Correlation found between Autism and timing of pregnancies

New research finds that autism is 3x more likely in children who were born less than a year after their older siblings. In other words, something about the time elapsed between pregnancies is related to the odds of having a child with autism. There is speculation that the connection between autism and inter-pregnancy-interval (IPI) might be "related to maternal depletion of key nutrients such as folate".

I am always fascinated by how much mystery and controversy surrounds autism. In this case it seems likely that something about the pre-natal time period is increasing the risk of autism. However, it seems like a good idea to point out once again that correlation is not causation (for a related thread see my discussion of baby sleep and the problem of spurious correlation). The fact that the incidence of autism increases with a shorter interval between pregnancies does not mean a shorter IPI causes autism. However, this research does raise all sorts of questions that could lead us to new knowledge about autism.

As someone who has worked with both children and adults with autism I have always felt that autism was a very complex diagnosis that is probably a result of genetic, environmental, and social processes. Unlike something like Downs' Syndrome I doubt that autism will ever be linked to a discrete gene or chromosome. Although I am happy to see research exploring possible causes or contributing factors to autism, I am wary that research which points to maternal factors as a cause may lead us down the path of blaming parents. In the early 20th century "bad mothers" were commonly seen as causing mental retardation among children (see Trent's book "Inventing the Feeble Mind" 1994), and I would hate to see us return to that type of logic even obliquely.

Baby safety - the safest way to install a car seat: get a professional to do it for you!

When you are nine months pregnant and exhausted and trying to plow through your to-do list of things to take care of before your baby is born one of the most daunting tasks is installing a car seat. My recommendation would be to take the easiest and safest route: get a safety professional to install it for you.

Safe Kids coordinates nation-wide car-seat inspections. And by "inspection" they really mean "we will look at your pitiful attempt to install the car seat, point out 99 mistakes that you made, and then install it correctly for you."

Here is their link for locating a car seat inspection: Safe Kids Car-Seat Check-Up Locator

The San Diego Safe Kids program is run through Children's Hospital and you can call 858-576-1700 ext 5096 to set up a car seat inspection.

The staff were super friendly and helpful. The whole appointment only took 30 minutes. The staff understand that with the wide variety of cars and car seats on the market it is nearly impossible to figure out what the safest way to install a car seat is with only the little booklet the car seat manufacturer gives you and your car's manual.

Some helpful hints I learned from our car seat inspections:

1. the center seat is always the safest place for a car seat (in the event of a crash)
2. sometimes using the seat-belt to secure the car-seat is safer and more secure than using the LATCH system
3. if you have an SUV or station wagon with an open trunk then putting a cover over the trunk will prevent anything stored back there from potentially flying up in the air and hitting your child (really important for rear-facing babies/toddlers in the event of an accident)
4. Even though manufacturers give you height and weight guidelines for when you can turn a rear-facing convertible car-seat to front facing it is safest to keep the kid rear-facing for as long as they fit comfortably in that position (some background on this issue)
5. how to use receiving blankets to make sure a newborn fits snugly into the car seat

My understanding is that in most towns police stations or fire stations and sometimes hospitals also will inspect car seats. I think this is a great service. However, since the professionals at the Safe Kids site I went to explained that they are the ones who actually train the police/firefighters on how to do the installation I like the idea of getting my advice straight from the horse's mouth - so to speak.

Not just for infant car seats! When we switched from an infant car seat to a convertible car-seat we went back to the same inspection station and again really appreciated with how helpful they were in teaching us how to install and use the car seat.

Bare feet and strangers

My son does not like socks or shoes on his feet. He will often tear the first sock off by the time I have finished putting the second sock on his other foot. We go on lots of walks with him in the stroller, and although winter in southern California is not really cold, it is cold enough that I have had a lot of strangers tell me my son's feet must be cold with a disapproving glare.

sockless, shoeless, and happily playing with his feet

So I figure there are a few ways I can handle this...

1. put duct tape around his feet for warmth
2. shop for lace up baby boots that I could then double knot
3. keep him in pajamas all day since they have little attached feet
4. not go out in public

Anyone have any better ideas?

Currently what I try to do is put on the socks and shoes and quickly cover him with a blanket and tuck the blanket in so that he has a tough time grabbing at his feet. Also I give him something to hold so that he plays with that instead of his socks/shoes. Both of these tactics usually work for about two minutes until he gets bored and flings off the blanket/toy/bottle and reaches for his feet.

