Bad Science in the Baby Shop: Baby Monitors

So I saw this story during the week and apart from thinking it was a crazy product designed for crazy people it got me thinking about the 'peace of mind' marketing surrounding this and similar monitoring products that advertise themselves as preventing SIDS.
What many parents may not know is that there is no monitoring product that is recommended for preventing SIDS. No device has ever been found to prevent SIDS and research has found that monitoring devices do not reduce SIDS incidence 3. There may be some place for hospital provided monitors for some babies with medical issues. For healthy babies however monitor use is not recommended nor is its use without medical supervision 2.  SIDS organisations alongside the FDA and NIH all recommend against the use baby monitors as a safety device.
Monitors sold in baby stores do not have any approved standards. No monitor has been shown to reduce SIDS and in fact the claiming of this makes it a medical device which is subject to FDA/TGA approval and regulations. The FDA/TGA has never approved any monitor for the prevention of SIDS and in fact has requested that manufacturers cease making these claims on their products and in their marketing 3 .
To understand why monitors are not helpful it is necessary to understand a bit about SIDS. Although the exact causes for SIDS are unknown, it is believed to be a three step process. Babies that die from SIDS have changes in the part of the brain that regulates breathing, heart rate control and temperature control which make them more vulnerable. If a baby with these changes experience a stressor such as an infection, sleeping on their stomach or covering their face with a blanket during a time in their development when neurological changes are taking place SIDS can occur 4. As it is impossible to tell which babies are vulnerable, the best way to prevent SIDS is to remove the stressors such as by lying the baby on its back to sleep in a safe sleeping environment. Since SIDS occurs from so many changes in the baby, the simple detection of a breathing interruption is not sufficient to stop the process. In fact interruption of breathing has not actually been shown to be associated with SIDS 2 and it may be the case that by the time the baby has stopped breathing other processes in their body have already been stopped, meaning it is not simply a case of resuscitation. A monitor alarm will also not be of assistance if the parent does not know how to respond appropriately, including resuscitation techniques. Babies have died in spite of being monitored 2.
So monitors, no matter how fancy or expensive have not been shown to reduce SIDS rates. The next question is are they actually harmful? I would say yes for two reasons.
1. Monitors can increase parent anxiety due to the large number of false alarms. False alarms result from the baby moving off the mat, natural shallow breathing and technical changes. Babies can also change their breathing frequently in a way that will set off a monitor but not be pathological. One study reported 6993 events exceeding alarm thresholds but only 653 of these events were considered to be risky and those were all in infants already at risk 1. False alarms increase stress in the parent, particularly if the false alarm is due to a breathing change in the baby.
2. For other parents, he use of monitoring devices can lull them into a sense of complacency that causes them to ignore safe sleep recommendations that are proven to reduce SIDS. Recommendations are that babies room share with their parents yet many parents put their baby into a separate room and use a monitor as a protective mechanism. This is despite evidence showing room sharing reduces SIDS incidence while monitoring devices do not. Anecdotally, I have also had a mother tell me it was okay that she put her baby on its stomach to sleep due to the use of a monitor.
The best method to prevent SIDS is to follow sleeping recommendations as well as other recommendations such as breastfeeding and avoidance of smokers. These monitoring devices do nothing to assist in the prevention of SIDS. In the case of the suit, they also seem to suggest that excessive anxiety is normal and can be managed by buying products for your baby. Some anxiety is normal and can be helpful in helping you make decisions about your babies care however if you are (as the creator claimed to be) so anxious about your babies health that you can't sleep you would be best served seeking medical assistance and support for your own mental health.


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  2. Can we talk about the lack of an evidence for SIDS, given how every state defines the thing differently, and the "standards" for diagnosing it vary wildly?

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