2019-09-20

Why My Toddler And I Participated In Today's Climate Strike

Today I took our toddler out of daycare (with his mom's permission!) and participated in the Climate Strike in downtown Chapel Hill.


It was a youth-organized, peaceful protest against climate inaction, featuring student and faculty speakers. The gathering started at Peace and Justice Plaza, where there was music, chanting, and some speakers. We then processed through campus to the Old Well, where there were more speakers and more calls to action.

Many journalists were there as well and I was impressed that they all asked my permission before taking my picture because I had a toddler there with me. One of them asked me why I was there and I gave her a pithy response. Here is a slightly more thoughtful summary of my reasoning:

Too long have our politicians, our businesses, and we as consumers been addicted to an energy system that is fundamentally unsustainable. Our elected leaders are either ignorant or bought and paid for by those telling them to look the other way. Our businesses are myopically driven by quarterly numbers that are rewarded by maintaining the status quo and externalizing long-term costs. We as consumers demand cheap, abundant energy to support our immediate quality of life without regard for long-term impacts. It is easy to point fingers but we are all complicit in this destructive energy chain.

To be clear, I'm not demonizing energy. Energy has been transformative in elevating - and continuing to elevate - billions of people around the world to higher standards of living and quality of life. As Nobel laureate Dick Smalley said, if we can solve energy, we solve the other major challenges facing humanity essentially for free. We have not yet solved energy, though, and the repercussions of our toxic energy chain are already being felt: the Earth is warming, ecosystems are dying, and extreme weather events are becoming more severe and numerous (As I write this, Houston just experienced its second 1,000-year rainfall event in . . . checks notes . . . two years.).

I am also not demonizing capitalism. Capitalism is the mechanism that used energy to improve so many lives and I believe in it as a strong force for good. It isn't perfect, however, and it can run society off the cliff if it receives the wrong price signals as inputs: garbage in => garbage out, as they say. A role of regulators and policy makers is to ensure that our free market has accurate, comprehensive price signals and here we have so far failed. We allow dirty energy to be produced, distributed, and used artificially cheaply (subsidized, even!) by not capturing the cost of cleaning up the mess left behind. In essence we have been mortgaging those costs forward to future generations but the bill (which has been accruing lots of interest in the meantime!) has come due.

Maintaining the status quo is a path to economic and social catastrophe the likes of which we haven't seen . . . ever? We the people elect the political leaders and we the people buy the products that keep the businesses profitable so change must start with us. It is imperative that we demand action with our votes, with our dollars, and - on days like today - with our voices.

I'm actually very optimistic that we will solve energy. Humanity is incredibly effective when we unite around common cause, whether it is putting a person on the moon or defeating the Nazis. We have many of the solutions we need to combat climate change already and I know we can develop the rest. In fact, I believe solving energy will be the greatest economic opportunity we have ever created! It won't happen by itself, though, and time is running out; we need action now.

As many of you know, I have devoted my career to helping solve energy. It was the thesis of my first ever blog post and it is what I spend my day doing at Smart OES. So why strike? Shouldn't I be back at the office working hard on solving energy? Well, I think it's important to let others know that they are not alone in demanding this sort of change. Moreover, I wanted to demonstrate critical mass to politicians and business leaders who may be watching.

Most of all, though, I have been really inspired by this group of young climate activists. Older generations are failing them on climate change and, rather than just giving up, they are taking matters into their own hands. People claim that younger generations are lazy and entitled but what I witnessed today was the opposite; they are motivated, hard working, and effective - so I especially wanted to come out today to support them.

But why bring my toddler? After all, at 16 months old, he isn't going to remember it. That's true, but this is the most significant issue that will affect his life and I want to show him that his parents do care and are dedicated to creating a better life for him. I don't know if we will have righted the ship by the time he is an adult. I'm nearly the age now that I was when my dad died so frankly, I don't know when I will leave him or whether I will leave him anything more than a broken planet. One thing I can leave him, though, is a sense of empowerment and a feeling of duty to stand up and fight for what is right. One day when he is old enough to remember, he will look at old pictures and see himself exercising his civil rights to peaceful protest. As he builds the narrative of his life, one of his early chapters will include publicly, demonstrably doing what's right and that is why I brought him today.

As someone who has always been moved by Les Misérables, which is centered on a small group of young activists protesting against an unjust establishment, I feel like I've been training my entire life for this Climate Strike. I'm not sure exactly what it will accomplish but the experience was moving. The power of human voices and collective action is real.

Do you hear the people sing?
Singing the song of angry men?
It is the music of the people
Who will not be slaves again!
When the beating of your heart
Echoes the beating of the drums
There is a life about to start
When tomorrow comes!

2019-07-26

My Entrepreneurship Principles: Leadership

In my first piece on Mindful Entrepreneurship, I laid out several principles to optimize the entrepreneurial process.  In my second piece, I argued that culture is extremely important to startups. In this final (?) piece I will now examine how leadership can create an optimal startup culture and execute the entrepreneurial process.


