When anxious parents bring newborns home, they may turn to technology to ease their fears. Along with child-proofing the home, many caretakers choose to use baby monitors to keep tabs on their infants at all times.
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The trend has gone from audio and audiovisual with cameras, to interactive smart monitors that can track everything from cries to heart rate, blood oxygen level, and sleep patterns. Wireless electronics integrated into items like socks, diaper clips, onesies, or leg bands can send info to smartphones. Some devices use motion sensors to determine if a baby stops breathing, and others use pulse oximetry probes that shine infrared light through the skin to measure heart rate and blood oxygen levels. An alarm will sound if measurements go outside the predetermined range.
While these sophisticated monitors purportedly track infants' vital signs, they aren't always accurate and can further stress already sleep-deprived parents. In a 2018 study, Christopher Bonafide, M.D., a pediatric hospitalist at Children's Hospital of Philadelphia (CHOP), compared two pulse oximetry-based home baby monitors, the Baby Vida and the Owlet Smart Sock 2, to an FDA-cleared, hospital-grade monitor. The Baby Vida, which is no longer on the market, performed worse than the Owlet Smart Sock 2, but they both had problems with false alarms.
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"Neither of those monitors is FDA-cleared so they have not had to adhere to the same standards for accuracy, safety, or performance that are required of real medical devices," says Dr. Bonafide. According to Misty Bond, Owlet's director of communications, Owlet has been working toward getting FDA approval for the Smart Sock since its launch.
The problem with false alarms
Dealing with false alarms isn't easy for parents. Julia Dennison, mom of one and digital director of Parents.com, eventually had to silence her Owlet in the bottom of her laundry basket because of them. "I know there are ways to manage them on the app, but when I was a new mom running on no sleep, it seemed like the best move," she says. "I enjoyed the Owlet for that sense of security—what parent hasn't stood over their baby's crib to check they're breathing—but too many false alarms led to too many 3 a.m. rifts between me and my daughter's dad."
One of the biggest concerns for parents of infants less than a year old is sleep-related death. In the U.S., 3,500 infants die each year of sleep-related deaths, including accidental strangulation, suffocation, or sudden infant death syndrome (SIDS).
But parents shouldn't let vital signs baby monitors give them a false sense of security. According to the American Academy of Pediatrics (AAP), there is no data showing that home cardiorespiratory monitors reduce the risk of SIDS, and the academy does not recommend them. Furthermore, babies with serious heart and breathing problems are usually discharged from the hospital with FDA-approved monitors and respiratory support. "The children that require monitors are often the ones that need home oxygen, are significantly premature, or have serious breathing issues," says Alison Tothy, M.D., who practices pediatric emergency medicine at UChicago Medicine.
False alarms can lead to unnecessary emergency room visits that aren't helpful for infants or their tired parents. Sometimes it's a faulty read or a displaced monitor that triggers an alarm. It's also important to remember that it can be normal for infants to have irregular breathing at times, and that their sleep patterns will change as they grow.
"Unfortunately, when we see the baby in the ER, it is unclear what might have happened," says Dr. Tothy. "And, depending on the history, it can lead to unnecessary work-ups and evaluations, and might even lead to unnecessary admissions for observation." To avoid these situations, Elizabeth Murray, M.D., who practices pediatric emergency medicine at University of Rochester Medical Center, suggests using only sound or video monitors, as the vital signs-based devices "just create another data point for potential worry."
What should parents be doing to keep their babies safe?
A new government study shows many U.S. parents aren’t following recommendations on safe sleep for their babies. For example, less than a third of parents said they only put their infant to sleep on recommended surfaces. But these guidelines are crucial in helping to reduce a baby’s risk of SIDS.
The AAP recommendations for a safe infant sleeping environment include placing the baby on its back in a bassinet, on a firm mattress, without any pillows, stuffed animals, blankets, or bumper pads so that nothing can block the air flow. Ideally, the bassinet will be in the same room as the parents for the first six months to a year. Parents should also avoid bed-sharing.
For warmth, a baby should only be wearing one more layer than you. Avoid quilts and try wearable blankets or sleep sacks over winter weight pajamas and onesies.
"I like to say 'boring is best,'’ says Dr. Murray. "Your child won't remember the empty crib; they'll just know you are doing the best you can to keep them safe."