• Dr. Timothy Smith

Can I Trust My Baby Monitor?


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Baby monitors are supposed to provide peace of mind to parents and help protect their children. Parents can naturally become anxious whenever their baby is out of sight or earshot. Whenever an infant rests alone in its crib away from the noises and disturbances of the home, parents may want to know that the silence means sleep and not something terrible such as sudden infant death syndrome (or SIDS). The Mayo Clinic describes SIDS as “…the unexplained death, usually during sleep, of a seemingly healthy baby less than a year old.” (mayoclinic.org/disease) The most recent statistics released by the Centers for Disease Control reported 1,400 infant deaths from SIDS in 2017. (cdc.gov/sids/data.htm) Although unexplained, research indicates SIDS and the more general category SUID (sudden unexplained infant death) often involves a drop in blood oxygen levels due to obstructed breathing and an underdeveloped ability to wake up to life-threatening situations during sleep. Even though baby monitors are supposed to help parents protect their children, are the monitors always doing their jobs?

Baby monitors have been around for many years as an aid for parents and care givers wanting to keep an eye and ear on their infant while in their crib. The market contains many types of baby monitors from the basic audio monitor to more elaborate audio/visual monitors that also measure things such as room temperature, pulse, and blood oxygen levels. One company called Owlet offers a smart sock for infants that contains sensors that measure pulse and blood oxygen levels. The system called the Owlet Smart Sock 2 comes with a base station that glows green when pulse and oxygen levels are in the normal range, but it flashes, sounds an alarm, and even calls your smartphone when levels deviate from normal.

A group of clinicians from the Children’s Hospital of Philadelphia, including Dr. Christopher P. Bonafide, MD, published a research letter in the Journal of the American Medical Association titled “Accuracy of Pulse Oximetry-Based Home Baby Monitors.” The authors note that they bought two baby oxygen monitors, the Owlet Smart Sock 2 ($300) and the Baby Vida (no longer available), which are not regulated by the FDA. The paper sought to determine the accuracy of the two commercial baby monitors compared to the hospital grade Masimo Radical-7 Pulse CO-Oximeter. Placing the one baby monitor sock on one foot of hospitalized infants and the Radical-7 monitor on the other foot, the researchers compared the oxygen sensing and pulse measuring accuracy of the Owlet and the Baby Veda. They found that the Owlet Smart Sock 2 did detect some cases of low oxygen and increased heart rate, but it missed 11% of the hypoxia (low oxygen) events. On the other hand, The Baby Vida had a 100% failure rate in reporting hypoxia events and falsely reported low pulse rates. The authors expressed concern that “…physicians and parents should exercise caution incorporating data from these monitors into medical decisions.” Clearly, these devices do not have robust enough technology and manufacturing to accurately and consistently gather oxygen and pulse data from infants.

Parents and caregivers all struggle to provide the best care for their newborns, and the threat of SIDS and SUID haunts everyone precisely because the exact cause of death is still unknown. The promise of monitoring devices that could help protect babies from SIDS and SUID sounds terrific, but in reality, baby monitors are currently unregulated by the FDA, and baby monitors such as Owlet Smart Sock 2 and Baby Veda may not be accurately providing data to parents and caregivers. In fact, what is being sold is peace of mind. The Owlet website notes that “94% of Parents Report Better Sleep with the Owlet Smart Sock.” (owletcare.com). In contrast, the National Institutes of Health have many recommendations for preventing SIDS, including making sure the baby sleeps on their back and removing all choking hazards such as stuffed animals and bumpers from the crib. Moreover, they explicitly caution, “Do Not Use Heart or Breathing Monitors in the Home to Reduce the Risk of SIDS.” (nichd.nih.gov) SIDS has decreased in the United States since the government released the recommendations for SIDS prevention in the 1990s, but SUID remans the number one cause of infant mortality. In the case of baby blood oxygen monitoring at home, a useful monitoring system to prevent SIDS and SUID sadly remains elusive.

Dr. Smith’s career in scientific and information research spans the areas of bioinformatics, artificial intelligence, toxicology, and chemistry. He has published a number of peer-reviewed scientific papers. He has worked over the past seventeen years developing advanced analytics, machine learning, and knowledge management tools to enable research and support high level decision making. Tim completed his Ph.D. in Toxicology at Cornell University and a Bachelor of Science in chemistry from the University of Washington.

You can buy his book on Amazon in paperback here and in kindle format here.