It’s most definitely the medical establishment.

There are similar issues with the “back to sleep” campaign - the risk of SIDS apparently is indeed Slightly lower for babies sleeping on their back, but it is only very slightly lower, and some babies will not sleep on their back unless they are exhausted which causes other non trivial issues. If you actually look into the “back to sleep” study data, it is much, much weaker than proponents imply it is.

And yet, every nurse in the hospital kept telling us with religious fervor to not even think of letting the baby fall asleep on their stomach. I was so impressed that I was sure the evidence was overwhelming. But after a week with a hardly sleeping newborn (relatively speaking), I decided to look into it myself. You should to, rather than trust the “experts”. (Or a random internet post like mine, for that matter)

I went and looked at a few studies. I did not find the same weakness of evidence that you described. E.g. [1] seems decently strong, to take just one example, although I'd be happy to be shown my error. I do agree that folks should examine the research for themselves, since it's so easy to do once you get practice. I also agree that the research on screen time is extraordinarily weak, and that there isn't really a good reason it has a causal negative impact on children as yet.

[1]: https://www.nejm.org/doi/full/10.1056/NEJM199308053290601

I am away from home on phone at this second, and likely have not kept my 10 year old notes, but from memory:

Strongest predictor of SIDS was mom’s education level, followed by whether or not she was smoking; stomach/back was third. It’s the strongest one that can (easily) be changed, but something is very fishy about the data.

Proponents point out the inverse correlation between sleeping on back and SIDS, starting at the time the recommendations were made, as proof that this is a causal relationship. However, inclusion of time prior to recommendation shows that SIDS is inverse correlated to time; and sleeping on back is positively correlated with time only after recommendations were made.

Also, it’s possible data in the last 10 years paints a different picture - but at the time, the case for causal “back to sleep” was very flimsy.

Fwiw the study I linked to is case controlled. It does not rely on the population timeseries you mentioned. I don't know the downfalls of case controlled trials, but they are not the same as population timeseries data I am certain.

Can't find my old notes, but found this graph on a quick google: https://www.cdc.gov/sids/data.htm

Note the decline in SIDS rate, which starts in 1988 (see e.g. https://pediatrics.aappublications.org/content/105/3/650 ), before the recommendation (1992) and "back to sleep" campaign (1994) and though it does track the decline of belly sleeping position, I found in the past graphs of belly sleeping from before 1986 in which it was essentially uncorrelated (or even inverse correlated, if you go back enough - but I don't trust that data).

But what's more alarming, is that although there is a continuing decline in SIDS, if you look at the combined SUID (Sudden Unexpected Infant Death) rate, it is essentially flat since 1996 (following a decline from 1990 as visible in the CDC graph, and which goes much farther IIRC). As a data scientist, this hints either (a) change of classification system that was not properly noted, or (b) that there's an underlying reason which causes infant death, which may manifest in different ways depending e.g. on whether the infant sleeps on their belly or their back.

As a new parent, this was terrifying (is anything really ever safe?) but also reassuring (the expert advice might technically be true, but seems to be useless).

I've found this over and over in many other cases - e.g., statins seem to reduce the change of a heart attack, but do nothing for (or even slightly increase) all cause mortality. Also financial advisers give advice which is technically correct but often useless.

Experts rarely qualify the limits of their advice, and that goes double when it is delivered 2nd hand (by nurses or even doctors who never bothered to look at the data but just parrot the official recommendations).

> As a data scientist, this hints either (a) change of classification system that was not properly noted, or (b) that there's an underlying reason which causes infant death, which may manifest in different ways depending e.g. on whether the infant sleeps on their belly or their back.

As a data scientist, you should really consider more than these two causes. For example, perhaps some other cause of infant deaths was rising during that same period. Or, perhaps there is a change in classification, AND there has been a saturation point reached in terms of how the existing public health initiatives can affect population behaviors. You really just cannot reason from coarse, population level death rates like this to a specific condition or cause.

