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“I wonder how we can get them to sleep more.”


This simple thought, expressed by my wife, not even a question, became a challenge to me. My engineer mind took this as a problem to be solved, and when a software developer sees a problem, they devise tests. Luckily, I knew the perfect system for testing out some ideas in a controlled and measurable setting. And with twins, testing would be even easier. Welcome to parenting, A/B testing style.

A/B testing is used all over the web. You likely encounter it dozens, if not hundreds of times a day, without even noticing it. All the big tech companies do it, using it as a tool to test the performance of ideas and measure them.

Google is famous for testing 41 shades of blue for search results. Designers allegedly couldn’t decide which of two shades to use, so they tested 41 in total to see which led to the more users clicking on the results.

Facebook tests different experiences within the feed constantly. Amazon even changes around the buy buttons and cart layouts fairly often. You may notice these if you ever log in from a new computer or see a friend using a site that looks subtly different from yours.

A/B testing is used to test one or more “treatments” or experiments over a “control” or the existing experience. A metric is measured, usually based on a user action such as a click through or “conversion” with a baseline against the control.

For the Google example, they might test the likelihood of users clicking through to at least one result with the different shade. After a statistically significant period of time, often a week or two, whichever experience has a better rate will be chosen as the winner and becomes the new control.

Where this gets really complicated is when multiple experiments are run at the same time or when the percentage of users is not equally split. Here a complicated knowledge of statistics is needed. Or the use of any of the many powerful testing tools available. At Audible and Amazon, we test experiences like this all the time. It’s the best way to see how users actually behave as often what users say they will do and what they do can be slightly different.

At Audible and Amazon, we test experiences like this all the time. It’s the best way to see how users actually behave, as often, what users say they will do and what they do can be slightly different.

Charting results

I decided to use this method of testing with the boys to see if we could increase the most important metric in the house, as anyone with 10-week old children, especially twins, knows: sleep times. Using one of the boys as a control and the other as the treatment – nevermind the fact that no one would describe any part of our lives right now with the words “control” or “treatment” – I tested several theories about length of sleep, baselined against the control.

In any experiment, accurate measurement and data tracking are critical. Often a success metric is chosen due to the availability of data or measurability. You don’t want to be trying to measure something that takes longer to measure than it does to change the test or test input. Luckily measuring sleep is about as easy as it gets.

When they wake up at night, we just write it down. This is exactly what we’ve been doing since the day they were born as the nurses at the hospital instructed us. We’ve gone through several notebooks already, but it’s so easy to track. For this, we even started importing the data into a spreadsheet to see the impact more visually.

 

Big Data

First, we tested increasing the amount given at the feeding immediately before bedtime. Instead of the normal four ounces, we tried five, then six. To prevent bias from one child, we alternated who was the test and who was the control since they seem to be on alternating cycles. While one child had a larger evening feeding, the other would stay at four ounces. The result: inconclusive.
Both children seemed to start increasing length of sleep anyway during this period. They both slept almost the exact same length of time as well. There was one night where an increased feeding correlated with a record 5.5 hour stretch of sleep, but one data point is insignificant in this dataset.
It was also hard to continue testing this as anything beyond five ounces had a high likelihood of being spit out a few minutes after eating.

Next was a secret whispered about in the dark corners of parent blogs around the web and passed from parent to fellow parent, at least in my office, gripe water. Ok maybe it isn’t that much of a secret, but it took us a while to try it. Supposedly this mix of herbs and spices, as opposed to KFC’s blend, would settle stomachs from reflux and gas, especially overnight, resulting in longer sleep.

After a week of testing, we found it did actually help with reflux, especially spit ups, and though we didn’t track individual burps or farts, seemed to reduce them as well. The length of sleep was not impacted much, though. We did see a small increase on average, between 20 and 30 minutes, but again this may have been natural increases due to age.

No reflux equals a happy baby

After gripe water, which became the new control, we tested an extra feeding before bed. The boys were starting to do this naturally on their own, anyway, and we had been trying to prevent it. However, it seemed like an opportunity ripe for testing, so we gave it a shot. Many children will “cluster” feed before bed, with a second feeding only a short time after the previous one. We did this feeding about 1.5 to 2 hours after the previous, compared to 3 hours normally. In this feeding, we tried 4 ounces compared with the 4–5 they normally take during daytime feedings. Sometimes they would refuse to take more than 3. Of all the experiments, this seemed to work best. We saw increases in up to an extra hour of sleep as a result, though often not until a few days into the experiment, apparently this takes time to affect sleep patterns. A good lesson for A/B tests is that sometimes there is a several day adjustment period while people figure out the new treatment and adjust. It’s important to capture both the adjustment period results and the post-adjustment ones, though. Apple has famously neglected the adjustment period on several product launches, notably maps.

