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As of early June, Minnesota’s measles outbreak has led to more confirmed cases than in all of the United States in 2016.


Minneapolis’s Somali population, in which vaccination rates have sharply decreased throughout the last decade, has seen the majority of the measles cases. In 2014, their vaccination rate was just 42 percent, significantly less than the 95 percent needed to ensure herd immunity.

Part of the reason for that decrease, experts suggest, is the lectures Andrew Wakefield gave to Minneapolis’s Somali community in 2010 and 2011 about the dangers of vaccination.

You may not be familiar with Wakefield’s name, but you’re likely familiar with his most impactful work: linking vaccines and autism. For vaccine skeptics, that work makes him a hero. For vaccine proponents, that makes him a villain.

This article is not another contribution to the larger debate nor is it a judgment of people on either side. Yelling at each other on the Internet is not going to solve the “problem” of vaccines, whether you view the problem as an increasingly unvaccinated population or an increasingly vaccinated one.

Instead, this article focuses on how a single scientific study had such an outsized impact on how the world understands vaccines and autism, and draws out five research lessons all parents can learn from that study.

The link between vaccines and autism

In February 1998 the British medical journal, The Lancet, published Wakefield’s article, “Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children.” You wouldn’t expect a paper with that title to generate decades of impassioned fighting over vaccine policy. You probably wouldn’t even expect that of its main finding: that children’s bowel disorders, which might be causing autism, were “generally associated in time with environmental triggers.”

However, if you’d listened to the press conference about that paper, you would have heard Wakefield asserting his belief that the measles, mumps, and rubella (MMR) vaccine was causing autism.

Retraction and disbarment

Even without the fraudulent behavior that led to the paper’s eventual retraction, Wakefield’s work would not have been considered very strong science. First, the study enrolled 12 children. That is an impossibly small size from which to draw any conclusions. The study mostly relied on parents’ narration of events, which is not generally considered strong evidence.

In an editorial that also ran in that February 1998 issue of The Lancet, Robert Chen and Frank DeStefano critiqued Wakefield’s reasoning. They pointed to the millions of vaccinated children around the world who had not experienced gastrointestinal problems. They raised concerns with Wakefield’s data collection, which relied heavily on parents’ memories of events. They warned that correlation of an autism diagnosis with the timing of the MMR vaccine did not mean that one caused the other.

The last paragraph of Chen and DeStefano’s critique is eerily prescient. They feared that without a careful system of rigorous measurement, the vaccine-safety fears stoked by papers like Wakefield’s “may snowball into societal tragedies when the media and the public confuse association with causality and shun immunisation.”

Chen and DeStefano’s concerns were echoed by other researchers and physicians at the time Wakefield’s article was published. Even greater concerns emerged once The Lancet’s editorial staff began investigating ethical claims about Wakefield’s research. By 2010, when Wakefield was giving those lectures targeted at the Somali population of Minneapolis, his article was being retracted and he was being banned from practicing medicine in the U.K.

The Lancet’s editorial staff retracted the article for two main reasons. First, Wakefield and co-authors claimed that the children who participated in the study were “consecutively referred,” meaning that they were chosen as they came and that no eligible participants were selected. That turned out not to be true. Second, Wakefield and co-authors claimed that they had received permission from local ethics boards to conduct the study when they had not.

After the retraction, other investigators found even more serious issues, such as Wakefield’s undisclosed role in a lawsuit against MMR vaccine manufacturers and his falsification of data in each of the 12 cases included in his study.

The aftermath

Wakefield’s disbarment doesn’t appear to have slowed him down. In 2016, he released “Vaxxed: From Coverup to Catastrophe.” The promotional website describes him as “an academic gastroenterologist” before listing his degrees, accolades, and publications.

Despite that description, Andrew Wakefield is not an academic gastroenterologist. He is a disbarred gastroenterologist, disallowed from practicing medicine in both his home country and unlicensed to practice medicine in the United States. He is not employed by an academic medical center. Those details don’t appear until six paragraphs later, so only the most thorough readers are likely to see that information.

