Parenting with Science – PediaCast 399

Show Notes

Description

  • Tracy Cutchlow visits the studio to talk about her book Zero to Five: 70 Essential Parenting Tips Based on Science. Discover evidence-based recommendations on a variety of topics, including sleep, meal time, play time, discipline, exercise… and many more. We hope you can join us!

Topics

  • Parenting with Science
  • Evidence-Based Parenting
  • Zero to Five (Book)

Guest

Links

Transcription

Announcer 1: This is PediaCast.

[Music]

Announcer 2: Welcome to PediaCast, a pediatric podcast for parents. And now, direct from the campus of Nationwide Children's, here is your host, Dr. Mike.

Dr. Mike Patrick: Hello everyone, and welcome once again to PediaCast. It's a pediatric podcast for moms and dads. This is Dr. Mike, coming to you from the campus of Nationwide Children's Hospital. We're in Columbus, Ohio. 

It's Episode 399 for March 7th, 2018. We're calling this one "Parenting with Science". I want to welcome everyone to the program. 

So we are right on the doorstep of episode number 400. Been doing this for awhile. And this week, we're going to talk about a topic that is near and dear to my heart, parenting with science. And really, this notion is why I started PediaCast back in 2006. Because as a pediatrician, I find science important. 

0:01:15

And, of course, doctors use science every day. We start with our core base of knowledge, what we learned in medical school and residency training. We add in our past clinical experience, so patients and conditions we've come across during our training and since our training. 

And finally, we consider new discoveries. We evaluate the strength of the findings. We determine if the way we practice and what we recommend changed in any way based on new discoveries. 

And sometimes our practice changes. Sometimes it doesn't because not all research is created the same. As we consider science, we don't automatically incorporate every single piece of advice that comes along. 

There's a lot of questions we have to ask. What is the investigator's question or hypothesis? What of other studies, ones that relate to the topic, what have they shown?

0:02:05

Is there a conflict of interest present? How is the study designed? What methods were employed? Are the results significant? Or could they have happened by chance? And then, what did the authors make of their findings? What advice do they have for how things should change? Which can affect diagnosis, treatment, prevention of the condition.

And it might be a parenting behavior or some other call to action related to health and wellness. How can we take these research findings and actually translate them into how we practice medicine, how we parent our kids. And sometimes the authors don't have a call for action at all. 

We want them to let us know what their barriers and limitations that they've identified, what further work needs to be done before any recommendation can be made.

Then, at the end of the day, once you kind of ask yourself those questions as a clinician, how much do I agree with the researchers and their discussion and their conclusion? What do my peers think? Am I going to act on this on my clinical practice or not?

0:03:07

Should parent act on the findings? What are the benefits of acting? What are the risks of acting or not acting on the findings? So, lots of consideration goes into this.

And what I found back in 2006 and I think it's even more so today, there's a lot of commentary and advice out there in circles of family and friends and certainly online. Commentary and advice that aims to be helpful, but the source of that advice sometimes doesn't do their due diligence. 

They haven't considered their sources critically. They haven't ask themselves the question list that I just went through. They simply repeats study results because they believe them to be true without conducting a proper evaluation. And often, the findings really just serve to support their already established position on one thing or another. So they really have a conflict of interest of sorts right out of the gate.

0:04:00

Now, when one takes a closer look at a lot of these stuff that's out there, you realize the study side that is not well designed. There is significant flaws or conflicts of interest. The work has not been properly reviewed by established experts in the field that's not been considered in light of previous research.

And the conclusions that the authors draw don't necessarily line up with what the results are saying. And yet, even these studies are passed off as true usually by well-meaning folks. But the end result is misinformation which can affect the health and well-being of our kids. 

So, I created PediaCast in part as a response to that misinformation. I wanted to create a place parent could visit online, get answers to their questions based on an honest assessment of the science. And I wanted to help parents really parent with science. And my vehicle to provide this sort of service was the podcast. 

So what is my point with all of this? Well, we have a guest who has  similar passion. Her name is Tracy Cutchlow. She's a journalist, having worked with MSN Money and The Seattle Times. She's an editor working with Dr. John Medina on his New York Times best-seller Brain Rules. And she's the author of a terrific book for parents called Zero to Five: 70 Essential Parenting Tips Based on Science (and What I've Learned So Far).

0:05:22

So she'll be joining us in the studio to talk about her book, how she arrived at her 70 topics, the methods she used to delve into the science, the research and provide practical tips based on evidence.

Then, we'll explore a healthy sample of nine topics and tips from the book with advice for parents. We'll take the 70 and hit 9 of them. Again,  advice for parents rooted in science. And the topics we're going to cover, nutrition during pregnancy, reading with your kids, meal time, play time. 

We're also going to consider marriage relationships and how that affects the family, discipline, exercise, and a few more. 

So, stick around, Tracy will join us soon. 

0:06:06

First though, I do want to remind you if there is a question that you have, if you like to suggest a topic for the program or you want to point me in the direction of a news article, journal article, whatever it is, whatever's on your mind, it's easy to get in touch. Just head over to PediaCast.org and click on the Contact link.                

Also, I want to remind you, the information presented in each and every one of our episode is for general, educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals. So, if you do have a concern about your child's health, be sure to call your doctor and arrange a face-to-face interview and hands-on physical examination. 

Also, your use of this audio program is subject to the PediaCast Terms of Use Agreement, which you can find at PediaCast.org. 