Also: https://www.cdc.gov/sids/data.htm

The graph on that site very clearly shows that most of offsetting increase is caused by strangulation and suffocation, not an actual unexplained cause. It appears to be mostly a change in classification.

Finally, I really want to point out that we should not expect that a public information campaign would decrease SIDS rates to zero. After all, we can see in this thread that there are still plenty of parents who put their babies to sleep on their tummies. As far as most people know, the data could show that SIDS is 100% caused by prone sleeping and people would still doubt the evidence and put their child to sleep prone. SIDS rates would still not drop to zero, and that would not be evidence against the hypothetical cause.

I did consider more, and I looked much more deeply into it, as I mentioned though that was 10 years ago. Everything about the available data was weird - e.g. Mom’s education level came up in several studies as the strongest predictor inversely correlated with SIDS (but irrelevant in others) - controlled for the usual confounders of that input (smoking, salary, marital and spousal status, mother’s age).

And I started with saying that my conclusion was that it is likely safer for babies to sleep on their back from the SIDD/SUID perspective, but the evidence didn’t seem as conclusive or overwhelming as I was led to believe.

The hospital staff made it sound like letting my baby sleep on their tummy is signing their death warrant.

Do note, also, that prevalence of back sleeping went from less than 30% to more than 80% over the period graphed. One should not expect compliance from such a campaign in general, but (as far as medical compliance goes) a very good one was achieved. New parents are perhaps the most compliant group.

I am unlikely to dig as deep into the data again, but my well supported (I believe) conclusion at the time was that, all-cause-infant-mortality-wise, the recommendation may be somewhat justified, but the strength, might and terror in which it is given is definitely not.

I would be interested in seeing a data set for the risk of SIDS from cosleeping (even on the baby's back) vs. the risk of various other problems from indescribably exhausted parents and a baby who will scream bloody murder for hours and hours and hours and hours if you try to get them to sleep alone in a crib.

Also, not to be all hippie but would we not have evolved to want to be held as infants? What species just leaves its young to sleep without physical contact?

You won’t find it, likely. Also, on the recommendation against co-sleeping, I went looking for the actual data. What I found was not SIDS related, but deaths from being squashed, and quite a few of them. I managed to find a few case studies, and they all included a parent under the influence (alcohol mostly in cars I found) and obese parents.

Regardless of how true it is, the establishment cannot make a recommendation of the “Co sleeping is ok if you don’t drink, not overweight, and a light sleeper” kind, as many of the people in those categories are in denial of being in those categories. so it will be “co sleeping is always dangerous”.

Here in Norway they make that exact recommendation.

I'm impressed. In the US, such a recommendation would be disastrous and whoever made it would be sued to oblivion ....

But then, you nords leave your babies to sleep in the snow which is perfectly healthy but would get you a visit from child protection services in the US (did not hear of such a case, but have heard of cases for letting 9-year old kids walk from school or play basketball without parental supervision)

...which inevitably leads to things like this when the two worlds come into contact: https://www.theguardian.com/us-news/2017/nov/26/anette-soren...

I'm leery of co-sleeping mostly because it seems to be highly correlated with kids who have bad sleep habits and keep waking up their parents constantly (don't worry how you'll know, they'll tell you) well into their toddler years, and beyond. And I'm pretty sure the co-sleeping is a big part of the cause (can't get used to waking up mom & dad for entertainment every time your natural sleep cycle wakes you up a smidge if they're not there to wake up and start giving you attention instantly).

But like anything else, fuck, if it's working for you and the risk is very low, do what you need to do. I avoided it because I kept seeing hellish outcomes but if that's not what's happening for you, go for it.

My wife and I coslept (and often still cosleep) with both of our children. They both sleep through the night without issue.

Our oldest goes to sleep early and will insist on going to sleep when she feels tired and will wake up with me in the morning. Our youngest fights sleep until exhaustion and prefers to sleep in (until 9-10am if allowed). They have been raised exactly the same way.

We take way too much credit for our children's sleep habits.