Entrepreneurial Leadership
  • Culture starts at the top; in a startup, all eyes are on the founders and the management team. Mission statements, declarations of values, and pronouncements of "our culture" have little effect on a venture's actual culture, which is determined much more by the actions of its leaders. If a company claims to have a culture of psychological safety but everyone sees a software engineer getting reamed out by the CTO for not doing things his way, then that culture is not actually safe. It is crucial that that startup leaders walk their own talk; however they act, that will be the culture.
  • Bring the right people onto the team. Startup hiring can definitely be a challenge; finding people who are not only good but will also succeed in a less stable context isn't easy and many of the hiring best practices used by larger organizations fail at a startup. The best advice I can offer here is to seek out candidates who exhibit both humility and curiosity. These attributes are a perfect storm for contributors who thrive in the highly uncertain, rapid learning environment of a startup.
  • Hire for diversity. Recall the effectuation principles from my first post: I was brought into a rapidly scaling startup to talk about how to apply those principles to leadership. One key take away is to prioritize the additional means that new hires bring to the team. Hiring for a very specific skillset is folly at a startup, where everyone wears multiple hats and what you think you need changes on a daily basis. Rather than evaluating candidates purely based on some pre-fab job description, give weight to all the additional skills, experiences, and perspectives they bring to the table.
  • Encourage divergent thinking. Instead of asking your employees, "What is the right answer," ask, "What is possible?" Follow up with, "What else is possible?"
  • Ask questions. Rather than barking orders, ask employees how they think problems should be solved. This serves the dual purpose of empowering employees with agency while also reinforcing a culture of skepticism. "Why?" "Why not?" "Is that a fact or a hypothesis?"
  • Foster collaboration. It can be tempting in a startup to divide and conquer as much work as possible. Remembering that groups make better decisions in the face of uncertainty than do individuals, though, it is beneficial to reduce employees working in isolation as much as is practical. Use techniques like pair programming, team huddles, and strike forces to increase collisions among team members.
  • Push employees out of the building. It is also important to increase collisions between team members and the outside world. Bring internal staff along on client visits. Provide incentives for employees to give talks (tech or otherwise) in the appropriate domains of the community. The more your team interacts with the outside world, the higher your venture's chances of benefiting from serendipity.
  • Maintain a constant feedback loop. It is hard for startup employees to take big swings if they aren't standing on solid ground. Use 360 feedback to ensure that employees always know where they stand, how they are perceived, and how they can improve.
  • Put the fish on the table. Feedback need not be limited to anonymous tools and it is important that it be provided - sensitively - in person. We use the term "fish on the table" to motivate team members to share open, honest feedback with each other. If there is a rotting fish kept under the table, it will start to stink. If it is brought up above the table, however, it can be dealt with. When a team member asks to put a fish on the table, others listen and try to accept the feedback openly because they know it is for the good of the team.
  • Be a secure base. As babies learning to walk, we know that, if we fall, Mommy or Daddy or another care giver will be there to pick us up. We develop the confidence to take risks through reliance on these secure bases. This circuitry persists through adulthood such that, if you want your employees to take risks, you need to be a secure base for them. Let them know frequently that you will still love and value them even if they fail - show them rather than just telling them. A major role of being a startup CEO is also being the CPO - Chief Psychology Officer! Joining a startup is scary; being a secure base to your employees emboldens them to be fearless.
  • Create meaning for your team. Working at a startup can be daunting. The work can be hard, the hours can be long, the pay and benefits can be below market . . . remind your employees of the purpose of their work. Mission and meaning are like secret weapons for startups; they make up for many other shortcomings so you can't let anyone forget about them. At my startups, we have very visible indicators of our progress toward meaningful metrics and periodically bring in speakers who have been impacted by our mission.
  • Keep your integrity. Startups are hard and there is temptation to cheat in some ways even just to keep your venture afloat. At the end of the day, though, the only think you will take with you from one startup to the next is your integrity. If you fail, people will forgive you as long as you were honest. (I know an entrepreneur who lost all of an investor's money but did so honestly and transparently; that same investor then backed the entrepreneur's next venture as well.) If you are dishonest, however, your reputation will be trashed forever. 
  • Never stop learning. Leadership is like other skills: it can be practiced. It can be improved. It can be developed. Just as a startup organization should never stop learning, neither should its leaders.

2019-07-17

Rocky Mountain High Colorado

Katie had a conference at Copper Mountain in Colorado so our toddler and I tagged along. Copper Mountain is where I learned to ski when I was four years old so it was a fun "homecoming" of sorts for me.


We arrived in Denver Friday morning and spent the day in Boulder, where I had meetings with some startups that I advise - it was great to see them in person rather than over Skype for once!

Friday evening we drove up to Copper Mountain, where we had a spacious condo all to ourselves. I didn't sleep well Friday night due to the sudden change in altitude (~3,000 m / ~10,000 ft) but I was greeted the next day by gorgeous views regardless.

While Katie participated in her conference Saturday, our toddler and I explored the village and hiked around a bit. Copper Mountain is clearly primarily a Winter ski destination - many shops and restaurants were closed for the offseason - but I thought it was just wonderful during the Summer. The cool temperatures were a refreshing change from the heat and humidity of North Carolina and they did a great job of creating activities more appropriate for the season. Saturday all day was a three-peak cycling race called the Triple Bypass and Saturday evening there was live music in the village center.

Sunday, after an early morning hike, we made our way back to Denver, stopping at Red Rocks for lunch with the same family that taught me to ski 36 years ago. It was lovely to see them again and fun to introduce them to the next generation! The stunning red rocks reminded me that Colorado isn't just alpine but actually features a great deal of landscape and architecture more reminiscent of the American Southwest.

