If there's one thing every parent has in common, it's that we're always afraid. The fear is usually tamped down, only surfacing when our children get too close to the deep end of the pool or try to scale Trump Tower with suction cups. Sometimes it rages unexpectedly in our minds, creating impossible scenarios of Grizzly bears emerging from the forest to snatch them away or waking up to find a lifeless baby in the crib with no explanation of how or why. Only, that last scene isn't impossible. It's one that plays out horrifyingly for the parents of about 1,500 infants a year, as of 2014. Sudden Infant Death Syndrome (SIDS), is the leading cause of death among healthy infants over one month and under one year of age.
These amorphous, unexpected deaths are the reason we can't sleep even when our babies do, and why we resort to tiptoed stalking late at night to watch their chests rise and fall with every breath.
That fear is why Katie Silva, a 33-year-old Nevada mother, invested in a Snuza, a compact, cordless device that clips onto a diaper. It works quietly throughout the night, measuring the baby's abdominal movements, vibrating if there's no movement for 15 seconds to "rouse" the baby, and setting off an alert if breathing doesn't return.
"I was a total wreck before I got it," Silva says. "Our son was born after years of infertility treatments and eventually gestational surrogacy. I had a lot of concerns most moms have, but it may have been amplified by the effort it took to get him here."
Although her baby was born without any health issues, Silva was barely sleeping to the point of hallucinations for his first two weeks of life. "Every time I closed my eyes for a few minutes I'd wake up in a panic and check his breathing," she says.
Despite a few false alarms due to user error and, later, from her baby moving around in the crib, she says the $105 device was absolutely worth the peace of mind. "Once we used the Snuza, I would still check on him, but less frequently and less hurriedly."
Meanwhile, Los Angeles mom Kera Bjornerud, 36, had a very different experience with her Angelcare, which combines video and audio monitoring with a device that fits under the mattress to track movement. "As first-time parents, we figured we'd pay a little extra to have motion detection," she says. "But then we realized how many things you have to do for proper installation, and the monitor would go off falsely and randomly beep in the middle of the night."
There are several other monitoring devices that promise to look after your baby while you sleep soundly. Mimo Smart Baby Movement Monitor is a crib sheet that tracks activity and movement, and the Mimo Smart Baby Monitor uses onesies to gauge breathing, sleeping temperature, body position and activity level. The Owlet Baby Monitor is a tiny smart sock that uses pulse oximetry to determine oxygen levels and heart rate, all from the baby's foot.
While these monitors have the potential to assuage our deep-seated fears, none of them are FDA-approved, nor can they claim to prevent or reduce the risk of SIDS. In fact, the American Academy of Pediatrics (AAP) says flat out, "Do not use home cardiorespiratory monitors as a strategy to reduce the risk of SIDS," in its recommendations for a baby's safe sleep environment, updated this past October.
Presumably, this is not because monitors are harmful to infants, but rather that studies haven't been able to establish their efficacy. Instead, when you're talking about a healthy, full-term infant, the medical community would rather you focus on creating a safe sleep environment, rather than relying on a home monitor.
Although SIDS deaths are largely unexplained, the "triple risk" theory suggests that a combination of factors can lead to the death of a baby who, outwardly, seems perfectly healthy: young age paired with an underlying abnormality that might impact the baby's breathing or heart rate, as well as his or her ability to rouse during sleep. Their environment can also increase this risk: sleeping on their bellies, tobacco exposure, a respiratory infection, or potentially hazardous materials in the bed.
So even if a device can't prevent SIDS, isn't it still worth it to monitor healthy babies for those preventable sleep-related deaths? Not necessarily. "We have to recognize that these monitors don't prevent SIDS and so we shouldn't be complacent," says Lori Feldman-Winter, New Jersey-based physician and member of the AAP Task Force on SIDS. "There are a lot of things we can do to lower the risk based on the evidence we have."
The monitors can indicate what's known as a brief resolved unexplained event, but even those scenarios, while terrifying, aren't necessarily causes for concern. "It's really common for babies to do slightly odd things like change color, have pauses in their breathing or go floppy or stiff for 10 to 20 seconds," says David A. King, a clinical lecturer in pediatrics at the University of Sheffield who authored a 2014 study on the monitors.%20).
Also, the false alarms that Bjornerud describes can feed into parents' fear and paranoia, sparking anxiety instead of providing comfort. Think of the cardiorespiratory monitor as a car alarm that goes off when the wind blows. And instead of your Prius, it's on your baby.
The AAP's recommended preventative measures reduce danger to the baby, in theory creating less need for a monitor. For example, putting the baby to sleep on its back, which is thought to reduce "rebreathing," or breathing in exhaled carbon dioxide; exclusive breastfeeding without formula (breast milk wards off infections)—and while SIDS studies haven't determined any specific amount of time, the AAP and World Health Organization recommend breastfeeding for at least the first six months; avoiding tobacco exposure; and eschewing bumper-lined cribs draped with matching blankets for more spartan sleep surfaces with only a firm mattress covered in a tight, fitted sheet. Updated guidelines also stress removing anything plush, like stuffed animals from the baby's sleeps pace to prevent suffocation.
AAP also says that sleeping in the same room (but not the same bed) as your baby for at least six months (ideally, a year) can reduce the risk of death by about 50 percent. "There's no need for a monitor if the sleep environment is shared," Feldman-Winter says.
The reason behind this advice, beyond simply keeping the baby within eyesight, is that parents and babies who share a sleeping environment tend to be incredibly in tune with one another. James J. McKenna, a professor at the University of Notre Dame who has done extensive research in co-sleeping (both bed-sharing and room-sharing), found that simply sleeping near mom, in particular, can regulate the baby's "breathing, body temperature, absorption of calories, stress hormone levels, immune status, and oxygenation."
That said, the makers of consumer home monitors are frustrated by the AAP's recommendations and lack of FDA approval, especially since they've noted the volume of positive testimonials from satisfied parents. Jordan Gallagher, co-founder of the Owlet sock, points out in an email that the AAP's guidelines essentially say, "We don't actively recommend monitors because we don't know if they benefit or not," rather than providing any concrete drawbacks of using them. In fact, Greg Gallagher, founder of Snuza, says that with over 300,000 devices sold, he's not aware of a single death among users.
Since high-tech monitors aren't inherently dangerous for babies (Bluetooth transmitters operate at a low power), there's no harm in providing an extra layer of security. But if it also comes with panic-inducing false alarms or leads parents to become lax about maintaining a safe sleep environment for their babies, the negatives may indeed outweigh the peace of mind.
Feldman-Winter explains that overall, using a monitor doesn't impact the risk of SIDS. "More than anything, it creates more anxiety for the family."