Last, we tested keeping them awake longer during the day. Our hypothesis was that they would therefore, be more tired at night and would sleep longer as a result. This may have been slightly true, we saw minor increases in length of sleep, but we didn’t account for the stress and exhaustion it would cause by keeping them awake and making them unhappy. It also took significantly longer to get them to settle down and sleep at night as they were overtired and fussy. The lesson for testing: don’t sacrifice other metrics for a small gain in one.

You can’t make me sleep!

Many of these tests were inconclusive. This is largely due to the sample size. With a sample population like Facebook, tests can be done in small segments and achieve statistical significance very quickly. With twins, it’s hard to know what is a real result and what is personality or natural progression. In order to more accurately test, we may need to increase the sample size. Triplets would come in handy for this. Maybe someone else’s triplets though, we are definitely not ready for that!

This also shows the importance of the test, measure, iterate process. Though several of the methods didn’t show large improvements, put together they may. By using the treatment as the control when it outperforms the control, small improvements get stacked. By continuing to try new things quickly and moving on, it’s easy to come up with new ideas to try. You don’t need to move the mountain, just move little handfuls of dirt over a long time. With this approach to parenting, the boys can continuously grow as well. And with luck, so will our sanity, well-being, and lives as parents.

This piece was originally published on Dad On The Run.

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We spend a lot of time prepping for the arrival of a baby. But when it comes to the arrival of our breast milk (and all the massive adjustments that come with it), it's easy to be caught off guard. Stocking up on a few breastfeeding essentials can make the transition to breastfeeding a lot less stressful, which means more time and energy focusing on what's most important: Your recovery and your brand new baby.

Here are the essential breastfeeding tools you'll need, mama:

1. For covering up: A cute nursing cover

First and foremost, please know that all 50 states in the United States have laws that allow women to breastfeed in public. You do not have to cover yourself if you don't want to—and many mamas choose not to—and we are all for it.

That said, if you do anticipate wanting to take a more modest approach to breastfeeding, a nursing cover is a must. You will find an array of styles to choose from, but we love an infinity scarf, like the LK Baby Infinity Nursing Scarf Nursing Cover. You'll be able to wear the nursing cover instead of stuffing it in your already brimming diaper bag—and it's nice to have it right there when the baby is ready to eat.

Also, in the inevitable event that your baby spits-up on you or you leak some milk through your shirt, having a quick and stylish way to cover up is a total #momwin.

2. For getting comfortable: A cozy glider

Having a comfy spot to nurse can make a huge difference. Bonus points if that comfy place totally brings a room together, like the Delta Children Paris Upholstered Glider!

Get your cozy space ready to go, and when your baby is here, you can retreat from the world and just nurse, bond, and love.

3. For unmatched support: A wire-free nursing bra

It may take trying on several brands to find the perfect match, but finding a nursing bra that you love is 100% worth the effort. Your breasts will be changing and working in ways that are hard to imagine. An excellent supportive bra will make this so much more comfortable.

It is crucial to choose a wireless bra for the first weeks of nursing since underwire can increase the risk of clogged ducts (ouch).The Playtex Maternity Shaping Foam Wirefree Nursing Bra is an awesome pick for this reason, and because it is designed to flex and fit your breasts as they go through all those changes.

4. For maximum hydration: A large reusable water bottle

Nothing can prepare you for the intense thirst that hits when breastfeeding. Quench that thirst (and help keep your milk supply up in the process) by always having a water bottle with a straw nearby, like this Exquis Large Outdoor Water Bottle.

5. For feeding convenience: A supportive nursing tank

Experts recommend that during the first weeks of your baby's life, you breastfeed on-demand, meaning that any time your tiny boss demands milk, you feed them. This will help establish your milk supply and get everything off to a good start.

What does this mean for your life? You will be breastfeeding A LOT. Nursing tanks, like the Loving Moments by Leading Lady, make this so much easier. They have built-in support to keep you comfy, and you can totally wear them around the house, or even out and about. When your baby wants to eat, you'll be able to quickly "pop out" a breast and feed them.

6. For pain prevention: A quality nipple ointment

Breastfeeding shouldn't hurt, but the truth is those first days can be uncomfortable. Your nipples will likely feel raw as they adjust to their new job. This will get better! But until it does, nipple ointment is amazing.