All I can say is it's a big relief that I don't live somewhere really cold!

The Cardinal Rule of Family Photography

So the holiday season and the gobs of photos of my son I have taken over the last week made me think of some of the problems posed by combining babies and photography.

Sadly in the process of trying to document my baby's first year of life I have discovered a very sad fact. I will call it the cardinal rule of family photography.

The Cardinal Rule of Family Photography:
The more members of the family the lower the likelihood that all family members will look sane or normal or attractive in a photo.

Before I had my baby I looked passable in about 1/10 photos taken in which I was the only subject. According to me theory in order to calculate the likelihood that everyone in your family will look decent in your photo you must multiply the denominator by # of people in the photo. So for photos of myself and my son there is a 1/20 chance that we will both look good. For photos of myself, my husband, and my son there is only a 1/30 chance that we will all look good. I don't know how people with big families ever even get everyone facing the same way, much less looking halfway attractive. My solution: stick to photos in which my baby is the only subject (this also helps alleviate guilt about not losing the post-pregnancy weight fast enough!)

I have been an avid photographer for years, and I love my Canon EOS 20D. For anyone looking to add an addiction to their lives, buying an SLR is a good place to start. For those looking to invest in a good digital camera dpreview.com has great reviews to help you select a good SLR. At some point I want to invest in a new SLR. Do any readers have suggestions of cameras they love?

Sick kids at day care=healthy kids at elementary school

I am hoping that recent research which found that kids in day care get sick more often early in life, but get sick less often once they reach elementary school is going to hold true in the case of my son.

This is one of those scientific findings which sounds like pure and simple common sense. The more viruses they get exposed to earlier in life I would think they would build up better immunity. I guess it is nice to see some evidence to support this common belief. See the abstract and description of the research here.

Baby safety: finally CPSC issues a ban on drop-side cribs

The one thing that all new parents are ultra paranoid about is that something somewhere somehow is going to hurt their baby. This week the Consumer Product Safety Commission banned the sale of "drop-side" cribs. The kind that allow you to move part of the crib rail down to make it easier to pick up or put down your baby. I think this ban is long overdue. Deaths from suffocation and entrapment due to the malfunction of these cribs have been reported for a long time.

CPSC image showing potential danger

Before we had our son we looked up recommendations about baby products online on Consumer Reports, and quickly found out that these drop-side cribs were considered dangerous. However, not everyone has the resources or time to thoroughly research what products they choose.

This ban on drop-side cribs leads me to the one nugget of baby safety advice that I would give new parents...
Nine times out of ten the more convenient something is for you the less safe it is for your baby.

Yes, it is a pain to have to lean over the crib railing to put your baby into his crib, and it is even more of a pain when they weigh 20 pounds. Yes, it is a pain to have to be fastidious about making sure the seat-belt in the car seat is tightened down every time you put your baby in the car. Yes, it is a hassle to put your baby in a pack n'play or crib before you run to the bathroom when odds are they will not hurt themselves in the 30 seconds you are out of sight. But do you really want to take the risk?

Another recall of Graco strollers this year was related to a strangulation hazard. I was really surprised until I read the recall notice and realized that the infants who were strangled were not buckled into the stroller so they slid down and got stuck. Back to the safety rule - more convenient for you not to have to buckle the child in the stroller, more dangerous for the child.

Crib bumpers: another safety hazard
Another safety notice regarding crib bumpers explain how these (and any other bedding, pillows, or stuffed animals in cribs can be a hazard). As far as I can tell these products are purely decorative, although they are supposedly helpful in preventing babies from getting their arms or legs stuck through the crib bars. With my son we used a breathable crib bumper, I am not sure it made a difference. Of course with him by the time he slept in his crib he could easily roll over and lift up his head. Even with the breathable bumper he still occasionally got an arm or leg stuck through the crib railing. However, I would much rather have this happen than have him somehow suffocate on fabric!

What do people think? I am sure some libertarian-minded people out there might say that parents should have the right to use whatever products they want with their child, even if they might pose a safety risk. Of course most babies who sleep in these drop-side cribs never get stuck, but I personally could not handle living with the fear that it might happen!

One Year down! Thanks to my mommy friends

Well my son turned one year old last week. Bye-bye baby, hello little toddler boy!

I could never have made it through this year without all the love, support, and advice I received from my friends who are also mommies (and some who are not yet mommies). So I thought I would write a blog post about how important it is as a new parent to have friends who are also parents and can understand what you are going through and provide support and advice.