> can't get used to waking up mom & dad for entertainment every time your natural sleep cycle wakes you up a smidge if they're not there to wake up and start giving you attention instantly

The opposite: When my kids wake up in the middle of the night if they are alone they freak out. If there is another person there they feel comfort and go back to sleep without waking anyone else up. But YMMV.

The thing with babies is that they are, from the start, individuals. Some like a lot of contact, some don’t; some are very active sleepers, some aren’t; some will do fine by themselves in a crib, some won’t. You have no choice but to figure out what works for that kid. That’s not to say there aren’t some general procedures you should follow. I think most kids do best on a regular schedule, for example. But you’ve got to take them as you find them.

The problem is that those indescribably exhausted parents roll on otherwise restrict the breathing of the infant.

Babies want that feeling of comfort, which is why you swaddle.

You seem to have preconceptions that you defend without evidence. There's no 'medical establishment' that purposefully gives bad advice. There are pieces of advice that are later found to turn out wrong, but on average you'll be better off trusting the experts. Don't trust blindly but 'did my own reaearch' is usually codeword for 'read a few mommy blogs'.

Those kind of overreactions and bulldozer parenting are in large part the result of 24/7 news, which made unusual events seem common and created an environment of neverending fear.

Additionally, as the world became safer and sanitized, we became more distanced from injury and it seems more traumatic. Parents are more afraid and focused on the downsides. As well as the fact that we have fewer kids than in the past. The potential consequences are greater.

It's also worth noting that the body and brain are anti-fragile. That is, they become stronger and more robust when challenged. Weaker in the absence of it. The end result of all this sanitization, safetyism and overprotection is a fragile human. One that is less able to cope with the challenges and messiness and nuance of the real world.

That negative feedback loop has led to quite a mess. The Coddling of the American Mind does an excellent deep dive on all this: https://www.amazon.com/Coddling-American-Mind-Intentions-Gen...

Anti-fragile indeed, still sucks when your 7month rolls off the bed unexpectedly...

I once jumped off the bed straight onto my head and got a concussion at 5. Turned out fine

My sis used to climb out of her crib and flop down to the ground when she was little. Turns out she was just naturally athletic. Now she’s a personal trainer.

Put some pillows next to their bed and let them roll

That will be a very educational experience for it.

The grudge against the breast is best is legitimate and valid. My son was just born in a baby friendly hospital 6 weeks premature. Mom was pumped full of fluids for days before the delivery and they built up in her lungs. The day after delivery, she woke up to the cardio and respiratory alarms going off at 6am and she was talking nonsense to the nurse, presumably because she wasn’t getting enough oxygen. That day, the nurses kept coming into her room and the top priority was to get her to pump. The top priority. I finally had to go talk to the charge nurse and demand they look at her lungs because she obviously couldn’t breathe.

So yes. The hyper focus on breast feeding is a problem. Baby friendly is often hostile to the mother. The medical community is to blame while in the hospital prioritizing pumping over breathing.

I don't know that it really has that much to do with "breast is best". I think nurses are just normal overworked people following their script. If it wasn't the breast is best thing, they'd be ignoring you for different reasons.

We had twins two years ago and some of the nurses were just very lacking in empathy. A few of the other ones were fantastic.

The second night we were in the hospital, I went home to stay with our older daughter. This left my wife on her own in the room, and the understanding was the nurses were going to give her time alone and handle a couple of the feedings for her. Well, shift change happened and the new nurse didn't give a care. Have to follow the script.

Sure they took the twins away after the feeding, but when they need to eat every two hours and it takes an hour to do, and then they have a half hour of other checks they need to get in, basically my wife didn't get any sleep all night.

She broke down crying in front of her nurse and the nurse basically said, "Suck it up." Without considering that my wife was dealing with a C-section, new twins, having nurses in and out of the room constantly, and me not being there to lend a hand.

I came in at like 5 am, and she was basically just sobbing in her bed. Thankfully one of the nice nurses came in and sat with her and calmed her down, and then said she would have a chat with the younger nurse and let her know that she needed to cut new moms some slack.

