Does Your Baby Need a SIDS Monitor?

With SIDS baby monitors flooding the market, should you invest in one? Using a baby monitor to prevent sudden infant death syndrome is a hotly debated topic. Here's what experts say.

Owlet Smart Sock in two colors
Courtesy of Owlet. Photo: Owlet Smart Sock in two colors

Bringing home a new baby can be a totally overwhelming experience. The responsibility of caring for a new life is a huge undertaking for any parent. The desire to keep a watchful and vigilant eye on your new baby 24 hours a day, especially in their earliest days, has led to the invention of many types of at-home baby monitors.

While these monitors aren't specifically designed for preventing sudden infant death syndrome (SIDS), many of them do monitor babies' movements, breathing, and oxygen levels, which can help alert parents to a potential emergency. No one fully understands exactly what causes SIDS, but doctors do know infants' breathing is involved, so these monitors are often marketed as a way for parents to monitor their baby's breathing while sleeping.

"SIDS refers to the sudden death of an infant below 1 year of age. It is very rare, yet causes anxiety in parents for obvious reasons," says Gina Robinson, M.D., a pediatrician at Cleveland Clinic. According to the Centers for Disease Control and Prevention (CDC), around 3,400 babies each year die from SIDS.

With SIDS baby monitors flooding the market, should you invest in one? Using a baby monitor to prevent SIDS is a hotly debated topic. We spoke with two pediatricians and investigated the latest studies and statistics to learn about the benefits and risks of SIDS prevention monitors and find out if they are worth trying.

What Is a SIDS Baby Monitor?

"A SIDS monitor, or home apnea monitor, is a device meant to be used on sleeping infants to decrease the risk of SIDS," says Dr. Robinson. "The monitors track the breathing and heart rate of sleeping infants. If there is an apnea, or pause in breathing, or the heart rate drops below a certain level, the monitor will sound an alarm."

There are various types of monitors—some use a pad that fits under the mattress, and some have a type of sensor that fits on the body, such as on the waist or on the foot. "If parents choose to use a monitor, they should read the instructions to ensure proper placement of the sensors and wires," says Dr. Robinson.

Are There Any Benefits of Using a SIDS Monitor?

In general, at-home oxygen monitors should only be used for babies with medical problems or those who have been born prematurely and need supplemental oxygen at home. For instance, the American Academy of Pediatrics (AAP) recommends a home apnea monitor if your baby needs home oxygen or has serious breathing problems. Other than that, most doctors do not recommend at-home monitors for babies born at term with no medical complications.

"There are some infants (i.e., infants who are premature, discharged on oxygen) who definitely benefit from having their breathing monitored in this fashion," says Dr. Robinson. "There are no real benefits for the average healthy infant."

Risks of Using a SIDS Monitor

Ultimately, the negatives of using a "SIDS prevention monitor" may outweigh the benefits.

"Research studies have not shown a decrease in the incidence of SIDS with the use of a home monitor," says Melissa Manrique, M.D., a pediatric hospitalist at Lurie Children's at Northwestern Medicine Central DuPage Hospital. "In addition, monitors do not guarantee infant safety. There have been reports of infants that have died while being monitored."

Along with no guarantee of SIDS prevention, these monitors may also increase anxiety in parents and lead to false alarms. A 2020 article in the New York Times pointed out that even among healthy infants, normal breathing fluctuations could trigger the alarms to go off without any real cause for concern.

"The monitors frequently sound false alarms and can actually increase anxiety in a lot of parents," says Dr. Robinson. "There are even some studies that found an increased incidence of depression in parents who use them."

At-home monitors can also increase stress and may impact parents' sleep. "Monitors have been shown to increase stress in families that use monitors that may be related to false alarms," says Dr. Manrique. There is also an increase in sleep disruption for families with monitor use, leading to increased fatigue.

Lastly, the monitors may not always be used correctly. A 2022 study in Life (Baseline) found that many families aren't using the monitors correctly. And unfortunately, some of the underlying conditions that can lead to SIDS may not even be detectable by a home apnea monitor, leading to a false sense of security for some parents who may think a monitor will accurately prevent a medical emergency.

What the Studies Say

A 2018 study published in the Journal of the American Medical Association tested the accuracy of the heart rate and oxygen blood level (called hypoxemia) measurements by two popular baby monitors on the market at the time compared to hospital-grade monitors. And the results weren't great.

One monitor, which has been since pulled from the market by the Federal Drug Administration (FDA), detected hypoxemia but performed inconsistently. And the other never detected hypoxemia, and also displayed falsely low pulse rates.

"There is no evidence that these monitors are useful in the reduction of SIDS in healthy infants," says Dr. Robinson. "The infants who are at risk due to prematurity, oxygen requirements, or other serious breathing issues should follow the recommendation of their children's doctors." She notes that there will be children who are discharged from the hospital on monitors, but reiterates that in those instances, the home monitor use would be under the guidance of the child's physician.

It's also important to note that there are no SIDS baby monitors that are regulated or approved for use by the FDA. And in fact, in October 2021, the FDA pulled a popular at-home monitor known as the Owlet Sock from the market, claiming that the company was marketing it under false pretenses. Since then, Owlet has stopped making the Owlet Sock but now offers a similar product called the Owlet Dream Sock.

The AAP also does not recommend the routine use of SIDS monitors. However, they do have safe sleeping guidelines that can help parents prevent SIDS. A 2019 investigative piece on SIDS monitors published in The Wall Street Journal reported that the number of SIDS cases has sharply declined since the 1990s thanks to a safe sleeping campaign created by the AAP in 1994 called Back To Sleep.

Instead of relying on monitors, practicing safe sleeping techniques and home safety are critical for reducing the risk of SIDS.

"Safe sleep strategies have been shown to decrease the incidence of SIDS and should be [the] first choice in decreasing the risk of SIDS in an infant," says Dr. Manrique.

Safe Sleep Recommendations

According to Dr. Manrique, parents should follow these safe sleep practices for babies to reduce the risk of SIDS:

  • Always place your infant to sleep on their back (not on their side or tummy).
  • Do not place your infant on a soft surface, such as a regular mattress or couch.
  • Never place items like blankets, pillows, or stuffed animals with your infant when they sleep.
  • Do not co-sleep with your infant.
  • Consider room-sharing, but not bed-sharing with your infant.
  • Use thin clothing when putting your infant to sleep and avoid over-bundling.
  • Avoid smoking, drugs, and alcohol while caring for an infant.
  • Offer a pacifier at nap and sleep time.
  • Use a fan for better air circulation.

While SIDS monitors are marketed to parents as an effective tool to prevent SIDS, it is critical parents know the facts when it comes to utilizing these tools. "Many products are marketed as necessary or helpful to new parents. Be careful, do your research, and ask your physician for recommendations about new products," says Dr. Robinson.

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