Monday morning we hopped on our flight back to North Carolina. This was a very quick trip but it reminded me how much I enjoy Colorado. It seems to be about the closest thing I can find to Switzerland here in the US - but with more direct flights. We may try to visit more often - and especially during the Summer, when we are seeking refuge from the heat and humidity!

2019-07-03

Is Vinyl Better Than Modern Media?

A friend recently asked what was going on with the recent popularity of vinyl records. Is vinyl "better" than more modern music media? Or is it just a hipster fad with no base? I am far from an expert but, as I have a fair bit of experience with vinyl (~100 LPs and a jukebox full of 45 singles), I weighed in with the following take.



Vinyl can be "better" (a very loaded - and subjective - term!) than newer formats for older music:


  1. When a song was originally recorded, mastered, and stamped out to vinyl, that was how it was "supposed" to sound (barring disagreements between the artists and the production/engineering staff, disagreements within the band, limitations of production technology of the time, etc.).
  2. When the music is transferred to digital formats, some sound quality loss necessarily occurs. Digitization samples the original audio many times per second to create the new, digital signal. If it samples more frequently, the audio is higher quality; if it samples less frequently, the audio is lower quality. Practically speaking, the human ear probably can't tell the difference but hardcore audiophiles care about it.
  3. During early digitization, ie to CDs, many filters were used during the digital transfer process to remove pops and other imperfections that are often found on vinyl (and that vinylheads find endearing - a feature, not a bug!). Those filters, though, often filter out more than the imperfections and the music loses some of its top end and/or bottom end sound.
  4. During digitization, "remastering" sometimes happens as well; someone remixes the tracks, plays with the volumes, applies filters, etc. to make the the music sound "better" in the new, digital medium. Occasionally this works out well, like the 50th anniversary re-release Sgt Pepper's Lonely Hearts Club Band (performed painstakingly by the original engineer and his son!), occasionally it is disastrous, and usually it is a mixed result. Regardless, it changes the music from the original standard.
  5. For most digital file formats, e.g. mp3, after digitization of the original analog music, there is also compression to save space; the compression further distorts the music. This is probably imperceptible to those who aren't looking for it but, again, hardcore audiophiles care about it.
  6. For streaming media, digital files are further compressed and altered, especially when bandwidth is low, further reducing the quality of the audio.

So what does this all mean? Firstly, vinyl pressings of modern music that has been digitally recorded offer no real benefit other than a cool physical medium. For older music, recorded on analog tape, there are indeed differences between its vinyl format and its conversion to more modern media.

Whether the vinyl is "better" depends on a number of factors and is highly individualistic. Not all digitization efforts are equal and neither are the preferences of the listener. Whether vinyl is right for you really comes down to personal taste.

2019-03-06

My First Track Meet

Last weekend I competed at the USATF Masters Indoor Track and Field Championships. I took home a couple of medals but mostly it was an exercise in humility! It was great fun, I made some excellent friends, and I left feeling incredibly invigorated.


My journey to the nationals began last Summer. As I have blogged about before, I participate in the annual summer track meets hosted by Carolina Godiva Track Club. These are informal events with participants ranging from 8 to 80 years in age. I have never trained for them and have mostly viewed them as a fun, social way to get in some speed work for my distance running.

Last year, though, my world was rocked at one of these events when a 60-year-old woman named Becky lined up next to me in the 100m dash and ran neck and neck with me the entire way - wow, I was impressed! It turns out that she was the US national 100m champion in the women's 60-64 age division. Between her, Louise (78 years old), and William (77) - all of whom came out to some of the summer track meets - I was thoroughly inspired.

Although I have never run track competitively, I spent the first half of my life as a sprinter of sorts on the football field. I carry around a lot of muscle that does me no good in long distance but helps me generate power in a sprint. Whether for these reasons or for the reason that I've just been getting kind of bored training for the same 5-10k distance races for the last 15 years, the inspiration I felt from Becky, Louise, and William motivated me to make a change. In August of last year, I shifted gears and began training as a sprinter.

Another friend from summer track nights, Cindy, took me under her wing and helped me get started. As a world class track and field athlete, she helped me ramp up quickly in this new world. Her husband, Dante (an Olympic-caliber 400m runner himself), helped and supported too. It was hard to make consistent improvement throughout the Fall, though, as I was traveling a great deal and getting sick every other week as our son brought home various bugs from the petri dish that is daycare.

I ran two "test" track meets, one in October and one in January. The results weren't great and, due to my inconsistent training, I wasn't showing much progress. I recognized several friends at the January meet, though, and they encouraged me to join the Piedmont Pacers, a local track club that competes together as a team at these types of events.

Joining the Pacers really marked a turning point in my training. At least once a week I began joining a team practice with other Pacers. Louise, who turned out to be a Pacer, brought along her teammate, Angela. Rick, a very fast sprinter and middle distance runner about my age - brought along his awesome wife, Ryan. Even Becky, who isn't a Pacer and lives hours away, would come join us when she would happen to be in town. Anyone who knows me at all, knows that I am 110% extrovert so turning training into a team event really supercharged my workouts.

