel told her, “You’re smart Nana!  You can figure it out!”)

There will be plenty of long years (decades even) that Mabel will be in one classroom or another.  Some will offer freedom of inquiry, others will require rote memorization, some will engage her, others will bore her.  She doesn’t need that dichotomy as a 3 year old.  Mac and I want her to use her inherent scientific abilities while she still can, I want them to be nurtured and encouraged.

So when it came down to it, we chose the modified Montessori program and we’re really happy.

Adapted from Mabel’s school website:

Program … children between the ages of 2 1/2 and 6… modified Montessori approach… stresses both a learning and social environment… cooperation, social interaction, and FUN… preschool program of basic skills, art, music, movement, and games… also offer beginning French and  Italian…  accompanied by Montessori educational materials for practical life, fine motor development, math and number concepts, science, and age-appropriate literacy development. (Forgive me for not directly citing this source for privacy reasons)

Mabel’s school recently held Parent’s Day- where the parents were invited to come and spend the morning.  Everything was play to Mabel. She wanted to play with the pink tower, play with the button box, play with the butterfly life cycle.  Everything was play.  She was learning, and she was loving it.  Soon enough school will be a chore or a reason to pray for snow days, but for now it’s a lot of fun!

Mabel showing me all about the life cycle of butterflies at Parents Day.

So how often?  How long?  How many days in school?  The cost varied depending on the number of sessions, but compared to what we’d paid for childcare when we lived in Massachusetts, the preschool costs were practically negligible (ie I thought the yearly tuition was the monthly cost when I first looked at the pay schedule).  Aside from cost, I really don’t want Mabel (or the rest of us) to feel over booked.  I remember having lots of free time as a kid, to fill however I wanted, to be home and be comfortable.  I want Mabel to have that too.  I read an article in The Atlantic not too long ago (with plenty of data in it) that scared me:

[Peter Gray, Ph.D., Professor of Psychology (emeritus) at Boston College] cites a study which assessed the way 6- to 8-year-olds spent their time in 1981 and again in 1997.  The researchers found that compared to 1981, children in 1997 spent less time in play and had less free time. They spent 18 percent more time at school, 145 percent more time doing school work, and 168 percent more time shopping with parents. The researchers found that, including computer play, children in 1997 spent only about eleven hours per week at play. Source.

Thankfully Mabel thinks all her ‘work’ at school is playing.  Still, I don’t want to manage or run Mabel’s life (or Nemo’s when he’s older).  I want her to have time to do “nothing” and “just play”- which is important.  Both Polly Polumbo’s post and Jennifer Smock’s post for the Evidence-Based Parenting Blog Carnival talk about the data that show just how important.  Mabel is in an Irish Step Dancing class (30min once a week), and a ballet class (30min once a week).  We opted for her to go to school three mornings a week (from 9am to 12pm).  Next school year, we’ll up it to two full days (9am to 3pm) and one half day (9am to 12pm) a week.  Other than that, she’s free to play, go to the library, do whatever she can think up.

Mabel and I playing with the traditional Montessori “Pink Tower.” Step 1: Take turns moving the blocks, one by one, to the mat. Step 2: Take turns stacking the blocks in size order, one by one. Then disassemble the same way. Step 3: Take turns returning the blocks to the platform (you can see over Mabel’s shoulder in the first image), one by one.

It is not surprising that Mabel mistakes her school work for play, there are many similarities (and some differences) between Montessori-style and play-based learning (source).  Programs like those at her school show that students are more physically active (not confined to their seats) than kids in more traditional programs (source).  Of course, there is some data to support better outcomes (ie abilities and academic achievement) with Montessori programs (here); however, Mabel is in a modified Montessori program (which some studies indicate limits the benefits).

That said, I am happy to have her in a modified-Montessori, and not a strict Montessori for a reason that relates back to that inherent scientific nature.  Studies have shown that children left to explore an object on their own learn more about it than a child who is shown how to use the object and doesn’t further question its features (see here).  In traditional Montessori, students can’t play with items the teacher hasn’t taught them to use yet, and once they are shown the use, they should not use it in other ways (source).  This irks me- certainly kids should be capable of using the items in the way they are intended (stacking blocks in size order for instance- lets them understand the spacial relationship, sizes, motor skills required to stack them, etc.); however, I think limiting students exploration or imagination with a toy can have draw backs.  Mabel’s classroom is modified-Montessori and I hope the modifications alleviate that.

Painting on Parent’s Day.

There is a lot of data on the benefits of different styles of learning.  I have to confess, I did a lot more research to write this post than I did when picking a program for Mabel.  While I knew much of the info I’ve included here, tracking down sources and finding references certainly reassured me that Mac and I made a good call when putting Mabel into her preschool program- our gut feeling was spot on.

Our choice hinged on (in no particular order):  proximity to home, cost, teaching style, gut feeling, recommendations from other parents, and whether the program would be engaging and fun enough to instill a love of learning while being structured enough to allow Mabel to progress behaviorally and be ready for kindergarten.

I’m certain that not every parent, even given the same data, would choose the same program- certainly not all the Evidence-Based Parenting Bloggers did.

Just check out how other Evidence-Based Bloggers turned to the evidence:

The Early Education Racket (Melinda Wenner Moyer)

Preschool Should Be Less School and More Play? (Momma Data)

Preschool at Home? Let the Children Play! (School of Smock)

Mixed-Age Preschool: Benefits and Challenges (Science of Mom)

On parenting (and teaching) in the name of science (Jeanne Garbarino)

Universal Prekindergarten: Evidence from the Field (Six Forty Nine)

What Can We Learn from a Single Preschool Study? (Red Wine and Apple Sauce)

Preschool, Schmeschool (Fearless Formula Feeder)

So, I’m curious, how did you choose a preschool for your little one?  What did you consider?