Thank you to all the experienced moms (and dads) out there who take the time to help us newbies!
Thanks for your wisdom, sympathy, product reviews, long conversations, hand-me-downs, diaper changes, humor, home-cooked meals, and general camaraderie.

As one of my best friends (who is also my mommy-mentor) said to me and my husband right after my son was born "Welcome to the we don't know what the hell we are doing club". She was right, life has been wild since he was born, but it has been so much fun.

A big thank you to my mommy-mentor (she knows who she is) who has been there throughout my whole pregnancy, and the whole first year. She lets me vent to her about everything baby related and has been the source of most of the really useful advice I have received. She was the perfect person to vent to about colicky baby stress since she survived it herself! Thanks again for telling me to do the Ferber sleep training!!! Everybody with a new baby should be so lucky as to have a mommy-mentor-friend like you :)

Of course some people who are not yet or never will be parents are still the most helpful and supportive when you are in your sleep-deprived, clueless, new-parent stupor. One friend in particular brought us lots of yummy meals so that we did not have to cook much in the week after our son was born (and even when he was older and we were perfectly capable of cooking). She is going to be a mommy this spring and hopefully I can return the favor!

Thank you to everyone who helps new parents you make a huge difference!

Baby sleep and the problem of spurious correlation

So if you have a newborn or even an older baby who does not sleep well you should mentally prepare yourself for an avalanche of advice from well meaning people who are only going to frustrate you.

They will tell you: All you need to do to get that baby to sleep is X.

 "X" is going to vary depending on who the person is you are talking to. But X is almost always something you have tried 100 times with no success, and it tends to be things like:

1. swaddling
2. rocking/walking to sleep
3. white noise
4. night light
5. co-sleeping
6. feed baby more before bedtime (the older generation will tell you to put rice cereal in the bottle)
7. pacifier/no pacifier
8. letting baby fall asleep on your stomach

These people could be anyone: your mother-in-law, best friend, distant cousin, neighbor, check-out lady at the grocery store, etc. When I was looking for a day care provider for my son one woman I met listened to me talking about how he has trouble falling to sleep and then after a dramatic pause she told me that the secret to getting babies to sleep was putting the radio on to play static and that this worked like a charm for all four of her children. The best part was the way she revealed this secret to me as though it was the holy grail. Needless to say I was not super impressed by her and found a much better day care provider somewhere else.

In order to respond to these people in your sleep deprived state of constant frustration you might want to practice nodding your head and saying "Oh really? Thanks so much for the good advice. I will definitely try that." If you are a truly sarcastic person then you can even add, "Wow, I've never heard of that idea before! I'm so glad I talked to you!"

Warning: this post represents my personal opinion and I should re-state what I believe is the cardinal rule of babies: Every baby is different. That said maybe some babies do transform from bad sleepers to good sleepers after doing something simple like swaddling them. I think it is always worth trying new things and taking advice from more experienced parents, but if following their advice is not working, then keep reading this post.

Here is the problem, all these people are assuming that the reason their babies slept like little angels is because of X (their intervention of choice). In my not so professional opinion babies sleep well for one of three reasons:

1. disposition - in other words you got lucky and gave birth to a baby who is a better sleeper and is better at "self soothing" from the get go
2. age - all babies gradually get better at sleeping as they age and learn the difference between night and day and eventually learn how to soothe themselves to sleep 
3. training/learning - some babies can become better sleepers earlier and faster if you do some consistent sleep training (although this should never be done during the newborn period)

If you have a newborn (0-3 months) the reason they are sleeping well is probably neither age nor training because they are too young for these to be causes. The reason they are sleeping well is that you baby was destined to be a better sleeper. Not sure what other mamas experienced, but I should have known from the first night with my son in the hospital that we were in for a very bumpy road as far as sleeping was concerned.

So why do all these well-intentioned people honestly believe that X is the secret to success? 

In statistics this phenomenon is called spurious correlation. The idea is that everything has a cause and effect, but sometimes we erroneously think the cause is B, when in fact it is actually A.

Example:
We notice that when people eat a lot of ice-cream (B) there seems to be a lot of riots/street violence (C) and we assume an increase in the eating of ice cream causes an increase in riots.  (example courtesy of Professor David Phillips)

What is really happening? There is a third variable that we are failing to consider: summer time. When it is hot people eat more ice cream. When it is hot and students are out of school and the days are longer people are more likely to riot.