When March rolled around, it was time to see if the training had been paying off. To be clear, my times indicated that I wouldn't be terribly competitive. I was still new to track, still trying to remind my muscles how to fast-twitch, and, to boot, I would be the oldest competitor in the 35-39 age division - just three weeks shy of moving up to 40-44! However, I thought it would be good experience for me and I hoped to help the Pacers earn at least a few points, so I left my pride at the door and headed to Winston-Salem for three days of intense competition.

Day 1

400m
On the first day of competition, I only had one event: the 400m. In January I had run a 1:08, which is substantially slower than my outdoor 400m times from the Summer. Because indoor tracks are shorter, requiring more time in tighter turns, I expect my times to be a little slower but I was hoping to bring my time down at least to 1:06. An even-ish race plan was to run a 32s split for the first lap and 34s for the second lap.

Well, best laid plans! I went out way too fast, probably pulled along by my much-faster-than-I-am competitors. When I saw the clock at 30s as I finished my first lap (barely slower than my 200m PR), I knew I was in for a world of pain in the second. The rest of that race seemed interminable - all the more so because I was basically running by myself at that point - but I finally crossed the finish line in 1:06.66.

It was an improvement but not quite what I had hoped for. I'll try to settle in and run my race next time. Dropping some excess weight will help too; I averaged 529W of power over the course of the race and that could propel a lighter version of myself much more quickly. Regardless, I have a long way to go; the winning time was 51.42!

Day 2

60m
I had three events to run the second day, starting with the 60m. The 60 is a pure, all-out sprint so I had no strategy other than run as fast as I could. The start really matters in the 60 since it is such a short race. I'm still pretty new to starting out of blocks but I was hoping my recent practice would pay off.

When the gun went off, my reaction time was good. I had violent arm swings and rapid step turnover. My top speed just isn't very good yet, though. My poor flexibility limits the range of each step and my competitors all pulled away as the race went on. I finished in 8.75, nearly two seconds slower than the winning 6.88. 8.75 was a new PR for me, so I'm pleased with the progress, but I have a lot of room for improvement. In addition to flexibility, I really need to work on explosive power for this race. I'm stepping out of my blocks rather than exploding out of them.

4x800m
After several hours of waiting around, my next event was the 4x800 with Matt (41 years old), Kevin (43), and Rick (38). A team's youngest member determines its age category so we were competing in the M35-39 division. 

Matt, who was battling a calf injury, started us off well with a 2:42 leg. I took the baton and ran a very uneven 2:47. My first lap was - surprise, surprise - way too fast so, after I passed two competitors, I settled down. I may have slowed down too much but it was hard to know my pace as I had taken the baton at an odd time and my brain was way too oxygen-deprived to do math! I averaged 432W on my leg.

Kevin did better, running 2:46 with disturbingly even splits. Seriously, he might be a robot! Rick, our fastest runner, started off hot, running a 32s first lap. We could see that the first place team was way ahead of us and we had a commanding lead over the third place team, so we called out to Rick to slow down and save his juice for the next race. He wound up running a 2:33, putting us at 10:48, which was good enough for the silver medal - huzzah!

4x200m
No sooner had we finished the 4x800 than we had to line up for the 4x200. Our 4x200 team had the same members and we ran in the same order so at least our exhausted minds didn't have to think much.

Matt ran a good 29s opening leg. He had to pass the baton to me in the outer lane on a curve, though, which was a bit of a challenge. I ran 30s (577W), as did Kevin after me, and then Rick brought home the anchor leg in 27s. Our final time was 1:56 but the competition was much stiffer in this race and we were only good enough for 4th. 

Day 3

200m
Having run the final heat of the final event of the day before, I was among the last competitors to leave the track. Naturally my first race the next day was early so . . . no rest for the weary!

Because my projected time was the slowest (by far!) in my heat, I was assigned to lane 1, meaning I had to run the tightest turns. When the gun went off, I had another powerful start, but I had to bend that power around a tight curve - and then another one at the other end of the track. I finished in 29.25 (633W), an indoor track PR for me, but far behind my competition. The same notes apply: I have a lot of work to do to increase my top speed.

4x400m
Our team reunited to run the final heat of the final event of the track meet: the 4x400.  We were tired and sore from days of competition but adrenaline pumped us up as we neared the starting line. The same teams who had beaten us soundly the day before were out there again but they were tired and sore too, so anything could happen.

Matt again started us off well, hobbling through a 1:06 opening leg, maneuvering us into 4th place. I grabbed the baton and all soreness seemed to leave my legs. It's hard to tell from the race video, but it looks like a ran a PR 1:04 (553W) for my leg.

It seems strange that I should be able to run seconds faster (and sustain higher power output) over 400m on the third day of competition vs the first. I definitely can't attribute the performance increase to a running start as we were being extra cautious with our handoffs to ensure that we didn't drop the baton. I have two hypotheses:
  1. I'm a team sports guy, not an individual sports guy. Put me out there with teammates depending on me and I will rise to the occasion.
  2. In the relays, other runners are spread more evenly around the track, motivating me to surge and pass them. Compare that to the individual events, during which the closest I ever was to the competition was when were at the starting line!
Regardless of the mechanism, I ran a good time (for me) and passed two competitors to put us in 2nd. Kevin ran a strong 1:13 and then Rick brought us home with a smoking 58s anchor leg. Final result: 4:21, good enough for another silver medal!