Let's take a quick break, and then we will be back to talk more about parenting with science. It's coming up right after this.

[Music]

0:07:25

Dr. Mike Patrick: Tracy Cutchlow is author of the book Zero to Five: 70 Essential Parenting Tips Based on Science (and What I've Learned So Far). She's also editor of the bestselling books Brain Rules and Brain Rules for Baby, which were based on the highly regarded work of Dr. John Medina. 

In the past, she's also been a journalist, working with MSN Money and The Seattle Times. And most importantly, she's a parent like you and me who wants the best for her child and understands the importance science can play as we make all those daily little parenting decisions, which add up to tremendous influence in the lives of our kids.

That's why she's here to talk about today parenting with science. So, let's give a warm PediaCast welcome to author Tracy Cutchlow. Thanks so much for joining us. 

Tracy Cutchlow: Thank you. Happy to be here.

0:08:09

Dr. Mike Patrick: Really appreciate you taking time. So  let's begin just with a description of your book Zero to Five. And I love the subtitle by the way, 70 Essential Parenting Tips Based on Science (and What I've Learned So Far). Give us a little overview of the book.

Tracy Cutchlow: The book is, it takes a whole range of topics that are important to parents and really summarizes the research that is most relevant across feeding, potty training, discipline. And it's presented in a very practical and friendly way.

Dr. Mike Patrick: Yeah, you know as I was reading it, it really reads like notes from a friend rather than a science book on each of these topics. 

0:09:02

Tracy Cutchlow: Yes, that's what I was going for. I remember when I was sitting at home with my new baby, as you mentioned, I had edited some brain development books. I had these information in my head, but as I was sitting there with my new baby, I couldn't remember everything about how to apply it. And I just could not bring myself to dig through all of these books to find really the most practical tips.

I love books, I love reading, but I did not have the bandwidth at that time. So, I really just want one of those very practical, friendly, accessible reference.

Dr. Mike Patrick: And I love the photos too that really makes it interesting. Photojournalist Betty Udesen, right, is the one who did those? And they're wonderful pictures.

Tracy Cutchlow: They really are, yes. They really bring a sense of humanity to the book and make it feel a little definitely more accessible.

Dr. Mike Patrick: So who then is the target audience for your book? Who did you really write this for?

0:10:16

Tracy Cutchlow: Initially, I wrote it for parents like me who were having their first baby and haven't really been around babies before and had focused so much on the labor and the birth. And then, we're sitting around like three months later after you figure out how to keep your child alive, you know?

Dr. Mike Patrick: Right.

Tracy Cutchlow: Then you're like, "Oh, now there's this parenting thing that needs to happen and I did not prepare for that."

[Laughter]

Dr. Mike Patrick: Yeah. I mean, you have this human being now that you're responsible for and it's time to get serious about it.

Tracy Cutchlow: Yeah. So, that was the initial audience. However, I am hearing from people who have older kids, people who have second kids, and professional who run parent education programs or who train childcare providers, pediatricians keeping it in their exam room. Because it's just a very handy reference and a really good jumping off point for discussion.

0:11:27

Dr. Mike Patrick: Yeah, and just so easy to read. I love the bullet points. And the thing I really appreciate about it is when you sort of review some research related to whatever topic it is that you're talking about. 

So, what sort of motivated you, because that's a little different than most parenting books out there, what motivated you to actually look up the research on these 70 topics and include that in the descriptions?

Tracy Cutchlow: Well, the book, I really wanted the book to be founded in science. Personally, I felt like there were just so much information out there. And I really needed a solid filter for it. It's not that science is perfect but it's just sounds like best thing we've got. And there are some really important things that are understood now, that how the brain develops optimally. And that was really my starting points. 

0:12:28

Dr. Mike Patrick: And I really,  like I said, appreciate it. And I also love that you said science is not perfect. And in the introduction to this program, I mentioned that not all studies are created equally. And we do want to have some skepticism and look at studies with a critical eye. So how did you go about sort of judging which were good studies and maybe which ones that you didn't want to influence your writing?

Tracy Cutchlow: Well, I started with editing Brain Rules for Baby by John Medina, as you mentioned, and he was very strict about studies that were randomized controlled trials that had been replicated. So I was starting from, I learned a lot working with him on the book, and I was starting from those researchers that he mentioned. 

0:13:18

And then I would go read their books. What did they say? Who did they say it to? And so, that's how I formed kind of the evidence bases for the book.

And then, on top of that though, I was just paying attention to the things I wanted to know about as a parent and the things that other parents around me were talking about on the playground and then the parent-child classes. And that's how I ended up bringing in more, going beyond brain development to the sleep, and then feeding, and those topics. 

And then I had experts on these fields review the book.

0:14:02

Dr. Mike Patrick: Now, it's excellent and 70 topics definitely cover a lot.

I also really like your approach to organizing the book contents. So, there are nine sections. You start with sort of preparing for baby. And then love, talk, sleep, eat, and potty. I love that those are grouped together. Play time, connecting, and then discipline, moving, and slow down. And each of this single topic just presented in one to two pages. 

So, it's really something that you can look at on the go. I mean, you can just open up to one particular topic, and it just takes a few minutes to really get the most important aspects of that topic.

Tracy Cutchlow: Yeah, yeah. I think about is as like getting a degree in parenting, but in a very easy way. Well, the way the organization came about, I had this huge list of all these things that I knew would be useful for parents to know. 

