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    By who you are · 17 tips

    New parents

    From pregnancy to before kindergarten, the tips in this book that matter to you: your child's safety and health, and the money and work side of raising a child.

    1 Your child's life

    Caring for a newborn

    Put a baby to sleep on the back, on a firm flat surface, in the same room but not the same bed, with nothing soft in the bed

    While the child is a baby, lay the baby face up on a firm, flat surface that does not tilt; inclined cradles and baby seats can't be used as a bed. Adults share the room with the baby but not the bed. Put no soft things such as pillows, quilts, bumper pads or stuffed toys in the bed. In the U.S. alone, about 3500 babies a year die of sleep-related causes.

    • High value
    • Evidence A
    • Buys life
    • For: Child under 3, Pregnant or trying
    Caring for a newborn

    However tired or angry you are, never shake a baby

    A baby's head is large and the neck has little strength. Shaking hard can cause bleeding in the brain and eyes, and it can kill the baby or leave a lifelong disability. Gently rocking a baby to sleep does not count; the danger is violent shaking you can't control. When you are about to lose your temper, put the baby back in the crib and walk away for a few minutes. Letting the baby cry for a while is safer than holding and shaking.

    • High value
    • Evidence B
    • Buys life
    • For: Child under 3, Pregnant or trying
    Don't die early

    Put children under 4 in a child safety seat in the car, not on your lap

    For infants under 1 riding in a car seat, the chance of a fatal injury in a crash is about 70% lower. For children aged 1 to 4, it is about half. Holding a child on your lap gives no such protection.

    • High value
    • Evidence A
    • Buys life
    • For: Child under 3, Child aged 3–18, Pregnant or trying
    Don't die early

    If there are small children at home, put window stops on windows and balcony doors; a window screen is not protection

    A pair of stops costs a few dozen CNY. New York City installed window guards free in high-risk households and visited to explain how to use them; in one borough, reported child falls dropped by half over 3 years. New York later passed a law requiring landlords to put guards on apartments where children aged 10 and under live. A window screen does not count as protection.

    • High value
    • Evidence B
    • Buys life
    • For: Child under 3, Child aged 3–18
    Emergencies: what to do first

    If a baby under 1 year old is choking and can't cry, lay the baby face down and give 5 back blows, turn the baby over and give 5 chest pushes, alternating, and don't press the belly

    If the baby can still cough and cry out, let the baby cough on their own and stay beside them watching. If the baby can't make a sound and the face is turning purple, have someone call 120 (China's ambulance number), lay the baby face down along your forearm, and give 5 blows with the heel of your hand between the two shoulder blades. If it hasn't come out, turn the baby over and give 5 quick pushes in the center of the chest, and alternate the two, without pressing the belly. If the baby stops responding, switch to CPR.

    • Top value
    • Evidence B
    • Buys life
    • For: Child under 3, Pregnant or trying
    Emergencies: what to do first

    If a baby under 1 year old is unresponsive and not breathing normally, put the phone on speaker and call 120 (China's ambulance number), and give infant CPR: 30 pushes and 2 breaths

    If tapping the sole of the foot brings no response and the baby isn't breathing normally, put the phone on speaker and call 120 (China's ambulance number), and keep your hands going. Encircle the chest with both hands and press with two thumbs, or if you can't encircle it, use the heel of one hand, pressing down about 4 centimeters, about 2 times a second. After every 30 pushes, cover the child's mouth and nose with your mouth and give 2 breaths. A baby's heart most often stops because of not being able to breathe, and more survive when the CPR includes breaths.

    • High value
    • Evidence B
    • Buys life
    • For: Child under 3, Pregnant or trying
    Emergencies: what to do first

    If a child swallows a button battery, or swallows two or more strong magnetic beads, go at once to the emergency room of a hospital that has endoscopy; don't wait for it to pass on its own and don't make the child vomit

    A button battery stuck in the esophagus can cause a serious burn in as little as 2 hours, and the child may look fine at first. Two or more magnetic beads will attract each other through the intestinal wall and can press a hole through the bowel. If you suspect your child swallowed one, go to the hospital for an X-ray right away; don't make the child vomit, don't wait for it to pass on its own, and don't wait for symptoms before going.

    • Top value
    • Evidence B
    • Buys life
    • For: Child under 3, Child aged 3–18

    2 Your child's health

    Caring for a newborn

    Get all the vaccines in the national immunization program on schedule, which are free all the way, and if you miss one, only catch up on the doses not yet given

    Vaccines in the national immunization program are free all the way, and the vaccination unit cannot charge. When a child enters nursery or school, the immunization certificate is checked, and missed shots will be found and made up. If you missed some, only the doses not yet given need to be caught up, with no need to start over, and you can continue even if the maker has changed.