Final Thoughts

As I returned home, exhausted but exhilarated, I reflected on my first real track meet experience. Here are a few of my final take-aways:
  • It was fun - a lot of fun! I didn't expect that. There were long stretches between my races when I intended to sneak away to a cafe to get some work done but staying and cheering for my friends as they competed kept me at the track.
  • I loved being on a team; that made all the difference in the world, adding meaning to every race. The Pacers finished 7th in the team points competition and I was proud to have helped contribute 15 of those points through our relay performances. Being part of a team also gave me more people to cheer for throughout the meet.
  • I wonder how "valid" the results of the competition are. It's neat to receive a silver medal and claim that our team earned #2 in the nation but we were really only #2 of those present at the meet. How many faster teams might be out there who didn't have the time, money, or other wherewithal to travel across the country to compete? This point isn't very important to me since I'm really not in it for the medals, but it did make me wonder.
  •  What I will remember most about this meet is the friendliness and supportiveness of all of the competitors. Before each race, competitors shook hands and wished each other luck. Between races, I met and made fast friends with competitors from all over the country and with very diverse backgrounds. Kudos to the USATF and JDL Fast Track for cultivating such a culture of positive sportsmanship - that is, after all, what sports are all about!

2019-01-27

Parenting Recommendations 3: Parenting Books

My final post on parenting for the moment: here's a list of postpartum parenting books I've read so far, again sorted by my rating, descending.

The Science of Mom (another evidence-based book for the first year postpartum) is the only top ranked of these for which I have notes:

  • Good review of scientific method, publication
  • Delayed cord clamping 2 min
    • More blood, iron 88% higher iron at 6 months of age and low iron leads to lower test scores this is especially important for breastfed babies because breast milk does not contain much iron
  • Vitamin k shot
    • Get it
    • Initial link to cancer disproven by subsequent research
  • Eye profilaxis
    • Consider delaying until after initial bonding up to one hour
    • babies don't see as well with it so it may inhibit initial bonding
    • could affect microbiome
  • Breastfeeding
    • Benefits primarily during infancy (eg immunoprotecton)
    • possible long term benefits on cognitive development
    • introduce solids 4-6 months (but let baby lead), continuing breastfeeding
    • start with low allergenic foods and gradually introduce foods with greater allergenic potential one at a time
    • avoid cow's milk until one year bc it can lead to iron deficiency
    • Meat good for heme iron but limit liver to a few servings per week to avoid too much vitamin A
    • Egg yolks good for iron and DHA
  • Sleeping
    • Safest place is in the same room but in separate bassinet
    • Expose to natural light during day (even when napping) for first three months to establish circadian rythyms
    • prepare baby for sleep before they become overly tired
    • institute pre-sleep routines
    • self soothing babies are put to bed while awake, not soothed to sleep because falling asleep is a learned skill
    • wait a couple minutes to respond at night; confirm that crying is distress, not baby noises
    • babies use sleep aids; make sure you aren't it
    • use a sleep aid when you're all together to lay the foundation for making the transition to more independent sleep easier
  • Feeding Solids
    • Whole grains have more phytates, which could reduce iron absorption, than refined grains. Soaking grains reduces their phytates.
    • Fruit instead of juice. If juice, dilute it with water and serve in a cup, not a bottle.

Parenting Recommendations 2: Prenatal Books

Each time we became pregnant, I was both elated and scared as it reminded me that I don't know anything about babies! My way of dealing with that anxiety was to read everything I could get my hands on. And since we were cumulatively pregnant much longer than nine months, I managed to read a lot! Some of the books were great, most were OK, and some were downright terrible.

Here are the prenatal books I read sorted by [my] rating, descending. And for the top books, here are my notes, because you may have other things to do than reading all the time! Caveat: these notes are not necessarily complete or good; they reflect what I took out of each book at the time.

Expecting Better (evidence-based analysis of "conventional" prenatal "wisdom"):

  • obese women (before pregnancy) have more pregnancy complications
  • up to 2-3 drinks / week first Tri
  • up to 7 drinks / week rest of term
  • avoid raw milk / raw milk cheeses / queso fresco
  • avoid undercooked meat and deli turkey
  • raw egg fine
  • seek high omega-3 / low mercury fish, e.g. salmon, sardines
  •  6 vomits average per pregnancy
  •  vitamin b6, ginger for nausea
  •  CVS and amniocentesis both safe, but CVS better/earlier
  •  Avoid raising body temperature to 101+ during first trimester
  •  Hair dye is probably fine
  •  Avoid gardening or at least wash hands thoroughly
  •  Gain 25-35 lbs during pregnancy but err on the high side
  •  Regular exercise good but don't go above 90% HR
  •  Kegels good and reduce labor time
  •  Yoga probably good
  •  Sleeping on back probably fine unless you feel faint
  •  Medication - check safefetus.com and stick to A and B class drugs
  •  Bed rest not effective for reducing pre term labor
  •  Cervical effacement in addition to dilation a good indicator of labor readiness
  •  Intermittent fetal monitoring better than continuous during labor
  •  For labor augmentation, break water first then try drugs
  •  Just say no to episiotomy - cutting the vagina
  •  Vitamin k shot after birth is OK
  •  Having a doula is good
  •  Epidural has pros and cons
  •  Drink fluids during labor (including calories like Gatorade)
  •  Induction problematic so make sure fluid levels are measured deepest pocket, while well hydrated, and consider a second test
  •  Clapping effective sugar ineffective for non stress test
  •  Nipple stimulation and membrane sweeping work for inducing labor
  •  Vaginal birth preferred