0:15:05

And then I was just kind of sitting with that and noticing how they're related to each. And when these broad categories kind of came to me, I thought they're really wonderful because those simple things are really the most important, actually the most important message. That that's what we really need to focus on and that we all and innately have the capacity to do these things, love, talk, play.

Dr. Mike Patrick: Yeah, absolutely. And so, I wanted to just take sample of from each of these sections and just sort of talk it through. So folks get an idea of what sort of information they can expect and what research that you're looking at. 

So, let's begin with Prepare. And one of the topics that you explored was are you really eating for two? So tell us about that.

[Laughter] 

0:16:04

Tracy Cutchlow: One of the things I personally noticed when I was pregnant the first time was just kind of idea in my head that I should be eating everything. And when I found out how many calories you really need, how many extra calories you really need in the first trimester, and second, and third, I'm just kind of the researcher and perfectionist that's hard to keep up. Also, I looked up what kinds of food add up to that many calories. 

And it was so minimal, like you need 300 extra calories a day in the first trimester, and 350 in the second, and you can get that from one 8-Grain Roll at Starbucks, just as I say in the book. 

And that just gives me a new perspective on what I needed to do. It wasn't necessarily finishing everybody else's French fries at lunch.

0:17:14

Dr. Mike Patrick: Yeah. So you're eating for two, but one of those two is very, very, very small, so it doesn't take a lot of calories  for them to grow. So, yeah, and then the third trimester, 450 calories, and you say that's just that a couple of oranges with your 8-Grain Roll.

Tracy Cutchlow: Right. That was interesting to me. And the other thing was this issue of eating fish and the Omega 3 that you get from eating fish. I had always heard kind of don't do it. But this NIH study that was drawn from a dataset of 12,000 nearly women, sound that really the message should be make sure you're getting 12 ounces of fish rather than limit yourself to 12 ounces. 

0:18:06

Dr. Mike Patrick: And they found that of those 12,000 women, those who had less seafood consumption, it was really remarkable. Their babies had verbal IQs in the lowest quartile when they were eight years old, more behavioral problems at seven years of age, poor social communication, and fine motor skills in the early years. 

And so their conclusion really was the benefit of at least 12 ounces of fish per week are really outweighs the risk of any mercury exposure plus you can select fish that are less likely to have mercury in them, correct?

Tracy Cutchlow: Yeah, exactly. And the reason it outweighs is that Omega 3s are just so critical for normal brain development and the part of the membrane that makes up the neurons in your brain. So, yeah, it less about mercury and more about Omega 3 is what you want to get. 

0:19:08

Dr. Mike Patrick: Yeah. And interestingly enough, flaxseed oil is not converted to usable Omega 3 as well. So, you really do want to get this from fish if possible. And then, of course, in the book you outline that. And then, folic acid is another important one that expecting moms should be getting enough of. 

Tracy Cutchlow: Yeah, that kind of prenatal vitamins, it's really beneficial to start getting that four weeks before conception. I mean, you don't always know this, but really, as early as you know, you want to start taking that.

Dr. Mike Patrick: Yeah, absolutely. And then we move on to Love. And then, one of your article is just the importance of cuddling with your baby.

Tracy Cutchlow: Yeah. Touch, touch, skin-on-skin touches is so important for signalling safety to a baby. It soothes the baby's nervous systems and lowers stress hormones. It's kind of amazing how we're designed. 

0:20:18

Dr. Mike Patrick: And one of the studies with preterm babies, tell us about that one. With the daily skin-to-skin contact. 

Tracy Cutchlow: That was with preemies. In the study that the researchers had the parents have a skin-to-skin contact every day with the babies and the control was babies who cared for in an incubator. And what they found was they would follow up when the babies are six months old, and then regularly until they were ten years old actually. 

And they found out that that contact had helped the babies have more efficient stress responses, more organized sleep patterns, and even better executive functions. 

0:21:07

So yeah, that's with preemies, but there's other studies that show the benefit of touch. And even like just a brief massage for a baby each day can improve their mood and make them less anxious and stressed. And I thought that was nice, because I thought, well, that's just true for everybody. I want a massage every day.

Dr. Mike Patrick: Yes, absolutely. And there really was a study that looked at four-month-olds who had a daily eight-minute massage and the study showed that they were in a better mood, they were less anxious and stressed, more attentive, they were sleeping better. So not only is it brand new baby skin-to-skin contact, but really just touching your kids and holding them and giving them massages, all really important things.

0:22:01

I do want to point out that in the course of cuddling and touching and loving, we still want to make sure that we practice safe sleep, that babies sleep alone in a crib, on their back. Belly time is fine with supervision, but no co-sleeping because it's easy for babies to get rolled over on and suffocate. 

Tracy Cutchlow: Yeah, there's so many other ways to get it. You're nursing or just having your baby on a wrap while you're going about your day.

Dr. Mike Patrick: Yeah, absolutely. And then, Talk. One of your articles in the Talk portion of the book is the importance of reading and reading together. Tell us about that.

Tracy Cutchlow: Well, I think for my baby shower, one of the things I love was getting kind of a library of books to read with my baby. But I didn't really imagine there was anything to it. But when I started looking into how you read with the baby most effectively, there were really those stuff that you could take depending on the baby's age. 