My favorite is the Earth Mama Organic Nipple Butter. We love that it's organic, and it is oh-so-soothing on your hard-at-work nipples.

Psst: If it actually hurts when your baby latches on, something may be up, so call your provider or a lactation consultant for help.

7. For uncomfortable moments: A dual breast therapy pack

As your breasts adjust to their new role, you may experience a few discomforts—applying warmth or cold can help make them feel so much better. The Lansinoh TheraPearl 3-in-1 Breast Therapy Pack is awesome because you can microwave the pads or put them in the freezer, giving you a lot of options when your breasts need some TLC.

Again, if you have any concerns about something being wrong (pain, a bump that may be red or hot, fever, or anything else), call a professional right away.

8. For inevitable leaks: An absorbing breast pad

In today's episode of, "Oh come on, really?" you are going to leak breastmilk. Now, this is entirely natural and you are certainly not required to do anything about this. Still, many moms choose to wear breast pads in their bras to avoid leaking through to their shirts.

You can go the convenient and disposable route with Lansinoh Disposable Stay Dry Nursing Pads, or for a more environmentally friendly option, you can choose washable pads, like these Organic Bamboo Nursing Breast Pads.

9. For flexibility: A breast pump

Many women find that a breast pump becomes one of their most essential mom-tools. The ability to provide breast milk when you are away from your baby (and relieve uncomfortable engorged breasts) will add so much flexibility into your new-mom life.

For quick trips out and super-easy in-your-bag transport, opt for a manual pump like the Lansinoh Manual Breast Pump .

If you will be away from your baby for longer periods of time (traveling or working outside the home, for example) an electric pump is your most efficient bet. The Medela Pump In Style Advanced Double Electric Breast Pump is a classic go-to that will absolutely get the job done, and then some.

10. For quality storage: Breast milk bags

Once you pump your liquid gold, aka breast milk, you'll need a place to store it. The Kiinde Twist Pouches allow you to pump directly into the bags which means one less step (and way less to clean).

11. For keeping cool: A freezer bag

Transport your pumped milk back home to your baby safely in a cooler like the Mommy Knows Best Breast Milk Baby Bottle Cooler Bag. Remember to put the milk in a fridge or freezer as soon as you can to optimize how long it stays usable for.

12. For continued nourishment: Bottles

Nothing beats the peace of mind you get when you know that your baby is being well-taken of care—and well fed—until you can be together again. The Philips Avent Natural Baby Bottle Newborn Starter Gift Set is a fan favorite (mama and baby fans alike).

This article is sponsored by Walmart. Thank you for supporting the brands that support Motherly and mamas.

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Motherly is committed to covering all relevant presidential candidate plans as we approach the 2020 election. We are making efforts to get information from all candidates. Motherly does not endorse any political party or candidate. We stand with and for mothers and advocate for solutions that will reduce maternal stress and benefit women, families and the country.

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A viral video about car seat safety has parents everywhere cracking up and humming Sir-Mix-A-Lot.

"I like safe kids and I cannot lie," raps Norman Regional Health System pediatric hospitalist Dr. Kate Cook (after prefacing her music video with an apology to her children."I'm a doctor tryin' warn you that recs have changed," she continues.

Dr. Cook's rap video is all about the importance of keeping babies facing backward. It's aptly called "Babies Face Back," and uses humor and parody to drive home car seat recommendations from the American Academy of Pediatrics (AAP).

"Switching from rear-facing to forward-facing is a milestone many parents can't wait to reach," Dr. Cook said in a news release about her hilarious video. "But this is one area where you want to delay the transition as long as possible because each one actually reduces the protection to the child."

Last summer the AAP updated its official stance on car seat safety to be more in line with what so many parents were already doing and recommended that kids stay rear-facing for as long as possible. But with so many things to keep track of in life, it is understandable that some parents still don't know about the change. Dr. Cook wants to change that with some cringe-worthy rapping.

The AAP recommends:

  • Babies and toddlers should ride in a rear-facing car safety seat as long as possible, until they reach the highest weight or height allowed by their seat.
  • Once they are facing forward, children should use a forward-facing car safety seat with a harness for as long as possible. Many seats are good up to 65 pounds.
  • When children outgrow their car seat they should use a belt-positioning booster seat until the vehicle's lap and shoulder seat belt fits properly, between 8 and 12 years old.