In the documentary (and basically to whatever journalist will interview him), Wakefield defends his research and his integrity, noting that he never said that he’d proven a link between the MMR vaccine and autism. But, as Susan Dominus puts it in the New York Times, “his concerns, not his caveats, ricocheted around the world.”

So now here we are in June 201 with a measles outbreak in Minnesota. In an interview for The Washington Post, Wakefield claimed that the Somali community of Minneapolis “had decided themselves that they were particularly concerned” about vaccines. “I was responding to that,” he states. In its coverage of the outbreak, Vox’s Julia Belluz explains what Wakefield imagines himself to be doing: “he’s just giving concerned parents information they want.”

Maybe concerned parents shouldn’t always get what they want.

Five research traps to avoid

You don’t have to look hard for “evidence” that vaccines cause autism, because Wakefield will pop up right at the top of your search results. If you want to build a case that vaccines are dangerous, you can get what you want.

Your child isn’t likely to suffer from this choice, at least not directly. The reason that Minneapolis’s measles cases now outnumber the entire U.S.’s measles cases from 2016 is that, overall, the rate of measles is incredibly low. Even if you choose not to vaccinate, your child isn’t likely to contract any of the diseases that those vaccinations have been designed to ward off, because many other parents will be picking up the slack in establishing herd immunity.

What suffers is science and reason. In a world where the accusations of “fake news” and “alternative facts” are feverishly lobbed at those who disagree with us, it’s more important than ever for parents to model good scientific literacy and critical thinking. It is our obligation as parents to educate ourselves, not about a specific issue like vaccines, but about how to do high-quality research. That education will help us make sense of the seemingly contradictory results in our Google searches.

Trap #1: Googling a yes or no question

Wakefield’s Lancet paper appears to have been built on a yes or no question he already “knew” the answer to. He looked for evidence that a vaccine caused a bowel issue that caused autism, and guess what? He “found” it.

The same basic principle applies to your own research. If you’re asking a yes or no question, you probably already have an answer in mind. If you Google that yes or no question, you will find whichever answer you’re looking for, because it’s incredibly difficult to consider contradictory evidence if you’ve already answered your question.

Of course, it’s impossible to be completely open-minded about the question you’re researching, especially if you’re researching about your own child’s illness. But you can open up your research question by phrasing it in terms of “how” or “why.”

Trap #2: Mistaking correlation for causation

Wakefield’s subjects may very well have had diagnosable autism and diagnosable bowel disorders. They may also have had MMR vaccines near the timing of those other symptoms.

Even if this was the case, the correlation of those conditions is not proof of causation.

Humans are really powerful storytellers. It’s well-documented that we see patterns even when none exist. When we read about medical tragedies online, it’s really easy to connect the dots and decide what caused it, but there are countless other details missing that could help complete the picture.

When conducting your own research, don’t settle for the first cause you find. Or better yet, focus less on what may have caused a medical problem (you don’t have the lab equipment to make that determination, anyway) and instead focus on what to do about symptoms.

Trap #3: Focusing on newsworthy numbers

Humans may be good storytellers, but we are lousy unaided statisticians. When we see an one-in-a-million chance, we tend to see ourselves in the “one” rather than in the “one million.” Or we see a scary sounding conclusion and forget to look at the sample size.

Even if Wakefield’s sample wasn’t compromised, even if his research methods were pure, he only studied 12 children. That’s an incredibly small number to base any conclusion on, especially given the millions of children who have received vaccinations without developing either bowel problems or autism.

When you see stats reported in the news, pause and consider them in context.

Trap #4: Not identifying “they”

In her profile of Wakefield, Susan Dominus mentions his use of a powerful rhetorical tool: “He said he believes that ‘they’ – public-health officials, pharmaceutical companies – pay bloggers to plant vicious comments about him on the Web.”