0:23:11

That really is just thinking of it as exploring the concept of books, you have this sturdy board books and can just let your baby chew on it and just kind of delight in the experience of being there together with your baby and just pointing at pictures and talking about what you see in them. And it's not that you have to get to the whole thing.

Dr. Mike Patrick: I love that because that's what babies do. When they're 6 months and even up to 12 months of age, they're going to grab the book and put in their mouth just like they try to put everything in their mouth. And that's okay, it's okay to let them have that tactile interaction with books, and as you say chewing on the corners of board books. But just get them used to books being a part of their daily experience.

0:24:11

Tracy Cutchlow: Totally, yeah. And the other thing that parents will notice as they do this is how your baby reacts if you read dramatically, like you have big gestures or create different voices. Or you kind of like, maybe there's a bee in the book and it goes buzz, and you kind of as close to your baby and start pointing those with your fingers. It's like those interaction of it makes it such a rich experience. And that kind of one-on-one social interaction is what helps develop language.

Dr. Mike Patrick: Yeah, so important. And then, when they get to be to the point 18 months to about 3 years as they're learning to talk, then you really let them become the story teller, right?

Tracy Cutchlow: Yeah, well, kids went through the same book over and over and over.

0:25:09

Dr. Mike Patrick: Yes.

Tracy Cutchlow: And as they're doing that, you can back off a little bit and talk to them about what they're seeing, "What is this picture?" and they name the thing. And yeah, you expand on that, just maybe say that's a bird, and you say, "Yeah, that's a black bird." And, "Can you say black bird?" You're just kind of making it a conversation about the story.

Dr. Mike Patrick: Yes. And they do like to read the same books over and over. And there's nothing wrong with that, right?

Tracy Cutchlow: Oh, no, no. But that gives them a familiarity with the story and the characters and the words that you're saying. And they'll many times have a really good memory for the story, you can kind of pause at the end of the line. Especially for books that rhyme and they'll finish the line, and it's so cute.

0:26:07

Dr. Mike Patrick: Yeah, absolutely. And then as they do start to realize words, you really start reading them alphabet books and rhymes. And having them sound out words and syllables and just get them involved in the reading process of the words themselves is kind of a natural evolution of them talking about the pictures.

Tracy Cutchlow: You can get that specific with it, yeah. For general language developments, so much is about the conversation and the experience of talking about what's happening in the pictures and relating that to your own life or their own lives. "Oh, remember that time when we did this thing?"

Dr. Mike Patrick: Yeah, so making it more than just about the story itself, but really relating that to your own family life, that's a great idea. 

0:27:03

And then, as we move on to the next section of the book, Sleep, Eat and Potty. The one I pulled out of that one was a question pediatricians get asked a lot. How do you know if your child is getting enough to eat?

Tracy Cutchlow: A friend of mine was kind of joking with it, because he was doing his residency in pediatrics, that when a parent came in worried that their child wasn't eating enough, that they should check about whether the child was in the 90th percentile of their weight or 95th.

[Laughter]

Tracy Cutchlow: That's something that parents tend to worry about that perhaps, they don't. But I think, yeah, we have our own random idea about how much a child should be eating. And if they take a few bites, it seems like, "Was that really enough?" 

And we can get very focused as parents on every single meal rather than looking over the broader week about what they're eating and looking at how they're growing, and that their weights are okay.

0:28:17

Dr. Mike Patrick: Yeah, yeah.

Tracy Cutchlow: Three decisions can help us get back into that perspective. 

Dr. Mike Patrick: Yes, definitely. And I think when parents are concerned about that, that is what we do, we pull up the growth chart. And even if they're not at the 90th percentile, if they're at the 25th percentile, but they've always been cruising along at the 25th percentile, and grandma on both sides of the family is 5'1", then you would expect your kiddo is normally going to be at the 25th percentile.

And so as pediatricians, we really can reassure parents about or say yeah, there is an issue. It was 50th percentile and then we dropped a little lower and now, we're at the 25th. And maybe there is a concern, so definitely something to talk to your doctor about. 

And one of the thing that I always like, and you really alluded to this in article is sort of as a parent, you pick the foods, but let your child decide within reason when and how much of those foods that they're going to eat. And sort of trust their signal that they're going to stop eating when they get full. And we can, as parents, sometimes cause more issues when we push them to eat too much.

0:29:22

Tracy Cutchlow: Yeah, absolutely. Yeah, that's  Ellyn Satter's division of responsibility for feeding, is that parents decide what the child will eat. The child decides whether they will eat and how much they will eat. And when we trust that, we're really helping them stay in touch with their own instinct, their own body signal.

And that's what they're really going to need for healthy eating later, to know when they're full, to know when they're hungry. And so, it's not helpful for us to say, "Are you done?" and they say "Yes". And we're like "Are you sure? Just have some more bites. Just finish what's on the plate." We're really overriding their awareness of their own signals. 

Dr. Mike Patrick: Yeah, and as long as there's not an issue with their growth and their development, then it's not an issue. Now, sometimes there is and then you have to come up with some different ideas to try to get more calories. 

0:30:19

And then, for the majority of kids, I love the way you put this in the book, hovering and prodding them and even cheering on every bite can get pretty annoying. I mean, can you imagine someone standing by in your chair doing that. Not much fun. 

[Laughter]

Tracy Cutchlow: Yeah, sometimes it's useful to think about what we would like or not because, yeah, there are cases where mealtimes become really stressful and difficult. And what I tend to recommend is to look at how much connection is going on. 