The Informed Parent (same, evidence-based approach but extending beyond prenatal to the first few years of childhood):

  • No evidence for benefit of eating placenta
  • Pediatricians: personal experience, beliefs, staying current on literature
    • use online questionnaire (including this book's website) to interview pediatricians
    • AAP (American Academy of Pediatricians)
  • Induction: reduces risk of cesarean birth in late-term pregnancies
  • Augmentation: combination of mechanical (e.g. forceps) and chemical
  • (e.g. oxytocin) may help modestly speed along slow labor but either individually not effective
  • Episiotomy not beneficial, often worse
  • Pain
    • Epidural works; combined spinal epidural (w/ local anesthetic) works faster
    • Epidural associated with more cesarean and intstrumented (e.g. forceps) births
    • Nitrous associated with dizziness, nausea/vomiting
    • Sedatives work but not as well as opioids
    • Immersion in water and relaxation/massage techniques may work
    • Acupuncture associated with fewer interventions and cesarean births
    • Water injection, aromatherapy, biofeedback - insufficient evidence that they work
  • Cesarean
    • slightly higher risk for mom
    • First stage labor: 0.5-0.7 cm dilation / hour (for first time moms - 0.5-1.3 cm/hour for experienced moms)
    • Second stage labor: outcomes good for 3 hours pushing (first time moms - 2 hours experienced moms); labor augmentation like forceps or vacuum => < 3% need cesarean
    • Fetal heart rate: stimulation of fetal scalp, mom position change, amnioinfusion (saline into uterus) may address HR irregularities
    • Induction does not increase risk of cesarean delivery
    • Breech Position: external cephalic version => only 21% need cesarean
    • Big Baby: < 11 lbs (or 9 lbs 14 oz w/ gestational diabetes) => evidence does not support automatic cesarean
  • Circumcision
    • Very few risks, most of which go away in modern medical procedures
    • Benefits reduce risk of penile cancer, reduce rate of STI contraction, reduce rate of UTI
  • Disposable diapers about even with cloth diapers for cradle-to-grave environmental impact - compostable disposables have an edge
  • Breastfeeding
    • Wide variety of better outcomes for children (dose-dependent: the more, the better)
    • Especially when fed at the breast (rather than pumped bottle) as breastmilk composition adapts to baby's nutritional needs
    • Exclusively breastfed babies need Vitamin K (shot) and sometimes iron and Vitamin D (supplement)
    • Premature/underweight babies benefit so much from breast feeding that donated milk is prescribed over formula
    • Up to 24 months of breastfeeding => benefits for the mom; after 24 months is understudied
    • Not all women can breastfeed (primary lactation failure - unable to produce milk at all - vs secondary - something interferes with breastfeeding early on)
    • Baby should breastfeed 8-12 times per 24 hours and should suck at least 10 min on each breast, feeling sleepy afterward
    • Baby should have 6 wet diapers / day and 4 yellow, seedy, cottage cheese-like stools / day
    • 44% of mothers don't get milk w/i 72 hours of birth
    • Nipple pain common in first week but may indicate a problem after that
      • Vasospasm: nipple turns white then blue as blood returns
      • Thrush: yeast infection causing red, sore nipples
      • Clogged ducts: tender lump
      • Mastitis: infection causing red, hot breasts with pea-sized lump
      • Expressed milk helps relieve nipple pain
    • Tongue tie in 3-11% of babies (mostly male) easily addressed with frenotomy (~100% success)
    • D-MER is a condition that causes negative feelings for mom during let-down but passes quickly
    • Low milk supply:
      • Relaxation can help a little
      • Metaclopramide increases prolactin levels for 1.5 oz more breastmilk per feeding but should only be used for 3 weeks
      • Fenugreek (~600mg) helped in a small, poorly documented study
      • Milk thistle helped in a very small study
      • Shatavari helped in a small study
      • Torbangun helped in a small study
    • Moderate caffeine and alcohol probably fine while breast feeding (no need to pump and dump) but we don't know much about marijuana
    • LACTMED is a database of mom medications and their effects on breastfed babies
    • Feed when baby is hungry; little/no evidence of benefits of feeding according to a schedule
  • Feeding
    • Teething usually 4-7 months
    • No evidence that adding complementary foods at 4 months vs 6 months is beneficial (except slightly higher iron levels)
    • One study shows better growth with meat as a complementary food vs cereal
    • Preschoolers told to clean their plates ask for more food even when away from home
    • Children for whom food is offered as a reward are more overweight
    • Screen time associated with weight in children most likely due to mindless eating and advertising of unhealthy foods
    • Inadequate sleep associated with childhood obesity
    • Children who regularly drink sugary drinks are heavier and more likely obese
    • Family meals reduce risk of obesity
    • Portion size and plate size can reduce overeating
    • CAN framework: make healthy food Convenient, Attractive, and Normal
    • Vitamin D deficiency possible if exclusively breastfed - especially if Mom has it
    • Cow's milk promotes vitamin D but inhibits iron; two cups a day seems to be a good balance
    • To address child's resistance to new foods, eat variety of foods while pregnant and repeatedly expose child to new foods without comment, pressure, or urging. Also exclusive breastfeeding to six months helps.
    • Allergies: small risk reduction when introducing potatoes before 4 months, oats before 5 months, meat and wheat before 6 months, rye before 7 months, fish before 8 months, and eggs before 11 months
  • Tdap and flu vaccines recommended for Mom
  • Cdc vaccine schedule recommended for baby
  • Private cord blood banking not likely to be helpful
  • Normal birth weight 5.5-8.8 lbs
  • Get the vitamin k shot
  • Erythromycin not helpful if mother is sti-free
  • Delay cord clamping 2-5 minutes to get lots of iron-rich blood to babies since breast feeding won't get them much iron
  • Mother-baby skin-to-skin contact immediately after birth associated with better breastfeeding outcomes, better mother-baby interactions 1 year later, improved blood sugar levels, decreased crying
  • Either parent may not feel immediately bonded with baby - but fake it till you make it
  • Crying
    • Pain: rapidly escalating to maximum intensity with eyes squeezed shut (repeated like a siren at the highest level)
    • Fear: rapidly escalating to maximum intensity with eyes open
    • Anger: gradually escalating with eyes half closed