Even as the medical community was rejecting him, Wakefield’s work continued to gain popularity. Perhaps that’s because of the very scary “they.” Invoking a mysterious other, with potentially impure motives, is a sure way to pull people over to your side. “They” don’t want people to see the research. “They” have money to gain from the existence of vaccines. “They” gain from making vaccine federal policy.

Now imagine that you are a parent to a child with an autism diagnosis. You’re probably also really angry with some amorphous “they.” “They” told you vaccines were safe. “They” didn’t tell you about Wakefield’s work. “They” didn’t catch the warning signs early enough. It’s easy to put your “they” and Wakefield’s “they” together.

In your own research, if you’re seeing frequent references to whatever “they” don’t want you to know, be skeptical. Define “they.” Ask yourself what “they” really have to gain from this supposed deception.

Trap #5: Failing to ask why you’re researching in the first place

Wakefield has defended the conflict-of-interest allegation against him, arguing that none of the money he received from law firms arguing against MMR vaccine manufacturers went to funding the 1998 Lancet paper. Even if that was true, he cannot be an impartial observer of the evidence because his erstwhile employers had something to gain if he concluded in their favor.

Parents who conduct research without asking themselves why they’re doing it may face similar conflicts of interest. It’s hard to be honest with yourself, but asking hard questions about your own research motives can help you avoid most common research traps. Has your child just received a scary diagnosis and you’re looking for comfort? Are you looking for someone to blame? Are you looking to find evidence to win a fight with your spouse or mother-in-law? Those circumstances don’t mean you will do bad research, but they can interfere with your interpretation. Making your own biases clear can help you steer clear of sources that cater to those biases.

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When you become a parent for the first time, there is an undeniably steep learning curve. Add to that the struggle of sorting through fact and fiction when it comes to advice and—whew—it's enough to make you more tired than you already are with that newborn in the house.

Just like those childhood games of telephone when one statement would get twisted by the time it was told a dozen times, there are many parenting misconceptions that still tend to get traction. This is especially true with myths about bottle-feeding—something that the majority of parents will do during their baby's infancy, either exclusively or occasionally.

Here's what you really need to know about bottle-feeding facts versus fiction.

1. Myth: Babies are fine taking any bottle

Not all bottles are created equally. Many parents experience anxiety when it seems their infant rejects all bottles, which is especially nerve wracking if a breastfeeding mom is preparing to return to work. However, it's often a matter of giving the baby some time to warm up to the new feeding method, says Katie Ferraro, a registered dietician, infant feeding specialist and associate professor of nutrition at the University of California San Francisco graduate School of Nursing.

"For mothers returning to work, if you're breastfeeding but trying to transition to bottle[s], try to give yourself a two- to four-week trial window to experiment with bottle feeding," says Ferraro.

2. Myth: You either use breast milk or formula

So often, the question of whether a parent is using formula or breastfeeding is presented exclusively as one or the other. In reality, many babies are combo-fed—meaning they have formula sometimes, breast milk other times.

The advantage with mixed feeding is the babies still get the benefits of breast milk while parents can ensure the overall nutritional and caloric needs are met through formula, says Ferraro.

3. Myth: Cleaning bottles is a lot of work

For parents looking for simplification in their lives (meaning, all of us), cleaning bottles day after day can sound daunting. But, really, it doesn't require much more effort than you are already used to doing with the dishes each night: With bottles that are safe for the top rack of the dishwasher, cleaning them is as easy as letting the machine work for you.

For added confidence in the sanitization, Dr. Brown's offers an incredibly helpful microwavable steam sterilizer that effectively kills all household bacteria on up to four bottles at a time. (Not to mention it can also be used on pacifiers, sippy cups and more.)