So we think B causes C (ice cream causes riots), but in reality A causes B and A causes C (summer time causes an increase in both ice cream consumption and riots).

Okay seems like a sort of silly example and the cynical reader will be thinking that anyone with a brain knows that ice cream does not cause riots. Correct, cynical reader. So lets give one more quick example.

It is commonly assumed that exercise (B) causes people to be healthier (C). Is this true? Maybe not. There is a third variable (A) health. Confused yet? Health can be both a cause and effect. It works like this. If you are healthier to begin with, then you are more likely to have the time and energy for exercise. So being healthier causes you to exercise more. Being healthy early in your life causes your to be healthy later in your life. Real life is full of confusing and messy examples of spurious correlation and knowing about this phenomenon might make you think differently about the world. For example is it intelligence and hard work that leads people to succeed in life? This is the meritocracy argument. Or could there be other factors that lead people to succeed (i.e. socioeconomic status, education, cultural background, circumstances). For an interesting and easy to read analysis of this issue read Malcolm Gladwell's Outliers.

So let's get back to baby sleep. Your mother-in-law/friend/cousin tells you that swaddling (B) causes her baby to sleep like an angel (C). So there is some correlation between swaddling and sleeping happily. I am arguing that in most cases it is the babies disposition (A) that is causing them to sleep like an angel (C).

At my son's 2 month doctor appointment when our doctor was explaining to us how our son fit the typical description of "colic" he told us about the latest theory of what causes colic. Colic basically occurs when a baby's brain has not developed enough to "self soothe". In other words babies are not born knowing how to calm themselves down. Just like adults babies wake up many times during the night. However as adults we do not even realize that we wake up and we generally just slip back into a deeper sleep. Most newborns will cry and rely on parents to help them get back to sleep. Like adults, babies fall on a spectrum and some are just born with less of the type of brain development that allows them to soothe themselves back to sleep once they wake up. One reason I am convinced that this theory makes sense is the fact that colicky babies seem to need the same high level of parental intervention during the day and non-sleeping hours (as opposed to what my good friend calls "plop down babies").

We may never understand exactly why some babies adjust to sleeping better or earlier than others but if you understand the logic of spurious correlation at the very least you should now know not to blame yourself if your baby is having trouble sleeping. Those mamas with the happily sleeping babies are not better parents than you. It may even be the case that some of those parents will come to you for advice when they have their second or third child and suddenly they are doing all the same things they did with the first kid, but this baby won't sleep. So when they come to you for advice and they are totally miserable from sleep deprivation you have two choices. You can tell them "All you need to do is X and your baby will sleep like an angel", or you can tell them the truth. I know what I would do :)

Ways to save $: Baby resale/consignment shops

Baby "suit" from a resale

Baby resale shops are a great way to save $ on baby clothes and other nursery items. Everything these stores sell is totally clean and sometimes it is even new and still has tags on it. I have bought clothes, bibs, pack n play sheets, and toys, at these shops and found some great deals.

For example, I found a baby "suit" from Nordstrom with the tags still on that was originally $100 and I bought it for $15. My son wore it to a friend's wedding and looked adorable.

My son wearing his penguin shirt - another resale shop find.

San Diego area stores:
Only Kidding

3619 Midway Drive #E, San Diego, CA   92110

great little store in a great location

BabyGoRound Resale
10330 Friars Rd., San Diego, CA 92120 
smaller store but good selection of clothes

Baby Trader
5282 Baltimore Dr., La Mesa, CA 91942
bigger store and lots of accessories, toys, gear



Forget Me Not
5005 Cass St., San Diego, CA 92109
have not been here yet? have any readers?

If you are shopping for bigger baby gear items (strollers, swings, high chairs) I would skip baby consignment shops, most people sell bigger items on Craigslist these days.

Why babies are like cats

Has anyone else noticed that babies are a lot like house cats?
Here are some similarities I have observed. Both my baby and my cat...

1. love playing with paper and magazines
2. love plastic bags
3. love cardboard boxes
4. sometimes give love bites
5. are fascinated by computer keyboards
6. cry/meow
7. love to sleep on mama
8. wake you up in the wee hours of the morning
9. want love on their terms: when you want to hold them they don't want to be held and when you are incredibly busy they decide they want to be on your lap
10. sleep a lot :)

Has anybody noticed any other similarities? I am currently dogless, but would be interested to hear if dog owners notice that their babies remind them of their dogs and vice versa...