I was talking with the parent who was struggling with this and her baby was taking food off of her plate and not wanting to eat on his plate. So she had started feeding him at a different time from the family. So very well intentioned, she had started doing some things that made the whole thing less connected. 

0:31:25

After she brought him back to the table and it was okay for him to experiment with the food and to share food and for it to be more of a family experience, those issues went away with him not eating. 

Dr. Mike Patrick: Yeah, absolutely. 

Tracy Cutchlow: So yeah, there's many factors.

Dr. Mike Patrick: And one of the studies that you bring up in the book is a study that looked at two groups of kids, and they were both offered slices of red peppers, which a lot of kids are going to probably turn their nose up to those. And so, group one, they were told, "Just eat as much as you like." And group two said, "If you eat one, then you can choose a sticker."

And of course, that group sort of jumped to eat the pepper more quickly. But the kids in the first group who were just sort of left alone and said, "Eat some of these much as you like," they actually ended up eating more pepper slices than the kids who were sort of bribed and then rewarded.

[Laughter]

0:32:22

Tracy Cutchlow: Yes, yeah, it's really really important for us to think about the long term versus the short term. And is the thing in the short term really getting us where we want in the long term? 

Dr. Mike Patrick: Yeah, because then you got to give your kid a sticker every time you eat a pepper, and that may not be practical.

Tracy Cutchlow: Well, it's not practical. And it's not actually what you wanted to happen, right? 

Dr. Mike Patrick: Right, exactly.

And then, we move to Playtime. And I love the article on make-believe. Tell us a little bit about the importance of playing make-believe as a kid. 

Tracy Cutchlow: Make-believe, that's a certain kind of play that is so beneficial to our children's brain. A play that they do on their own without our prompting necessarily that is pretending to be somebody else. And when they're doing this in a group, there's actually a lot of more than just play going on. 

0:33:23

I shouldn't say just play, play is so critical as our children learn. But in this kind of play, there are rules that they have to follow about. Say, "I'm the mom, you're the baby." What does that mean? Like, what are we going to do? What are the rules around making a meal together or carrying for his little baby? Whatever that is. 

And everyone has to stay in their roles and follow these rules. And that helps develop executive function as well in the brain. Kind of interesting. 

Dr. Mike Patrick: Yeah, in terms of planning and engaging and completing tasks. And the study that you cited looked to the 150 kids and they were kind of divided up into one group, had a certain kind of preschool that sort of incorporated what's called tools of the mind. And really, it encouraged lots of make-believe play as a part of the day. And then the others were just in a regular preschool class.

And the kids who spent more time in make-believe, they're, as you said, 30% to 100% better depending on the school in terms of executive functions. And they were more creative, they got improved language, improved problem solving, seemed less stressed. They have improved social skills. 

0:34:40

So just again, the importance of doing that. But you know, kids won't necessarily just sort of start elaborate make-believes on their own. When they're young, as a parent, you got to sort of get down on the floor and make believe with them, right? 

[Laughter]

Tracy Cutchlow: You can model it with them, yes, but maybe make up a role. "Hey, let's pretend we're so and so, and we're making dinner." And you try to act like that person and/or come up with a character and dress that way. And, yeah, like, "Let's pretend we're drinking tea," and you pick up the pretend cup and hold it to your lips. 

Dr. Mike Patrick: Oh, no, and the next thing you know they are doing it on their own. 

Tracy Cutchlow: Yes, and that point, we need to help them take the lead in the play.

0:35:36

Dr. Mike Patrick: I also love the idea of including household objects. As I think back, my kids love to sort of dig in to the kitchen and get out the bowls and silverware and play restaurant. So it doesn't always have to be with toys, just really getting creative and thinking about what's around in the house can also make-believe play more fun. 

Tracy Cutchlow: Absolutely. I would say it's more important to do that and try not to buy something from the store actually, because those things they're talking about are so open ended. They can be anything, and that's what really fosters imagination and creativity. 

Dr. Mike Patrick: Yeah, and then the next sort of evolution of this is when kids get to be a little bit older, then they sort of become the director, especially if they have younger siblings. And sort of tell them what to do or using dolls and action figures to sort of direct a scene. And that's sort of more advanced make-believe play now with props as people. 

Tracy Cutchlow: Yeah, when they're three to five, mm-hmm. And you can, again, use things around the house to make up these props, and uniforms,  and costumes, and whatever. 

0:36:59

And then, the important thing is that the child's telling the sibling or us or whoever what's going to happen and what's going to come next. And so, we're not the ones directing this theme but we're facilitating. 

Dr. Mike Patrick: And just really let them direct it and let their imagination go where it's going to go. It can be a lot of fun. 

Tracy Cutchlow: Yeah, words to use there, "What could happen next here?" 

Dr. Mike Patrick: And then, the next part of the book. I love that you included this, the Connect, and just really connecting with our kids and with our family. And one of those that you actually looked at marriage and how strong marriage is important, and that really, we should be trying to create more ups than downs in the context of marriage in the family. 

0:37:46

Tracy Cutchlow: Yeah. So that's why I like John Gottman's  work. He runs what he calls the Love Lab here in Seattle at the University of Washington. And he's done some pretty interesting research that helped  him predict whether a couple will stay together. 

The part that I included in the book was about he calls them The Four Horsemen of the Apocalypse. That if you actually do these four things,  you are more at risk of getting divorced. 