4. Myth: Bottle-feeding causes colic

One of the leading theories on what causes colic is indigestion, which can be caused by baby getting air bubbles while bottle feeding. However, Dr. Brown's bottles are the only bottles in the market that are actually clinically proven to reduce colic thanks to an ingenious internal vent system that eliminates negative pressure and air bubbles.

5. Myth: Bottles are all you can use for the first year

By the time your baby is six months old (way to go!), they may be ready to begin using a sippy cup. Explains Ferraro, "Even though they don't need water or additional liquids at this point, it is a feeding milestone that helps promote independent eating and even speech development."

With a complete line of products to see you from newborn feeding to solo sippy cups, Dr. Brown's does its part to make these new transitions less daunting. And, for new parents, that truly is priceless.

This article was sponsored by Dr. Brown's. Thank you for supporting the brands that support Motherly and mamas.

Three was not enough for Kim Kardashian and Kanye West. Mom and dad to North, Saint and Chicago are expecting again.

The story broke earlier this month, but this week Kim appeared on "Watch What Happens Live with Andy Cohen" and confirmed everything People and E! have been attributing to inside Kardashian sources.

Host Andy Cohen, a father-to-be himself, asked Kim to confirm if the leaked sex of the baby was also accurate.

    "It's a boy," Kim told him, revealing that she's the accidental source of the leak. "It's out there. I got drunk at our Christmas Eve party, and I told some people, but I can't remember who I told."

    Like Chicago, this baby will be born via surrogate, and Kim says he's due quite soon.

    Kim has previously talked about how the decision to grow her family through gestational surrogacy was a hard one, but the only one that made sense for her after two difficult pregnancies.

    "Anyone that says or thinks it is just the easy way out is just completely wrong. I think it is so much harder to go through it this way, because you are not really in control," she told Entertainment Tonight when expecting Chicago.

    "Obviously you pick someone that you completely trust and that you have a good bond and relationship with, but it is still … knowing that I was able to carry my first two babies and not my baby now, it's hard for me," she explained at the time.

    One of six kids herself, it's not surprising that Kim wants a large family (considering how close she is with her siblings) and, according to Kim, Kanye's been campaigning for more children for a while.

    "Kanye wants to have more, though. He's been harassing me," Kardashian said on a 2018 episode of Keeping Up With the Kardashians. "He wants like seven. He's like stuck on seven."

    Four is still pretty far from seven, but maybe Kanye and Kim will compromise a bit on family size. Kim has previously said four children would be her limit.

    [Update: This post was originally published on January 2, 2019. It was updated when Kardashian confirmed the news.]

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    Toxic masculinity is having a cultural moment. Or rather, the idea that masculinity doesn't have to be toxic is having one.

    For parents who are trying to raise kind boys who will grow into compassionate men, the American Psychological Association's recent assertion that "traditional masculinity ideology" is bad for boys' well-being is concerning because our kids are exposed to that ideology every day when they walk out of then house or turn on the TV or the iPad.

    That's why a new viral ad campaign from Gillette is so inspiring—it proves society already recognizes the problems the APA pointed out, and change is possible.

    We Believe: The Best Men Can Be | Gillette (Short Film) youtu.be

    Gillette's new ad campaign references the "Me Too" movement as a narrator explains that "something finally changed, and there will be no going back."

    If may seem like something as commercial as a marketing campaign for toiletries can't make a difference in changing the way society pressures influence kids, but it's been more than a decade since Dove first launched its Campaign for Real Beauty, and while the campaign isn't without criticism, it was successful in elevating some of the body-image pressure on girls but ushering in an era of body-positive, inclusive marketing.

    Dove's campaign captured a mainstream audience at a time when the APA's "Guidelines for Psychological Practice with Girls and Women" were warning psychologists about how "unrealistic media images of girls and women" were negatively impacting the self-esteem of the next generation.

    Similarly, the Gillette campaign addresses some of the issues the APA raises in its newly released "Guidelines for the Psychological Practice with Boys and Men."