    • High value
    • Evidence A
    • Buys life
    • For: Child under 3, Child aged 3–18, Pregnant or trying
    Caring for a newborn

    If a baby under 3 months has a temperature of 38 ℃, go straight to the hospital and don't watch at home

    If a child under 3 months has a temperature of 38 ℃, go straight to the hospital. Don't watch at home, and don't give fever medicine first and wait and see. The American Academy of Pediatrics has set out a specific management plan for feverish babies who look reasonably well, so "looks alert enough" is no reason to wait at home. The UK guideline also classes a child under 3 months with a temperature of 38 ℃ as at high risk of serious illness.

    • High value
    • Evidence A
    • Buys life
    • For: Child under 3, Pregnant or trying
    Caring for a newborn

    Watch for the signs of newborn jaundice: if the baby is yellow within 24 hours of birth, or can't be woken or won't feed, go to the hospital the same day; if it is getting more yellow or the stool is pale, get it checked as soon as possible

    More than 80% of newborns turn a little yellow. If the baby is yellow before 24 hours old, or is yellow and also sleepier than usual and hard to wake, won't feed, or is limp or stiff, go to the hospital right away. If the baby gets more yellow after 24 hours, or the stool turns pale, get it checked as soon as possible; pale stool may mean biliary atresia. Too much bilirubin can damage the brain and leave a lifelong disability.

    • High value
    • Evidence B
    • Buys life
    • For: Child under 3, Pregnant or trying
    Don't get hurt by the medicine cabinet at home

    Don't give a child aged 2 or younger combination cold medicines or cough medicines on your own for a cold

    The National Medical Products Administration (国家药监局) required 14 combination cold medicines for children to carry a warning: parents are advised not to give them to children aged 2 or younger on their own, and they should be used only under the guidance of a doctor or pharmacist. In trials in children, cough medicines and antihistamines (allergy drugs) worked no better than placebo.

    • High value
    • Evidence B
    • Buys life
    • For: Child under 3
    Don't get hurt by the medicine cabinet at home

    Don't use aspirin, nimesulide (尼美舒利) or metamizole (安乃近) for a child's fever, don't give minors cold medicines that contain metamizole, and measure liquid fever reducers with the dosing device that comes in the box

    For a child's fever, don't use any of these three drugs. Aspirin is linked to Reye's syndrome (瑞氏综合征), a disease that damages the brain and liver; about 30% of the children with it died. Nimesulide (尼美舒利) is banned at age 12 and younger, and metamizole (安乃近) is banned at age 18 and younger. Measure liquid fever reducers with the dosing device that comes in the box; spoons at home vary widely in size. Drops and oral liquids can have different strengths, differing 3-fold in a U.S. example, so if you switch the form, don't keep giving the same number of milliliters.

    • Top value
    • Evidence B
    • Buys life
    • For: Child under 3, Child aged 3–18
    Children once they start school

    Give no screens at ages 0 to 3, avoid them as far as possible at 3 to 6, and keep non-study use to no more than 1 hour a day for school-age children

    The National Health Commission (国家卫健委) asks for no screens at ages 0 to 3 and as little contact as possible at ages 3 to 6. For primary and secondary students, use that is not for study should be no more than 15 minutes at a time and no more than 1 hour a day. The reason given is that long periods of close-up eye use bring myopia on earlier. The evidence linking screens to myopia is not that firm. What has actually been shown to work in a trial is 2 hours outdoors every day.

    • Moderate value
    • Evidence B
    • Buys life
    • For: Child under 3, Child aged 3–18

    3 Money and work

    Is raising a child worth it?

    Count the money in three stretches: ages 0 to 3, compulsory education, and after compulsory education

    From 0 to 3, the money goes mainly to how the child is looked after: yourselves, the grandparents, or someone you hire. From primary school to junior high, it goes mainly to housing and extracurricular costs. After that, it goes mainly to the path of further schooling. The three stretches are spent very differently, and lumping them together only gives a frightening total.

    • Moderate value
    • Evidence C
    • Saves money
    Is raising a child worth it?

    Count the time cost of raising a child by whose time gets taken up, not by how tiring it is

    Turn the hours a day spent watching the child and the number of times you are woken at night into time. Then multiply by the hourly wage of the person doing the work. The number you get is usually far larger than the cost of formula and diapers. So it is best to agree on who does what before the baby is born.

    • Moderate value
    • Evidence C
    • Saves time
    Don't waste your money

    If people at home live on your income, buy term life insurance for the earner first, not for the children

    Term life insurance covers only a fixed number of years, and if the insured person dies in those years, the family receives a lump sum. It is for family members who live on your income, for example when the mortgage isn't paid off and the children are small. If no one depends on you, you don't need it. Children don't earn money, and the law even limits how much a death policy on a child can pay.

    • High value
    • Evidence C
    • Saves money

    Related

    This site arranged the groups and order on this page; the tips come from the book. About