The other noteworthy thing that happened was my wife ordered supper, and while the nurses were in the room, she very obviously was having an allergic reaction to it. They just carried on like nothing was happening because "we're here for the babies". Finally I put my foot down and pointed out that my wife was obviously having an allergic reaction and her eyes were basically swollen shut. Then they finally were like "oh, I guess we should get her something for that."

Which is a long way of saying, I agree that nurses aren't nearly attentive enough. And can relate. But also, I'm not sure if its the focus on breast feeding that is the issue.

Not noticing that someone can't breath when their face is visibly swollen isn't a matter of being overworked its rank incompetence. If its caused by fatigue one has to wonder how the facility managed to collect the most money in the world for the same situations and manage not to afford enough personnel.

My understanding is that the status quo is 24 hour shifts.

> Baby friendly is often hostile to the mother.

As it should be. You're the responsible adult in the room, and you will have to make sacrifices to take care of the helpless person you chose to bring into this world.

If you think "mom comes first", then get a fur baby instead.

It is not as black and white as that. You cannot simply ignore the mother and let her deal with baby blues or whatever pops up on her own or else you are not taking care of the child either. There is enough room to care for both the mother and the child.

> There is enough room to care for both the mother and the child.

I didn't say that there isn't. What I said, literally, is that the mother doesn't come first.

You do know what the difference is between anecdotal evidence and statistics right?

Your example sounds so far away from everything normal.

Right, and I suppose modern medicine should ignore rare conditions and syndromes, treating only patients who fall nicely into a normal distribution.

No. Where did i say that?

Has it ever crossed your mind, that medical people have a simliar distribution than every other field? Do you think every software developer is an expert?

Do you think everyone who is painting, paints equally well?

Do you think just because someone studied, that person is smart?

His point was that one anecdote of a bad experience at a hospital does not dispute the statistics that breast milk is better than formula.

The data does not support the claim breast milk is better than formula for long term outcomes [1]. Given this, it’s appropriate to be angry and frustrated at the way society and modern medicine treats women who do not breast feed. Especially when the woman is struggling to breathe.

https://www.theguardian.com/lifeandstyle/2019/jun/20/is-brea...

That is STILL anecdotal. Srsly there are bad people working in hospitals who are doing a bad job. But some of them also just be overworked or don't care or whatever.

“This is the most important thing you can do for your child, and if it doesn’t work for you, that’s very unfortunate and, in the long run, will have serious consequences.” never crossed my plate. In germany mothers try, if it doesn't work, it doesn't. Thats it.

I think you might be underestimating how hard breastfeeding is pushed in US hospitals. Our second night in the hospital with my son, my wife's milk hadn't come in yet.

Our son was screaming because he was hungry. The nurse kept saying this was good, that it would encourage breast milk production. It took several tries to convince her that, while it might be good in the long run, we needed some food for this baby.

This was a consistent experience with all nurses we dealt with. Interestingly, breastfeeding specialists tended to be more understanding.

I don’t have any kids, but I can’t figure out what people are actually complaining about here. Most comments seem to be referring to breast feeding in the hospital in the few days post birth. Is it just hospital culture we’re upset with? My understanding was that breast milk is generally pretty important to do as it helps transmit antibodies and the like. But, having some formula is fine too.

I see older cases about nestle misleading women in developing markets to suggest formula was better, which led to deaths. However this seems to be due to nutritional deficiencies which I, perhaps naively, would assume they have figured out by now.

> I see older cases about nestle misleading women in developing markets to suggest formula was better, which led to deaths. However this seems to be due to nutritional deficiencies which I, perhaps naively, would assume they have figured out by now.

They have, it's fine.

> But, having some formula is fine too.

It is harder to get the baby on the breastfeeding train, if you will, if you're switching between breast and bottle. You can pump but many women find that really distasteful and either way it takes up shitloads of time and their body might still not cooperate. A surprising percentage of babies (admittedly anecdotal, but I'm a parent and know lots of others and the sample size is actually pretty large as a result, though not randomized) have a hell of a time "latching" and actually getting enough milk out, and that's if the mother's body's producing enough, both of which are hard to measure so it's really easy to end up with a baby who's in the "failing to thrive" range which can lead to further hospitalization (and more judgement from nurses and such).