    According to the APA, "Traditional masculinity ideology has been shown to limit males' psychological development, constrain their behavior, result in gender role strain and gender role conflict and negatively influence mental health and physical health."

    The report's authors define that ideology as "a particular constellation of standards that have held sway over large segments of the population, including: anti-femininity, achievement, eschewal of the appearance of weakness, and adventure, risk, and violence."

    The APA worries that society is rewarding men who adhere to "sexist ideologies designed to maintain male power that also restrict men's ability to function adaptively."

    That basically sounds like the recipe for Me Too, which is of course its own cultural movement.

    Savvy marketers at Gillette may be trying to harness the power of that movement, but that's not entirely a bad thing. On its website, Gillette states that it created the campaign (called "The Best a Man Can Be," a play on the old Gillette tagline "The Best a Man Can Get") because it "acknowledge that brands, like ours, play a role in influencing culture."

    Gillette's not wrong. We know that advertising has a huge impact on our kids. The average kid in America sees anywhere from 13,000 to 30,000 commercials on TV each year, according to the American Academy of Paediatrics, and that's not even counting YouTube ads, the posters at the bus stop and everything else.

    That's why Gillette's take makes sense from a marketing perspective and a social one. "As a company that encourages men to be their best, we have a responsibility to make sure we are promoting positive, attainable, inclusive and healthy versions of what it means to be a man," the company states.

    What does that mean?

    It means taking a stance against homophobia, bullying and sexual harassment and that harmful, catch-all-phrase that gives too many young men a pass to engage in behavior that hurts others and themselves: "Boys will be boys."

    Gillette states that "by holding each other accountable, eliminating excuses for bad behavior, and supporting a new generation working toward their personal 'best,' we can help create positive change that will matter for years to come."

    Of course, it's not enough for razor marketers to do this. Boys need support from parents, teachers, coaches and peers to be resilient to the pressures of toxic masculinity.

    When this happens, when boys are taught that strength doesn't mean overpowering others and that they can be successful while still being compassionate, the APA says we will "reduce the high rates of problems boys and men face and act out in their lives such as aggression, violence, substance abuse, and suicide."

    This is a conversation worth having and 2019 is the year to do it.

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    Teaching a young child good behavior seems like it should be easy and intuitive when, in reality, it can be a major challenge. When put to the test, it's not as easy as you might think to dole out effective discipline, especially if you have a strong-willed child.

    As young children develop independence and learn more about themselves in relation to others and their environment, they can easily grow frustrated when they don't always know how to communicate their feelings or how to think and act rationally.

    It's crucial that parents recognize these limitations and also set up rules to protect your child and those they encounter. These rules, including a parent's or caregiver's follow-up actions, allow your child to learn and develop a better understanding of what is (and what is not) appropriate behavior.

    Here are a few key ways to correct negative behavior in an efficient way:

    1. Use positive reinforcement.

    Whenever possible, look to deliver specific and positive praise when a child engages in good behavior or if you catch them in an act of kindness. Always focus on the positive things they are doing so that they are more apt to recreate those behaviors. This will help them start to learn the difference between good and poor behavior.

    2. Be simple and direct.

    Though this seems like a no-brainer, focus your child using constructive feedback versus what not to do or where they went wrong. Give reasons and explanations for rules, as best as you can for their age group.

    For example, if you're teaching them to be gentle with your pet, demonstrate the correct motions and tell your child, "We're gentle when we pet the cat like this so that we don't hurt them," versus, "Don't pull on her tail!"

    3. Re-think the "time out."

    Many classrooms are starting to have cozy nooks where children are encouraged to have alone time when they may feel out of control. In lieu of punishment, sending a child to a "feel-good" area removes them from a situation that's causing distress. This provides much-needed comfort and allows for the problem-solving process to start on its own.