Dr. Mike Patrick: And what are those four things?

Tracy Cutchlow: The first is criticism. If you state your complaint as a personality defect of you partner. Like, "You're leaving messes for me in the kitchen. You're so lazy." Rather than starting with him more positive statement at yourself, like "I could really use some help with the dishes in the kitchen."

Dr. Mike Patrick: And, "Help me with the dishes now, and then I'll help you with what you're wanting to do." 

0:38:58

Tracy Cutchlow: Mm-hmm, yeah. The second one is contempt. If you're making statements like "I'm right. This is the right way to do it," "You're kind of a moron for thinking the way that you do or having done that." That doesn't go very far.

The third was defensiveness. If say your partner has a complaint about something and you respond with "Well, you did this thing." Or, "I wouldn't have done that if you didn't do this." Rather than starting with acknowledging what your partner is trying to say and showing that you heard.

And the fourth is stonewalling where you're just kind of sitting and staring in silence, not acknowledging or hearing anything they say.

0:39:50

Dr. Mike Patrick: Yeah, no eye contact. And I mean, you want to nod, at least follow-up questions, engage.  And I love that his work look at those sort of negative behaviors and then it showed, "Well, this is what I've noticed about happily married couples, that they really behave like good friends. They handle conflict in general in positive ways. If there's negative interactions, they repair them. They don't go to bed angry and really try to have empathy and try to see where the other person's coming from. And make it more a positive experience as you sort of meet in the middle."

And then, he also says, "Hey look, every marriage is going to have conflict." You're going to have some of those coarser behaviors in there. And the key is to try to have five good interactions for every one negative. And the marriages that did that seem to last the longest.

0:40:43

Tracy Cutchlow: That's right, that's right. And it's not like you're really keeping track of that. 

Dr. Mike Patrick: Yeah, right, exactly. 

Tracy Cutchlow: But it's such a general sensor of the relationship. 

Dr. Mike Patrick: No tally marks on the refrigerator. 

[Laughter]

Tracy Cutchlow: Yeah. And I did love his point that it's not about the lack of conflict. Some couple say, oh, we never fight and that's great. But actually, the couples that fight often, they can be fine too. It's just how they handle the conflict. 

0:41:11

Dr. Mike Patrick: Yeah, yeah. Do it in a positive way and just let each of them be right sometimes. Not one person has to be right every time. 

Tracy Cutchlow: That's true and it's really about acknowledging what the person is saying, but that they feel heard. 

Dr. Mike Patrick: Well, I love that you included healthy marriages as we think about parenting because that is so important. 

And then Discipline, the article that really stood out to me here was plan ahead. And the way you put in an ounce of prevention is better than a pound of punishment. 

[Laughter]

Tracy Cutchlow: Oh, my goodness, yeah. 

Dr. Mike Patrick: That was great. 

[Laughter]

Tracy Cutchlow: Well, there's so much we have to change about our lives as adults to accommodate kids. And we can often go further than we do, I think. If we just slow down, to simplify, to make sure that they've had food and sleep. And we're not taking them to the store right after they've been to daycare, and they haven't had a chance to run around. There's so much about making sure their basic needs are met that I think can be so useful. 

0:42:27

Dr. Mike Patrick: Yeah. If you kind of dread going to a certain place or a certain time of day because you know this is going to be a problem, if you can plan ahead and say, "Well, let's do it at a different time of day." Or maybe, "I'll get a sitter and I'll run those errands." Or just really try to come up with an alternative plan if you can predict that there might be a problem. 

Tracy Cutchlow: You can. It's not that hard to notice where there are problems. And I think a part of that is really sticking to the routine. It's so helpful for kids to have those predictable nap times and eating times and exercise times. Just basically, they're running around depending on how old they are. 

Dr. Mike Patrick: And managing expectations is important too, sort of explaining what's going to happen, how long are you going to be somewhere. This is what it might look like. And again, you can't control their behavior a 100%. But sometimes, just giving them an idea on what to expect can sometimes help prevent problems, too.

0:43:34

Tracy Cutchlow: That goes a long way and sets expectations of what children are able to do. 

Dr. Mike Patrick: Yeah, very important. 

Tracy Cutchlow: Yeah, the organization, ZERO TO THREE did a study on what they call expectation gaps, and they found that many, many parents believe that under age two, children are able to do things like resist the impulse to do something forbidden, share and take turns really well. What was the other? Oh, control their emotions, like not having a tantrum if they're frustrated. And these are things that don't come online until between three and half and four years old. 

0:44:19

Dr. Mike Patrick: If a kid's in meltdown and crying, telling them to stop crying is probably not going to work. 

[Laughter]

Tracy Cutchlow: It's not. And you can sit with it, like maybe you try that because you don't know. That's fine, but just be aware, notice that it didn't work. 

Dr. Mike Patrick: And then, I also like the saying yes instead of no. Even though you can't give in to everything, but if they want to do something and it's not the right time, and it's really not practical, you can't do it. Instead of just saying no, saying, "Yeah, I wish we could do that," or, "Yeah, we can do that tomorrow." Rather than being a no, really, that positive yes can go a long way to help with the disappointment that's likely to follow. 

Tracy Cutchlow: Yeah, it really does. I know there had been phases for my daughter where just the word no is such a trigger. And so, starting with the yes has made a big difference. Yeah, there's something about like, "I hear you. I hear that you want to do this. I wish we could. I'm on your side here, but we can't." 