Frankly, as soon as shit gets a little sketchy I'd say just go straight to formula and bottle. It's not as good, sure, but the other way seems to be wildly harder and more difficult to track, unless you get very lucky and have one of those pairings where both mother and baby sync up perfectly and it just goes great, in which case it's merely very time-consuming. This is like 20% of babies at best, in my experience.

The rest get to deal with non-stop stink-eye and condescension from nurses and other care providers while they're stressed out, hurting, and anxious already, to probably still fail at the whole breast feeding thing even if they try hard and feel like shit for weeks and maybe don't get their baby enough food to grow properly while attempting it.

Our hospital had a 50 year old lactation consultant that called formula poison when she heard our pediatrician recommended us to supplement breastfeeding with formula.

We decided not to even try with our twins, because it took an hour of pumping to produce half an ounce, every doctor we saw still pushed breastfeeding on us.

There's immense peer pressure surrounding it too. People love feeling superior to each other.

This kind of stuff, well the whole fertility process really, is what really opened my eyes to what women have to deal with that most men don't seem to have any awareness of.

The sheer amount of guilt, shame, tut-tutting, and general bullshit around the birthing process is just astounding.

Breastfeeding is the poster child for this (great example here) but so does every other thing about parenting. Women have to make "no-win" choices around this, plus career, plus body changes, plus so many parenting choices.

Every single one of these things has 10 books that say X and 10 books that say Y.

Our pediatrician was supportive of nursing and suggested we stick with it but also said "the data that breastmilk is better in any significant way is just not there".

My wife breastfed for 6 months with both our kids then called it good, and I thought that was heroic.

Having to duck out to pump every couple hours is literally the last thing a new mom back at work (guilt! shame! second-guessing!) wants to be doing.

Our kids were breastfed for the most part, but I still agree with you on formula not being a big deal. I disagree with this, though:

> People love feeling superior to each other.

I think it’s simply that people are poor at understanding that Option A being slightly better than Option B does not mean that Option B is bad. I think this deficiency in reasoning is what drives a lot of irrational behavior wrt to parenting (eg, making incredible sacrifices to afford a home in a neighborhood with “good schools”, going through hell so your newborn doesn’t sleep on its tummy, etc).

More directly to the topic of this discussion: the problem with screens is that they are a very easy tool for making children shut up and stop bothering the adults, and a much more difficult tool to make into a challenging and thoughtful experience. As a result many adults lean on using screens to distract their children much more than they absolutely need, and end up reliant on them. And the kids end up using screens in a way that is wasting a ton of time and not helping their development.

The material on screen is very often (from what I can observe just walking around town and seeing kids looking at them) grossly inappropriate for the child’s current level – either too simple and repetitive or too advanced and incomprehensible – but the sounds, colors, and especially movement are so exciting as pure distraction that kids will sit entranced, whether or not they are learning anything. The overstimulation from the screen is addictive enough for the kids that the kids will start to fuss and cry when the screen is removed, and when given the choice the screen will crowd out other toys and activities.

It is probably possible to make a screen a meaningful learning experience for young kids, but few parents (especially the ones who are using the screen to get a break from childcare) have the time to research and personally vet material to figure that out.

If a kid watches 30m of Mr. Rogers every day, they’re going to be fine. But the kids watching 2 hours of YouTube low-budget animated nursery rhymes on loop, or watching endless unboxing videos, or playing a too-easy iPad game, when they could otherwise be playing with and learning about the physical world, are really missing out.

This is not to say that kids shouldn’t regularly spend some time entertaining themselves while the parents do something else. But if they can learn to do so with a wimmelbook or some crayons or some blocks or a cardboard box.... they’re usually going to be learning more than if stuck in front of a TV.

