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The Quest for the Zero-Risk Option

“Sleep training might be harming your child’s brain – why would you take that risk?”

“Drugs have so many side effects!  I’d rather use natural remedies.”

“Parabens are hormone disruptors.  I always use preservative-free cosmetics.”

“I’ve researched the risks of vaccines, and I just can’t expose my child to all that danger.”

This is a theme I’ve noticed in the reasoning of “natural family living” devotees.  Usually these folks are just genuinely concerned about exposing themselves and their families to unnecessary risks.  But they’re missing something very important – there is no such thing as a risk-free option.  Every choice we make is a choice between two different sets of benefits and drawbacks.  I can hardly think of a life decision that will have no downside.  (Perhaps the decision not to smoke.)  Even most benign choices that are generally recommended for our health do have drawbacks.  Exercise is almost always a good decision, but it’s not risk-free.  Exercise brings the risk of injury, as well as frequently involving monetary and opportunity costs.  A healthy diet full of unprocessed fruits and vegetables is of course highly recommended by just about everyone, but again, this can be expensive and time-consuming compared to processed starch and fat obtained at the drive-through window.  Maybe that’s not a significant drawback to most people, but it is a drawback.

With this in mind, let me revisit those quotes, with a more balanced look at the relative risks:

Sleep training can involve babies crying for minutes or even hours.  We know that cortisol levels rise when babies cry, and that in other circumstances continuously elevated cortisol levels can cause serious health effects.  On the other hand, adequate sleep is vital for the health of both babies and parents, and continued sleep deprivation can cause serious health effects.

Medications often have potential side effects, some of which are bad enough to make taking the drugs unhelpful for a particular person.  On the other hand, any remedy that can have a positive effect can have a negative side effect, whether it’s a capsule or an herb, and of course most natural remedies are not proven to ameliorate any health condition, so relying on them involves a greater risk of leaving the original condition untreated.

There are indications that parabens do get into our systems through cosmetics, and it’s possible they have endocrine-like effects.  On the other hand, parabens are used to prevent bacterial growth in cosmetics, and it’s not clear that their actual presence in human tissues or their hypothetical contribution to breast cancer is more dangerous than the potential for smearing a happily thriving colony of staphylococcus on your face every morning.

Vaccines have risks.  Frequent side effects include soreness at the injection site and fever.  More serious health problems are rare, but possible.  On the other hand, vaccine-preventable diseases (VPDs) are even more risky.  Moreover, a child is at greater risk of injury when you drive them to Whole Foods to pick up some Oscillococcinum than they would be if you get them a flu shot.  (Seriously, more people die in car crashes each year than the total number of people who have even claimed to be injured by any vaccine over the course of 23 years of the National Vaccine Injury Compensation Program.)

When you unpack the assumption that there’s a zero-risk option, suddenly it’s clear that the “natural” option in each case isn’t as superior as it first appears.  Of course, it’s easier to make a buck or get publicity by scaring the pants off people about toxins, “Western medicine,” and vaccine injuries if you don’t include all that pesky factual nuance.  Not only do we consumers have to do some research and hard work to find out about the relative risks of our options, but we have to tolerate the notion that there is no perfectly safe choice, and we will have to expose ourselves to one risk or another.  That’s not a mental place many people want to be, so they turn off their skepticism and simply embrace the notion that “natural is safe and good!”

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About Christine

I'm a full-time mother to two kids, an ex-lawyer, a breastfeeding counselor, a skeptic, and (to steal a phase from Penn & Teller) a "science cheerleader." You can reach me through my Facebook page.

Posted on January 12, 2012, in Health, Natural Family Living, Skepticism and tagged , , , . Bookmark the permalink. 6 Comments.

  1. I do all of these things, and oh, so many others. But I NEVER assume that those choices carry LESS risk than traditional options, just DIFFERENT risks.

    However, I kinda think that’s the nature of humanity–people are afraid to fly, but getting into a car is MUCH more dangerous. Most people don’t have any problem doing that on a daily basis. The best scenario is to assume the risks we can handle, whatever they might be.

  2. There are a lot of dangerous, natural things. Let’s see, earthquakes, tornadoes, snake venom, toxic plants…

  3. I appreciate this post more than you know. I think we choose to worry more about some risks than others, and we also confuse perceived risk vs. actual risk. There are so many parenting debates where I’d like to just stick this post in. One of the big ones here is fluoride. Our city water is not fluoridated, and parents are scared to give their kids fluoride supplements. But talk to any pediatrician in town and they’ll tell you that they’ve never seen so much tooth decay as they do here. And talk to the dentists in town, and they’ll tell you horror stories about having to restrain and heavily sedate kids to work on their mouths. Then let’s talk about the risks of the sedation drugs and the filling material that you’re going to carry around in your mouth for the rest of your life. How can you ignore the advances we’ve made in science and medicine just because they aren’t natural?

    I’m pretty annoyed about the CIO thing, too. I loved your post on it, and I’m working myself up for a series on it. I hate when people claim there is science where there is none.

  4. I’m afraid you’re avoiding alternate options/confounding variables in every one of your breakdowns.

    Sleep training – it’s not really an either/or between parent sleep via CIO sleep training and infant sleep via being soothed by a parent. Infants sleeping in isolation is an abnormality for our species. This is not the way we evolved, and not the way the majority of the infants in the world today sleep. There is a reason that SIDS was first called “cot death” – the otherwise unexplainable deaths during sleep didn’t start being noticable until babies started sleeping in cots physically separated from caregivers. Yes, babies did and do die while co-sleeping. Babies are also sometimes saved by co-sleeping. I have roused to find my own son not breathing in his cosleeper on my side of the bed, not breathing even though there was nothing obstructing his airway. My husband has sleep apnea, as does his father and possibly other relatives on that side of the family from what I’ve been able to hear of their breathing while staying over to visit relatives over the years. This is not an all-or-nothing, one-or-the-other situation, there are MANY gradations of difference available that may be more suitable to some families than either pole of CIO or parental martyrdom.