    4. Use 'no' sparingly.

    When a word is repeated over and over, it begins to lose meaning. There are better ways to discipline your child than saying "no." Think about replaying the message in a different way to increase the chances of your child taking note. Rather than shouting, "No, stop that!" when your toddler is flinging food at dinnertime, it's more productive to use encouraging words that prompt better behavior, such as, "Food is for eating, what are we supposed to do when we're sitting at the dinner table?" This encourages them to consider their behavior.

    The above methods help create teachable moments by providing opportunities for development while making sure the child feels safe and cared for. It is important to mirror these discipline techniques at home and communicate often with your child care providers so that you're always on the same page.

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    To the mamas awake in the middle of the night,

    If you are one of the many moms with a little darling who doesn't sleep through the night, I feel your pain. I really do.

    Having been blessed with two wonderful sleepers (aka my first and second babies), my third baby has been a shock to my system. He hasn't slept through the night since he was born and he's now 16 months. I do everything "right." I put him down sleepy but awake so he can settle himself to sleep. I keep the room dark and quiet.

    But one simple fact remains: When my son wakes up in the night, he wants me. And he'll scream the house down if he doesn't get me.

    Last night my 1-year-old woke at 3:30 am. He was stirring a bit at first, then started to really let it rip, so I got him up out of his crib and brought him into bed with me. We cuddled for a while. Then suddenly, he wanted to get off the bed and I said no. Then he started to scream and throw himself around on the bed before eventually being sick everywhere.

    It was now 4:30 am. I dutifully changed the sheets, changed my son, changed myself, and then we climbed back into bed, the smell of vomit still lingering.

    I tried to put him back in his crib around 5 am but he woke right up. I brought him back into bed with me, but quickly realized this wasn't what he wanted either. He was thrashing around again, trying to figure out a way off of the bed.

    Finally, close to 6 am he decided he wanted to go to sleep. After about 10 minutes of watching him sleep, I felt brave enough to try to put him back in his room. I gently lifted him up, placed him in his crib and quietly crept back into my bed.

    This left me with just enough time to fall back into a deep sleep, which meant I felt exhausted when my alarm went off just after 7 am.

    Sadly, last night wasn't a one-off. This is a fairly frequent occurrence for me (although dealing with vomit is luckily quite rare!). Which means that when I say I understand what it's like to have a baby who doesn't sleep, I really mean it.

    So here's what I want you to know, mama.

    If you are awake in the night because your baby needs you then you are not alone. Despite what you might read, it's common for babies to wake up through the night. So if you're sitting in bed feeling like you're the only mother in the world awake, trust me, you're far from it.

    There are mamas like us all over the world. Sitting there in the dark. Cuddling babies or soothing them to sleep again. Some, like me, might be changing sheets or abandoning any hope of getting sleep that night at all. Others might be up and down like a yo-yo every few hours. The rest might just be up once and then will be able to go back to sleep.

    There will, however, also be mamas who are sound asleep. Mamas who have older children who no longer wake in the night. And they would want you to know that it will be okay. It won't be forever. One day, you'll realize that your baby no longer needs or wants you in the night.

    And while you'll be so glad for your sleep you'll probably also be a little sad that there are no more night time cuddles.

    It's hard to cope with a baby who doesn't sleep well at night. Really hard sometimes. You may feel like you can't deal with it anymore or you may be wishing that this phase would just stop already so you can get some rest.

    Exhaustion often means that you struggle to get through the day. It can mean that you find it hard to drag yourself out of bed. Or if you're anything like me, you might be irritable and snap at the people you love. Or maybe it means relying on caffeine, sugar and Netflix to get you and your kiddos through the day.

    But here's the amazing thing about mothers—no matter what has gone down during the night, we get up as usual. We go about our day just like everyone else. We care for and love our children, without giving them a hard time for disrupting our sleep. We don't moan, we don't complain. We just get on with it.

    And when night comes, we go to bed knowing that there's every chance we'll be awake in the middle of the night again...

    We get up without fail when our babies need us and we do what we need to do for them. Because we are the nighttime warriors. We are mamas.

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