> If a kid watches 30m of Mr. Rogers every day, they’re going to be fine

We try doing that with 20 min of Paw Patrol and it's impossible. Give a finger, they take an arm. It's impossible to regulate the quantity.

No matter how many different options they have available to play or what promises you try to make before hand, it ALWAYS ends in a total meltdown. We get 20 min of peace, followed by 40 min of hysteria.

Before streaming media (YT, Netflix) we could watch something say Sunday 6PM or Saturday 7AM, and that was it. Now everything's on demand and they know perfectly well there's always more as long parents say ok.

The only solution is to stop. After a few days of no TV, they stop asking and happily draw, leaf through books, build stuff. But nothing says "peace" like a kid watching TV.

This is because Paw Patrol is designed to a very specific formula that is designed to get kids super-hyped up so they a) become mesmerized by what they are watching and b) want more of it - which just so happens to be possible, courtesy of the toy store.

(The "there's always more [content out there]" component you mention - something I am very familiar with as someone with ADHD :X - folds nicely into the mesmerism/relive component described above.)

Where I learned about this recently: https://www.theglobeandmail.com/arts/television/whats-paw-pa...

Linked from: https://www.theatlantic.com/family/archive/2020/02/how-toys-... / https://news.ycombinator.com/item?id=22259025 (9 days ago)

Agreed. I don't think many kids could make it through 2 episodes of Mr. Rogers w/o wanting to do something else. I remember being really bored with my choices of shows / movies growing up. If I was a kid today, I think I'd be on YouTube every waking moment.

Maybe try watching full-length ballets or operas instead, or nature videos, cooking shows, videos of people doing carpentry projects, videos of people playing music, ...

Or something along the lines of https://en.wikipedia.org/wiki/The_Secret_Life_of_Machines

Dunno.. I tend to watch video with my 3.5 year old rather than leaving him to watch video while I go do something else. We only watch videos occasionally (maybe 3 hours/week on average), and don’t really end up with meltdowns when we stop. But that method doesn’t help if the goal was to get some time alone as a parent.

I generally agree with all of that. And all of that, to me, suggests even just a fundamental level of involvement by parents is what's important. This doesn't seem to have anything to do with screens being a problem.

well the problem is that screens exist. when i grew up screens didn't exist (at least not in my home), and so the problem solved itself in other ways. we got crazy on comic books. parents didn't get involved. (though they helped us buy up the remaining stocks of a second hand comic book dealer when that closed down.

the problem with screens is that they are strongly attractive. my kids don't even notice me when they watch a screen. from the available entertainment kids will pick what is most attractive, and the only way to reduce screen time is to not make it available, and instead provide other options.

> theatrical demonstrations of disgust near smokers outside on the sidewalk

I'm with you completely except for this one. Cigarette smoke feels like it sucks the air out of a nonsmoker's lungs from quite a wide radius. A nonsmoker can smell an outdoor cigarette from a block away, and it doesn't smell good even at that distance. Up close it makes people involuntarily gag. Not recognizing that seems pretty blind.

Never been a smoker or even smoked until I was well beyond 30 and even then, something like 6 small cigars over the course of 4 years or so.

None of my parents, aunts/uncles or grandparents have been smoking since before I was born AFAIK and I still disagree with you.

I've always liked the distant smell of smoke for some reason. As everyone stops I'll probably miss it a bit but that is OK, I don't want them to destroy their lungs.

But your blanket statements feels weird to me, even as a non-smoker from a non-smoking home.

> Cigarette smoke feels like it sucks the air out of a nonsmoker's lungs from quite a wide radius [...] makes people involuntarily gag

Unless you have an allergy or something, this is entirely in your head.

Some people also “involuntarily gag” when they think about interracial marriage or a person eating pickled cabbage. This kind of paranoid disgust is a conditioned response, not a reasoned risk assessment.

* * *

Note: I am not defending tobacco advertising, smoking in enclosed public spaces like restaurants, smoking in a car with kids inside it, smoking on primary school campuses, etc. (For that matter I’m not defending spending time near an indoor wood cooking fire, etc.)

