Research-Based Info: Is it good?

Read the headlines and your newsfeed, and you might be alarmed at all of the conflicting studies and information out there. Tylenol is good for your baby–or is it? Babies should not be born until 39 weeks, 40 weeks, 44 weeks! Cry it out will damage your child forever, but maybe it won’t. And is roundup really in breastmilk? (Spoiler alert–no, it’s not.)

To understand what you are reading, you need to understand that journalists get it wrong all the time, and sometimes even self-titled “scientists” get it wrong, too. To start, watch this excellent summary by John Oliver:

 

Okay, sort of get it?

In my birth classes, I use real peer-reviewed research from real scientists that shows us a true picture of what is and is not healthy for you and your family. And if the research is unclear, or in its infancy, or needs replication, I share that too. It’s important not just to understand what studies say from a general standpoint, but also to understand the limitations and strengths of each study. Here is what I look for when I teach:

Peer review in a respected journal

This is where I start. If a study hasn’t been peer reviewed in a respected journal, it isn’t worth my time. Recently, a “study” came out linking autism and folate in pregnancy. guess what? Not only is the study a denial of many other replicated studies saying the exact opposite, but it hasn’t even been peer reviewed yet!  Researchers fight to get their work in journals, which means they are pretty competitive at shooting down unsound research when it is presented for journal inclusion. With peer review, the study is picked apart to be sure that it is worthy of publication. Also, beware: many journals sound legitimate, but are actually online “pay-to-play” journals. A colleague of my cousin once submitted random text to one of these journals, just to see what would happen, and it was published. Know which journals are accepted as real peer review journals before you cite the study.

Type of Study

The gold standard in research is what we call a double-blind controlled study, which means that we can narrow down what we are studying to only the factors we want to study. One example of poor control is the many studies that link IQ to breastfeeding; as it turns out, many parents who breastfeed also have higher levels of education, which begs the question: is it the fact that the baby was fed at the breast, or is it the fact that the baby comes from a line of higher IQ individuals? Also, in double-blind studies, the patient doesn’t know if they are receiving a regular course of action or an intervention. Naturally, this is hard to do in a situation like birth where a mom will likely know of any interventions.

However, the fact that good studies are hard to come by in this field doesn’t mean we can’t get some good data, so many birth and parenting related studies are retrospective looks at data. Beware studies that rely on the memory of patients (in law, we talked about how witnesses are–correctly–assumed to be unreliable), and beware any study that does not fully disclose or share methods. These are huge red flags.

Sample size and spread

Look, a study of 10 women in a single town in Australia (cough cough the fake roundup-in-breastmilk “study”) is probably not going to speak for the rest of the world. What you want is a representative sample that reflects a variety of environments and is big enough to draw real conclusions. This doesn’t mean the study has to involve millions, especially when we are talking about something like childbearing, which has many variables that are difficult to control. However, a good representation (people from a variety of backgrounds and location) is the best bet to ensure that the results aren’t the product of a particular locale, lifestyle, or medical philosophy.

Funding source/independent verification

Many research denialists love to point to this one as a serious problem in the research realm. Yes, if a major corporation is sponsoring the research, it deserves a closer look. In nearly all of these cases, however, the results are sent off for independent verification to help remove the bias behind a study. Of course researchers are biased–they put their heart and soul into whatever they are studying, and it’s no fun if you don’t discover something cool (after all, we are all human, here). BUT, independent verification by another party ensures that the data remains as neutral as possible. And don’t forget; this goes both ways.

Replication

The real truth-teller: replication. When the roundup-in-breastmilk study was replicated on a bigger scale with a broader sample under stringent controls, independently verified, AND peer-reviewed (the original research met none of these qualifications), guess what they found? Nothing. Not even a trace, not even amongst lactating mothers who mixed the chemical for a living. On the flip side, a detailed study on sleep training methods (not actually straight “Cry-It-Out as the journalists reported) was recently released, which showed no harm (and maybe some benefit) to babies who were sleep trained. This study, though it sounds like something new, is actually a replication of previous studies that have indicated no harm to children who have been sleep trained. The fact that this study replicated several previous studies is promising for parents who worry about getting good sleep. Every now and then, something new will pop up in replication–perhaps a new variant of something scientists had not considered, and that is exciting too! Contrary to popular belief, scientists actually like proving themselves wrong or discovering something new because it means the potential for more research!

That’s the end of my guide to research tonight. I hope it helps you understand the basis for research-based education and why my classes are structured based on Cochrane Database research; only studies that meet all of these guidelines make it into the Cochrane Database, which is the same pool of research used to make guidelines for a wide range of medical and professional fields.

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