  • Soothing:
    • Swaddle
    • Side/stomach
    • Sway
    • Shush (including mom singing)
    • Suck
    • Skin-to-skin (including breastfeeding)
  • Pacifier benefits: pain relief, comfort, slightly lower risk of SIDS
  • Pacifier risks: increased ear infection rate, increased risk of teeth misalignment after 18 months. No evidence pacifiers cause diads to stop breastfeeding sooner or nipple confusion.
  • Sleeping:
    • Mothers who spend awake time in front of screens (computer, TV, etc - phone?) are awake longer than those who don't
    • Infants sleep average 13 hours / day, wake up 3 times / night, tend to transition to more predictable sleep patterns ~3 months
    • Research on bed sharing safety not great - not nearly as categorically unsafe as opponents claim (most studies don't control for other risk factors, e.g. smoking, many blur the lines of what is considered "bed sharing," e.g. including infant deaths on couches, many don't consider whether parents routinely bed share and employ best practices)
    • Increasing bed sharing risk: sofas, smoking, alcohol (or other depressant), multiple kids in bed, excessively tired parents, infant on pillow or blanket, premature infant, bed sharing with anyone other than parent, exclusive formula feeding
    • Reducing bed sharing risk: firm mattress, infant on back without blankets / pillow / mother's clothing, no strangulation hazards nearby, infant can't fall out of bed or get trapped, no smoke / alcohol / drugs, mom is not a heavy or restless sleeper, only mom shares the sleeping surface, infant isn't at risk of overheating
    • Sleep training is effective in ~80% of infants (4 months +) and no adverse long term effects have been found
    • Bed time routines helpful for sleep
    • Mother's emotional availability and responsiveness before bedtime helpful for sleep. Hypothesis: infant's feeling of security at bedtime persists through waking times so infant is more able to self soothe.
  • BPA has a high correlation (and likely causation) with negative biomarkers
  • No cough meds for children under 4 (unless doctor says so); honey (for children over 1) helps symptoms
  • Children's acetaminophen and ibuprofen OK
  • Avoid homeopathic and essential oils
  • Melatonin can help autistic or ADHD children fall asleep with few side effects
  • Keep guns out of the house; at worst, keep them unloaded and locked up. 1 in 3 parents of baby's friends will have guns so ensure they do the same.
  • Children don't learn anything from things on screens until ~24 months old
  • TV negative for children not just directly but also indirectly through less parental interaction
  • Advertising on TV often leads to more childhood obesity
  • TVs in child's bedrooms associated with poorer sleep and greater obesity
  • Media violence is associated with more aggressive children
  • Developmental Milestones
    • 6 months
      • Turns head when hearing name called
      • Briefly sits without support
      • Smiles
      • Plays peek-a-boo
    • 1 year
      • Waves bye-bye
      • Pulls to standing
      • Might say "dada" or "mama"
    • 18 months
      • Follows pointing and also points
      • Uses several words
      • Walks
    • 2 years
      • Uses short phrases
      • Can point to named objects
      • Follows one-step instructions
    • 3 years
      • Uses sentences of 4-5 words
      • Climbs
      • Engages in pretend play
      • Copies parents and peers
  • Reading
    • Infant reading programs don't work
    • Talk to child as early and as much as possible
    • Keep books around and expose early/often
    • Read stories to child; ask open ended questions about the story/characters
  • Discipline
    • Children unable to reason before ~3yo => negative reinforcement ineffective
    • Give attention for positive behavior, praise more effective for already compliant children
    • Withdraw attention for negative behavior
    • Maintain consistent routines
    • Consistent, immediate responses to behavior
    • Model the desired behavior (and not the undesired behavior!)
    • Clear, calm verbalization in age-appropriate language of what child did wrong and what he should have done
    • Help child make choices and understand consequences
    • The stronger the attachment to the parent, the more effective discipline is
    • Effective negative reinforcement:
      • Nonverbal (looks)
      • Verbal (calm and firm, not harsh, which is counterproductive)
      • time out or removing privileges to reinforce the reprimands
        • time out only works if "time in" is something child wants to be part of
        • time out is a removal of privileges, not a punishment (must be done calmly, no shaming)
        • 1 minute too short, 4 minutes effective for children age 3-6
        • some studies suggest a sliding time scale is more effective: time out ends after some time of good behavior; the clock resets with each outburst
    • Corporal punishment associated with 12 negative outcomes and dose-dependent
    • No evidence for long-term positive effects from corporal punishment
  • Toilet training
    • don't rush, shame, or pressure
    • 40-60% of children complete toilet training by age 3
    • Girls usually master it (22 months) younger than boys (25 months)
    • If child masters urination in the toilet but not BM, consider stool softening approaches
  • Childcare
    • Any effects of childcare are modest
    • Family factors (home environment, socioeconomic status, etc.) have 2-3x more effect than childcare
    • Quality of childcare matters a lot
    • Childcare associated with very mild behavioral problems that fade away by 3rd-5th grade
    • Childcare associated with stronger social skills, more self confidence, challenge management, self entertainment, more outgoing, less stress
    • Higher quality childcare with better trained caregivers associated with better performance on standardized tests
    • Daycare centers associated with independence, social skills, and higher test scores from age 2 through 3rd grade
    • Regardless of childcare, least problematic children come from homes with sensitive fathers who encourage independence, mothers who let children decide their own activities, and parents who have a loving / emotionally intimate relationship with each other
    • Families of daycare children lose an additional 13 days of sick leave (over the first 6 months?)
    • These GI, upper respiratory, and ear infections are going to happen whenever the child first begins regularly interacting with other peers.
    • Preschool offers academic benefits to lower class families, not much for upper-middle class families
    • The home learning environment (being read to, exposure to computers, etc.) has a much greater impact on academic success