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[Editor's note: Motherly is committed to covering all relevant presidential candidate plans as we approach the 2020 election. We are making efforts to get information from all candidates. Motherly does not endorse any political party or candidate. We stand with and for mothers and advocate for solutions that will reduce maternal stress and benefit women, families and the country.]

Suicide rates for girls and women in the United States have increased 50% since 2000, according to the CDC and new research indicates a growing number of pregnant and postpartum women are dying by suicide and overdose. Suicide rates for boys and men are up, too.

It's clear there is a mental health crisis in America and it is robbing children of their mothers and mothers of their children.

Medical professionals urge people to get help early, but sometimes getting help is not so simple. For many Americans, the life preserver that is mental health care is out of reach when they are drowning.

Democratic presidential candidate Pete Buttigieg just released a plan he hopes could change that and says the neglect of mental health in the United States must end. "Our plan breaks down the barriers around mental health and builds up a sense of belonging that will help millions of suffering Americans heal," says Buttigieg.

He thinks he can "prevent 1 million deaths of despair by 2028" by giving Americans more access to mental health and addictions services.

In a country where giving birth can put a mother in debt, it's not surprising that while as many as 1 in 5 new moms suffers from perinatal mood and anxiety disorders, more than half of new moms who need mental health treatment don't get it. Stigma, childcare and of course costs are factors in why women aren't seeking help when they are struggling.

Buttigieg's plan is interesting because it could remove some of these barriers. He wants to make mental health care more affordable by ensuring everyone has comprehensive coverage for mental health care and by ensuring that everyone can access a free yearly mental health check-up.

That could make getting help more affordable for some moms, and by increasing reimbursement rates for mental health care delivered through telehealth, this plan could help moms get face time with a medical professional without having to deal with finding childcare first.

Estimates from new research suggest that in some parts of America as many as 14% or 30% of maternal deaths are caused by addiction or suicide. Buttigieg's plan aims to reduce those estimates by fighting the addiction and opioid crisis and increasing access to mental health services in underserved communities and for people of color. He also wants to reduce the stigma and increase support for the next generation by requiring "every school across the country to teach Mental Health First Aid courses."

These are lofty goals with a lofty price tag. It would cost about $300 billion to do what Buttigieg sets out in his plan and the specifics of how the plan would be funded aren't yet known. Neither is how voters will react to this 18-page plan and whether it will help Buttigieg stand out in a crowded field of Democratic candidates.

What we do know is that right now, America is talking about mental health and whether or not that benefits Buttigieg's campaign it will certainly benefit America.

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[Editor's Note: Welcome to It's Science, a Motherly column focusing on evidence-based explanations for the important moments, milestones, and phenomena of motherhood. Because it's not just you—#itsscience.]

If you breastfeed, you know just how magical (and trying) it is, but it has numerous benefits for mama and baby. It is known to reduce the likelihood of developing cardiovascular disease, type 2 diabetes, and rheumatoid arthritis, and cuts the risk of sudden infant death syndrome (SIDS) by half.

If this wasn't powerful enough, scientists have discovered that babies who are fed breast milk have a stomach pH that promotes the formation of HAMLET (Human Alpha-lactalbumin Made Lethal to Tumor cells). HAMLET was discovered by chance when researchers were studying the antibacterial properties of breast milk. This is a combination of proteins and lipids found in breast milk that can work together to kill cancer cells, causing them to pull away from healthy cells, shrink and die, leaving the healthy cells unaffected.

According to researchers at Lund University in Sweden, this mechanism may contribute to the protective effect breast milk has against pediatric tumors and leukemia, which accounts for about 30% of all childhood cancer. Other researchers analyzed 18 different studies, finding that "14% to 19% of all childhood leukemia cases may be prevented by breastfeeding for six months or more."

And recently, doctors in Sweden collaborated with scientists in Prague to find yet another amazing benefit to breast milk. Their research demonstrated that a certain milk sugar called Alpha1H, found only in breast milk, helps in the production of lactose and can transform into a different form that helps break up tumors into microscopic fragments in the body.

Patients who were given a drug based on this milk sugar, rather than a placebo, passed whole tumor fragments in their urine. And there is more laboratory evidence to support that the drug can kill more than 40 different types of cancer cells in animal trials, including brain tumors and colon cancer. These results are inspiring scientists to continue to explore HAMLET as a novel approach to tumor therapy and make Alpha1H available to cancer patients.

Bottom line: If you choose to breastfeed, the breast milk your baby gets from your hard work can be worth every drop of effort.

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