You were a baby at some point. Maybe you still are one. But let's assume that you are now past babyhood, since you can read this. Apparently you survived without needing smartphone-connected home monitors in your diaper, onesie, sock or button to track your breathing, heart rate, activity and other measurements. But the past two years have seen an increasing number of such monitoring devices being marketed and sold to parents. Why then do babies need them now? Has life gotten so much tougher than when you were a baby?
That's the question that Christopher P. Bonafide, M.D., M.S.C.E., and Elizabeth E. Foglia, M.D., M.S.C.E. at the Children’s Hospital of Philadelphia and David T. Jamison, MBA, at the ECRI Institute asked in their Viewpoint article in a recent issue of JAMA. Some have suggested (sort of, as you will see later) that such devices can prevent sudden infant death syndrome (SIDS), which is when seemingly healthy babies who are less than a year old die unexpectedly. According to the Centers for Disease Control and Prevention (CDC), this occurs at a rate of somewhere between 40 and 60 of every 100,000 live births and has been steadily decreasing since 1990. The supposed rationale for monitoring babies is to catch any sign of distress early enough to intervene. However, Bonafide, Jamison and Foglia raise some "Bonafide" concerns (see what I did there?) about the widespread use of such devices. They give as an example the Owlet, a $250 sock that can monitor an infant's heart rate and blood oxygen levels, that in less than a year after reaching the market topped 40,000 units in sales.
The first "Bonafide" concern is TMI, or too much information. TMI doesn't just apply to a coworker telling you about his or her latest bathroom experience. Infant bodies go through natural fluctuations throughout the day. Their heart rates and breathing will go up and down without any real long-term impact. Constantly monitoring the infants may encourage paranoia among parents and can lead to unnecessary additional medical testing, which could actually end up harming the infant. For example, what happens if a baby's oxygen saturation drops below 80%, which according to a study in Archives of Disease in Childhood: Fetal and Neonatal Edition can be normal occurrences in babies, you freak out and ask the doctor to look for something wrong, and the doctor ends up putting your baby through a battery of unnecessary tests?
A second "Bonafide" concern is that these devices are not being regulated and therefore may be inaccurate. Therefore, who knows how often the device readings appear normal when something is wrong or the device readings appear abnormal when everything is actually peachy? Manufacturers of these devices have managed to avoid the U.S. Food and Drug Administration (FDA), you know, that organization that is there to protect consumers, by not making direct claims that the devices can prevent SIDS. Wait, isn't that the reason why you would buy such devices? As Bonafide, Jamison and Foglia describe, on the Owlet web site, the Owlet chief executive officer says, “We can’t promise to prevent [SIDS] right now, it’s an unknown issue but…we believe notifying parents when something’s wrong maybe can help.” Isn't this like showing you something that looks like a doughnut and saying that "we can't promise you that this is edible..."?
This raises a third "Bonafide" concern: the advertising for these monitors. The three authors say, "These direct-to-parent advertising strategies may stimulate unnecessary fear, uncertainty and self-doubt in parents about their abilities to keep their infants safe." In other words, millions of parents before you were able to take care of their kids without these monitors, but you...not so much.
A fourth concern: such devices may give parents a false sense of security and replace traditional face-to-face interactions with the baby. Nothing replaces you checking directly on your baby periodically. Babies need human interaction and touch for healthy development. There is also no proof that such monitoring devices actually prevent SIDS. As the authors relay, an American Academy of Pediatrics policy statement states, “Do not use home cardiorespiratory monitors as a strategy to reduce the risk of SIDS.” That seems to be a pretty definitive statement.
Moreover, how safe are these devices? How rigorously have they been tested? Can they harm your baby? Can you baby swallow the device? Can they catch fire? Do they emit any harmful radiation? Certainly, they could be safe...but how many have had formal and published scientific studies to prove their safety? More scientific studies are needed to determine the efficacy, usefulness, accuracy and the safety of many baby monitoring devices.
All of this doesn't mean that you should absolutely avoid all baby monitors. Talk to your doctor to make sure any monitoring that you are considering will do more good than harm before shelling out the cash. Also, check if the device has actually been scientifically tested and by whom...and have the results been published...not on a company web site, not in a chat room, but in reputable, peer-reviewed scientific journals. Individual parents here and there saying that a monitor is great is not equivalent to thorough testing. Finally, keep in mind that your baby may be tougher than you realize and that device cannot replace what parents have been doing for years and years: interacting directly with their babies. After all, you seem to have survived babyhood.