What's Going On In There (detailed look at prenatal and postpartum neural development)

  • Get purposeful prenatal winter daylight exposure for babies born april-june, who have a higher chance (18% vs 12%) of being very shy
  • First hour skin to skin contact does not seem to have extraordinary bonding benefits
  • Increasing variety of touch stimulation is likely to enhance brain development
  • Loving touch, stimulation, and massage have shown to improve health of infants
  • Bouncing, rocking, carrying stimulates the vestibular system
  • Breast feeding babies smarter than bottle feeding even adjusting for socioeconomic factors
  • Taurine in human breast milk (also in formula) probably helpful for brain and retina nerve development
  • Human breastmilk provides not just the essential fatty acids but also the enzymes with which to break them down
  • Breastfeeding babies prefer (suck longer) variety in tastes that come through breast milk
  • Alcohol still present in breast milk 3 hours after ingestion
  • Brain growth spurt through two years of age => especially important to have adequate fat in diet
  • Visual acuity develops rapidly - from 20/600 vision at birth to 20/20 later. Initially babies can only detect high contrast (e.g. black on white) and only "where" vs "what" but these both change rapidly. The most crucial period of development is 6-12 months so, if there are any visual abnormalities (e.g. crossed eyes or cataracts), get them fixed within the first six months.
  • First two months peripheral vision more developed than direct
  • Binocularity onset happens rapidly between 2 and 5 months as the cortex takes over image processing
  • While vision develops late and matures quickly, hearing matures early and matures gradually.
  • Sounds above 85 dB can damage newborn hearing
  • Newborns don't recognize daddy's voice until a few weeks
  • Up to one year of age, best for baby to hear one thing at a time, not lots of noise
  • Motherese good after high pitch response develops around 3 months
  • Lots of tummy time recommended to develop upper body strength, coordination
  • Walkers don't help walking
  • Holding baby upright to practice walking helps
  • Gentle challenging helps
  • Parenting style matters more than whether a child goes to daycare:
    • Less sensitive mothers trend to have less securely attached infants
    • Attached babies have lower stress response to unfamiliar stimuli
    • Temperament is lower limbic system and is genetically determined while personality is upper limbic system and is experientially determined
    • Parents must strike a balance between smothering attentiveness and fostering independence; children of always-attentive parents are less securely attached than those of parents who intermittently give them space to explore, fall down, etc.
  • Babies distinguish speech (left brain) better with right ear and music (right brain) with left ear
  • Toddler vocabulary usually explodes once they have 50 words
  • Language development contributors
    • Parents who talk to them more
    • More positive feedback (in all areas, not just about language development); corrections not helpful
    • Socioeconomic status of parents (Poor: 600 words a day directed toward baby, working class: 1200 words a day, professional class: 2100 words a day)
    • *Repetition (eg same nursery rhyme) to reinforce neutral pathways
    • Repetition with substitution and expansion
    • books
  • IQ physiology
    • Head circumference correlated 0.14 with iq (born more than 14" average 7 pts higher than born less than 12.75")
    • ‎brain volume correlated 0.35
    • stimulus response time correlated 0.5
  • Prefrontal lobes control wisdom and executive function, not iq
  • High quality Daycare centers generally show better cognitive development than home care
    • Student teacher ratio < 1:5 2yo, 1:7 3yo, 1:10 4yo
    • Not the time for academic focus
  • Iron helpful in second 6 months
  • Breast feeding for a full year
  • Rotate toys in and out weekly to combat habituation
  • Exposure to other people and places associated with higher IQ
  • But guard against overstimulation