0:45:22

And then, to allow that disappointment and help facilitate that and not try to shut it down or dismiss it. Just yeah, give them this practice of sitting with the emotions and seeing that they pass when you do that.

Dr. Mike Patrick: Yeah, absolutely great advice. And then we have Move. In this part of the book, I like to keep moving, and just the importance of exercise. Tell us about that. 

Tracy Cutchlow: Yeah, exercise is probably one of the best things we can do for our brain. Just evolutionarily, the way that we're designed, that's what we need. It increases oxygen to the brain. It protects neurons. It takes out stress hormones. It acts against mood disorders. It does a lot. 

And the surprising thing that I found was it can be damaging to sit for too long during the day more than four hours. And most of us at work are doing that. 

Dr. Mike Patrick: So it's important to get up and work around. 

Tracy Cutchlow: Yeah, it's not only about that how far we work out at some point during the day, but yes, just getting out there and walking around, having some movement. 

0:46:47

Dr. Mike Patrick: And that particular study looked at 63,000 men and women who were 45 to 64 years of age, so we're talking about older adults, but activity patterns start in childhood. And so, if you can encourage your kids to be active as kids and as teenagers, then hopefully that will translate into young adult and middle adulthood. 

But those folks who sat more than four hours a day, they have significantly increased likelihood of heart disease, cancer, diabetes, high blood pressure. So again, just the importance of really moving around. 

0:47:21

And so, what are some helpful hints for parents to keep them moving as they have young babies, and then encouraging their kids as they get older to move with them?

Tracy Cutchlow: Yeah, I think a lot of it is us modeling a certain lifestyle. There's that aspect of our own health and then what our kids see and what they perceive as being normal. When my kids was just a tiny baby, the things that helped me were signing workout classes where I could take her or ones that had childcare with them, friends who could come. 

Or in my case, I was very lucky that my husband is a runner and he would take our daughter out in the morning in the jogging stroller. That was useful for me to have as well. 

Dr. Mike Patrick: And I'm sure she love that. 

Tracy Cutchlow: She did. Yeah, well, we live in a beautiful place. We're lucky for that and we would be running along the waterfront and see the birds and the clouds and the water. 

Dr. Mike Patrick: And then, how do you get your kids, as they become toddlers and they're walking around, you don't want to call it exercise. How do you get them to move? 

0:48:41

[Laughter]

Dr. Mike Patrick: And a lot of times, they're moving anyway, right? Sometimes, we don't want them to move quite as much. 

Tracy Cutchlow: Oh, they want to move. 

Dr. Mike Patrick: Yes.

[Laughter]

Tracy Cutchlow: We just need to provide the space for it, an environment where it's okay and they can tell that it's okay with us. 

Dr. Mike Patrick: And there's lots of fun things you can do, playing tag, and dance parties, and a lot of ways that you can make moving fun and make a game out of it. 

Tracy Cutchlow: Yeah, absolutely. Those are such wonderful connected times. I think sometimes if you just go back to your own childhood and think about… And then, there's an element of us not having to be involved in all of that and direct it. 

0:49:26

Right now, we've got this foam carriage in our playroom that I've bought because it could fold out as a bed. Well, now, it's become like a trampoline and a fort and a climbing wall. I mean, you don't have to tell them what to do.

[Laughter]

Dr. Mike Patrick: Yeah, absolutely. 

Tracy Cutchlow: You just have to be okay with them doing it. 

Dr. Mike Patrick: Yeah. I mean, it is sometimes hard especially if you're an organized person and maybe messes stress you out a little bit. It's going to be important to let that just happen naturally and to just sort of go with it. 

Tracy Cutchlow: Well, yeah, you've got to have your own boundaries and think about what is okay with you. You can have rules about certain things and where they can be and play and move and that's fine. As long as there is something, you know. 

Dr. Mike Patrick: And then, the final segment of the book is the Slow Down. And in this part, I love really be careful about comparing your kids to other kids. 

0:50:33

Tracy Cutchlow: It's hard not to, but it's kind of pointless.

[Laughter]

Tracy Cutchlow: Because kids are developing at such different rates and everyone's in a different stage and kids will circle back through the stages. And at some point, they'll even out. And you can look at other kids and be like, "Oh, should my kid be doing this?" But probably not. 

Dr. Mike Patrick: Right. And again when there's a question about this. You know, talking to your child's healthcare provider, they're really going to have an understanding of what the normal range is and when you would want to become concerned about not meeting a particular developmental milestone. But it's also important to realize… 

Tracy Cutchlow: That's just a range. 

Dr. Mike Patrick: Yes, yes. And early development is not mean that that child is going to be smarter down the road. It's just means that that part of the brain matured earlier and that really doesn't necessarily mean a whole lot at the end of the day.

0:51:35

Tracy Cutchlow: Yeah, yeah. I was thinking about this with reading because apparently I started reading at age three. And my daughter is six and she isn't reading yet. I was kind of surprised and then I thought we'll do as were she's got decades to be reading. Everybody's going to get there.

Dr. Mike Patrick: Yeah, absolutely. And then, of course, then getting the school system involved. And if you are concerned, talking to the teachers and figuring out if a separate plan needs to be made. I mean, really just sort of communicating with folks whether it's with the school or whether it's with your healthcare provider. Rather than the parents of other kids who may kind of steer you in the wrong direction because they don't see that range. They only see their kids in their home.