It is clear that getting significant amounts of second-hand smoke is bad for anyone, and children are especially vulnerable because they can’t make choices about where to go.

But desire to avoid dangerous levels of smoke doesn’t excuse being a jerk to people who are engaged in a behavior (outdoor smoking) which they have a physical addiction to, and is predominantly harmful to themselves alone.

> Some people also “involuntarily gag” when they think about interracial marriage or a person eating pickled cabbage. This kind of paranoid disgust is a conditioned response, not a reasoned risk assessment.

What a peculiar defense. The next time you use a bathroom that has gone far too long between cleanings, just remember that your response to the odor is all mere conditioning and that you just need to make a risk assessment. Inhale deeply, my friend. Take it all in. Let the fresh shitsmelling air cleanse your thoughts. It's not dangerous after all.

> > Cigarette smoke feels like it sucks the air out of a nonsmoker's lungs from quite a wide radius [...] makes people involuntarily gag

> Unless you have an allergy or something, this is entirely in your head.

The fraction of the population with asthma is easily high enough that there's plenty of people for whom it's not in the head.

Personally I just hold my breath and speed up until I've passed those people, but its most definitely unpleasant.

That isn't being a jerk - it is downright narcissism to think that everyone or most who cough in their presence is faking it because it interferes with their fix and gratification. First time smokers cough frequently and that is why menthol was targetted, for making it easier to start by masking its effects. The old cliche even back when it was more acceptable was forcing precocious smokers to smoke the whole pack to put then off of it! A body /not/ rejecting tobbaco smoke is a sign of a problem.

The narcissism of tobbaco users is emminently obvious to non-smokers but completely invisible and incomprehensible to them and their gratification. Just like how cigarette butts are the most common litter, and chewing tobbaco was curtailed due to concerns of tuberculosis from spitting it everywhere. It seems to be an effect of the drug more than anything sociological that all dissenting evidence is mentally erased.

After having dealt with narcissism in people around me it's quite amazing how often this pattern emerges. They must be faking it to lord over me, to make me feel bad, clearly everything these other people are doing must be about me.

Cigarette smoke is not nearly as bad or gross for the average person as you make it out to be - how do you think smokers could possibly stand it otherwise? If you didn't know it was bad for you you wouldn't be making such a pearl clutching fuss about it.

This post is pure hysteria. You're rationalizing a conditioned, exaggerated reaction.

It didn't bother me back when everyone smoked, but now that I'm rarely around it it's about as bad as described. I can tell when someone's smoking two cars in front of me at a stoplight, too, when both our windows are rolled up. Smells awful.

On and off smoker chiming in here. I love the smell of cigarette smoke when I’m smoking or recently quit. If I haven’t smoked in several months, though, the smell is as the person you’re responding to describes: terrible, imposing, and wide reaching.

I honestly don't think you're posting in good faith.

Is it that difficult to understand that most people don't want to inhale smoke and find it really distasteful?

Honestly, inhaling flatulence is probably less dangerous than inhaling second-hand smoke, and I don't think anyone is going to blame someone for intensely disliking inhaling that.

> If the baby sleeps in the same bed with the mother the risk to the baby is trivial, unless the mother is an a severe alcoholic or high on drugs.

Yep, this is just as obvious as you want it to be.

And yet there's a massive government advertising campaign taking out billboards with the message "if you let your baby sleep with you, you are a bad mother and your baby will die". Check out the posters in the BART system sometime.

I find this incredibly disgusting. Nothing can justify this official message. But there it is out there anyway. The government, spending your money to hurt you.

Nope. Medical staff effectively saying you must feed your baby now or it will die three hours after it was born and after a 24 hour labour tends to focus your mind and scare the crap out of you.

There is just as much unsubstantiated fear generated by medical staff when it comes to kids as everywhere else in the community.

Seems that just having been a child qualifies somebody to comment on how you choose to raise your children.

Too much attention and you are a helicopter parent, not enough and you are neglectful. God forbid you let them play in the park without you being there.