    Medications/natural remedies – there is a middle way here too. My children are unvaccinated and rarely medicated because I have weird side effects from medications (often side effects that are so rare that you have to pull out the full drug reference book instead of just reading the paper from the pharmacy… including petite mal seizures from a fairly commonly proscribed medication). I chose to build up my children’s immune systems the way nature intended – breastfeeding to biologically normative milestones (I base it on tooth erruption as a sign of gut readiness instead of calendar marks… last I checked my baby’s gut couldn’t read a calendar), good nutrition, outdoor active time, etc etc. If they get sick and stay that way for more than 24 hours or are not holding down fluids, I take them to the doctor for evaluation. My eldest (7.5yrs old) never had any antibiotics until he was nearly 6 (got cellulitis from a cut on his hand that got infected, nothing would have prevented that but it DID heal up quicker than our doctor thought it would once I started putting breastmilk on it every time I changed the bandage in addition to putting him on antibiotics). My other two (ages 4.5 and 20mo) have never been on any medication other than the occasional dose of pain killer when the teething, or a bit of neosporen on a cut that hurts and can’t be easily bandaged, it the extent of 99% of the medication they’ve had. They haven’t needed them. If they actually needed medical treatment, I would not hesitate to get it for them, but it would be as fully informed a decision as possible after weighing all the costs and benefits of the MANY options available, with my own very capable research abilities as well as expert consultation.

    Regarding makeup, you leave entirely out the option of wearing less or none. Cosmetics are not essential for life. I rarely wear makeup, so I buy sample-sized “single use” packages of them whenever the opportunity presents itself. Therefore, very little paraben exposure, very little delicate tissue exposure to staphylococcus, AND a quicker exit out the door. Why not instead examine why women feel required to slather the crap on their face every single day (often multiple times per day) in the first place? I think that may be a more interesting conversation.

    Regarding vaccines, there are risks from all sides and the risks on all sides have been greatly exaggerated, as has the effectiveness of vaccines. I suspect I may have had whooping cough over the winter holidays. I am fully vaccinated. According to the CDC and NIH, best case scenario the vaccine is 80% effective by age 9 and THEY estimate that undiagnosed pertussis accounts for at least 7% of the adult “colds” every year. My children were also sick, but not as badly as I was (I was coughing so hard I was pulling muscles and the only thing that would suppress the cough long enough for me to get more than 20min of sleep was prescription narcotics, and this went on for over 4 weeks hardcore after a few weeks of a mild cough, no fever. The hardcore cough was a long series of coughs that left me making a sharp inhalation that sounded like an asthmatic inhalation but only happened once. I saw my doctor but she didn’t think to test the first time she saw me, 72 hours after the cough got severe, and told me the office doesn’t stock the testers when I suggested 4 weeks later that it might be pertussis). Many of the vaccinated illnesses (for well-nurished, reasonably hygenic, otherwise healthy children, as opposed to their counterparts that lived in very different conditions during the Industrial Revolution and Great Depression) are not really dangerous (just uncomfortable and inconvenient, which is pretty much what a large amount of parenting amounts to anyway). The effects of natural immunity are known, there are treatments for comfort measures or even medical cure-hastening options available, and my family lives 6 blocks from a decent hospital with a good ER if we REALLY need it (I’ve had two experiences as a parent in the ER – one related to my eldest’s neonatal jaundice and the other when my mother-in-law overestimated my 2nd son’s ability to walk down stairs at 19 months and he fell and required stitches in his eyebrow. Vaccines wouldn’t have done a thing, and in fact we suspect the neonatal vitamin k shot that my eldest received and that I refused for the later children may have triggered the jaundice getting as severe as it did). The norms for vaccines are based upon mainstream western parenting – no or very minimal breastfeeding, lots of time away from mother even if she is breastfeeding from very early in life because she needs to return to work where baby can’t be, childcare with other babies and toddlers who are also statistically unlikely to be breastfed to recommended minimums, and on and on and on. There are too many variables to say conclusively that vaccines are the right choice, and they aren’t studied in controlled scientific ways for long enough durations to be sure they’re not doing long-term harm. One of my primary concerns regarding vaccines is the rise in autoimmune diseases that used to be disease of old age, particularly rheumatoid arthritis, in teens and young adults. Screwing around with an immature immune system may have unintended negative consequences down the road. I chose to stick with nature on this one, and take the risks of my children missing school/play and/or needing medical assistance if they get the disease in a more severe form (which is statistically unlikely). You can never un-vaccinate a child. Parents of unvaccinated children, or the children themselves when they grow up, can always chose to start vaccinating if there is compelling reason to do so.

    Binary thinking is rarely truly sensible thinking, even when it appears superficially logical.

    • The above comment has so much pseudoscience and weak anecdotal “evidence” that I wouldn’t even know where to start with this person. It’s just sad to read someone that has bought into so much nonsensical garbage. Thank goodness for HER kids that most parents aren’t this ignorant about vaccinations, etc.

      • Exactly. So many people think only about themselves – vaccination especially is about other people, about protecting those who really can’t be vaccinated & definitely can’t afford to risk illness. As a naturopath myself, I believe there is no such thing as ‘chemical free’, ‘toxin free’ or risk free.

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