Tracy Cutchlow: Yeah. Talk to the people who know the range.

0:52:28

Dr. Mike Patrick: Yes, absolutely. Well, Tracy, it's such a wonderful book. I love the fact that all of the articles, 70 of them are really founded in science and sites research. It's really fantastic. 

Why don't you tell folks where they can Zero to Five?

Tracy Cutchlow: Yes, well, it's at many bookstores. It's on Amazon. My own website, zerotofive.net has it as well in various formats. That's it's an audio book. So, it's kind of depends what you like.

I also send out posts to parents. You can join the mailing list from my website as well.

0:53:12

Dr. Mike Patrick: And there's a blog, I saw there too, where you can update with new information. 

And I'll put links to all of those in the Show Notes for this episode, 399, over at PediaCast.org. So, we'll have a link to the landing site, zerotofive.net, the blog, Amazon, Barnes & Noble. 

As you mentioned, so many ways you can get the content, spiral bound book, paperback, Kindle, NOOK Book, Audible, if you like to listen to them. And again, I'll put links to all those places in the Show Notes.

Tracy Cutchlow: Yeah, thank you so much.

Dr. Mike Patrick: Well, Tracy Cutchlow, author and journalist of Zero to Five: 70 Essential Parenting Tips Based on Science. Thanks again just so much for joining us today. 

Tracy Cutchlow: I really enjoyed it, thank you.
   
[Music]  

0:54:26

Dr. Mike Patrick: We are back with just enough time to say thanks to all of you for taking time out of your day and making PediaCast a part of it. Really do appreciate that.       
     
Also, thanks to our guest, author and journalist Tracy Cutchlow. She wrote the book Zero to Five: 70 Essential Parenting Tips Based on Science (and What I've Learned So Far). And we'll put a link to the book in the Show Notes as I mentioned. Just head over to PediaCast.org. Click on the Show Notes for Episode 399, and we'll provide links for you there.

Don't forget, you can find PediaCast in all sorts of places. We are in iTunes, Google Play, iHeart Radio, Spotify, most mobile podcast apps.

And of course, there's a landing site PediaCast.org. You'll find our entire archive of past programs. Our Show Notes, transcripts of the programs, and Terms of Use Agreement. Also, our Contact Page so you can get in touch and suggest the topic or ask a question. I do read each and every one of those that come through. So, please do use that Contact Page and we'll try to get your ideas on the program.

0:55:22

We're also a part of the Parents On Demand Network. You can find them at parentsondemand.com. It's a collection of podcasts for moms and dads. It includes PediaCast along with many others. No affiliation there but there is a Parents On Demand, just a loose collection of podcast for parents. And you can find the programs in the app store, Google Play. The network's featured in iTunes you can subscribe easily to each show.

Speaking of those shows, when you might want to check out is the Expectful Podcast, if you're expecting a baby or you know someone who is. It's a pregnancy podcast. 

So you might to check out again, Expectful Podcast. Some recent episodes include #IHadAMiscarriage, Pregnancy Loss & Grief. It's an interview with clinical psychologist Dr. Jessica Zucker. Another one, Stronger Together with Fertility Educator Jake Anderson, and Fertility, Emotional Well-being, and Invitro Fertilization with Dr. Jaime Knopman and Dr. Sheeva Talebian, who both happen to be reproductive endocrinologists. 

0:56:25

So not necessarily your typical pregnancy podcasts, lots of interesting topics and expert guests. 

Now, this is true of any podcasts we talked about on this program. We don't endorse every idea presented because we don't control the content. And the Expectful Podcast has talked about things like home birth in the past. Certainly, not something I would endorse or encourage because I look at the risks and the benefits and my feeling is the risk of homebirth far outweigh the benefit. 

They didn't interview me to get my view although I would certainly explain it if they ask me to. That said, I'm not tossing the baby out with the bathwater either. There are many fantastic well-presented topics on the Expectful Podcast. I may not endorse everything they present, just as I would expect them not to endorse everything I present. But overall, I do think it's a worthwhile resource if you're expecting a baby. And I'll put a link to it for you so you can find it easily in the Show Notes for this episode, 399, again over at PediaCast.org.

0:57:25

Don't forget, we are also on social media, Facebook, Twitter, Google+, even Pinterest. So please do connect with us there and share our content with your own online audience, so they can hear about the program and access it easily.  

And of course, we really do appreciate those face-to-face referrals, just let your family, friends, neighbors, co-workers, babysitters, grandparents, anyone who has kids or takes care of kids. And, of course, that includes your child's teacher and his or her pediatric medical provider. 

And while you have their ear, let them know we have a program for them as well. It's called PediaCast CME. That stands for Continuing Medical Education. Similar to this program, we do turn up the science a couple of notches and offer free Category 1 Continuing Medical Education Credit for those who listen. Shows and details are available at the landing site for that program, PediaCastCME.org.

And that one's also on iTunes, Google Play, iHeart Radio, Spotify, most mobile podcast apps. Simply search for PediaCast CME. 

0:58:28

Thanks again for stopping by and until next time, this is Dr. Mike saying stay safe, stay healthy, and stay involved with your kids. So long, everyone. 

[Music] 

Announcer 2: This program is a production of Nationwide Children's. Thanks for listening. We'll see you next time on PediaCast.  

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