He is commenting on the depressingly short 1/2 life of recommendations from the medical fraternity, and he is spot on about breast feeding recommendations having changed recently. I'm guessing the abandoned recommendations got their start when Nestlé dressed up their sales women in WHO uniforms and instructed them to tell African woman "formula is best", and the medical fraternity understandably went basaltic, but they also went too far. Now that has come back to bite them.

Medicine is not unique in it's "accepted dogma" having a 1/2 life of course, all sciences do. But it's horribly short. From https://hms.harvard.edu/news/medicine-changing-world :

> Today, the half-life of medical knowledge is currently about 18-24 months, and it is projected that in about four years that half-life will be only 73 days.

That's from a mob trying to flog education so it's going to be an exaggeration, but it's still short no matter who measures it. By comparison Engineering knowledge 1/2 life is till measured in decades, although I expect they conveniently leave software engineering out of that.

Overall I agree with him, the doctors are far too eager to hard sell the latest advice in some paper. I guessing that's because selling advice is how they make their money. That behaviour has its downsides.

> theatrical demonstrations of disgust near smokers outside on the sidewalk, and so on.

We are disgusted because the poison in cigarette smoke is extremely harmful to young lungs.

Smokers should have to go into designated areas they should have no right to pollute the air of those around them.

The amount of crap you get from momentarily standing near a smoker nearby outside is orders of magnitude less than you get from automobile exhaust walking around a typical city.

When someone is idling their car or truck do you go knock on their window and make a big scene about how they are poisoning your child?

> The amount of crap you get from momentarily standing near a smoker nearby outside is orders of magnitude less than you get from automobile exhaust walking around a typical city.

That is a big claim. In view of the association with passive smoke and SIDS you will need some citations. It should not be hard to find them. Huge efforts have gone into researching causes of SIDS and there should be a good correlation between city vs countryside dwellers if your hypothesis is correct.

> When someone is idling their car or truck do you go knock on their window and make a big scene about how they are poisoning your child?

When my child was new born I would have moved away from them whilst saying loudly how disgusting they are - exactly the same as I did for smokers.

If someone is running their engine for no reason I would probably ask them to turn it off.

The complaints of the people you’re responding to are not merely health related, but also aesthetic. Cigarette smoke smells bad to most people. Smoking where other people will smell it is like farting in an elevator: highly inconsiderate.

From a purely aesthetic perspective, someone waving their arms, holding their nose, and talking loudly about how disgusting smokers are as they walk past a cigarette smoker is far more unpleasant than the original act. Theatrical public shaming is one of the ugliest things in society.

Given the strong association with SIDS and cigarette smoke the desire of parents to get their newborn babies away from the poison is not theatrical. It is practical.

I don’t know what to tell you, but there’s a fundamental difference between being the transgressor and responding to a transgression.

And I say this, FWIW, as a on and off smoker.

FWIW, I have never smoked a cigarette in my life. (But did grow up, as the child of anthropologist parents, frequently sitting near wood cook fires in small smoke-filled huts, which is at least 1000x worse than any second-hand cigarette smoke you could possibly get outside.)

There is a fundamental difference between someone minding their own business on a public street, not harming anyone else, and someone else putting on a show to shame them based on gross mis-assessment of risk.

I’m not sure what to say here. You have reiterated that there is no health issue, but my point is that whether or not a given behavior presents a physical harm to others is not the sole standard by which public behavior is governed.

> hyped up about trivial threats

and really, this is the worst for kids

It seems like in developing nations were getting into the realm of diminishing returns around health risks (obviously not everything, but a lot of things).

Go back 50 years and the things like nutrition, vaccination, etc had huge benefit in risk reduction.

Now that we’ve tackled those, we go after the next set. Now it’s breast feeding, screen time, etc. we put a similar focus on those but the returns are much smaller and sometimes questionable.

Is breast feeding better? Sure. Is your child going not going to reach their full potential if you use formula? No. Not worth getting stressed over.