Does my baby need a monitor, and where does the AAP stand on wearable oxygen monitors?

The AAP and NIH position

According to the AAP’s 2022 recommendations, home cardiorespiratory monitors should not be used as a strategy for reducing SIDS risk. Its site for parents adds an equally important caution: these devices shouldn’t lull you into a false sense of security. The AAP likewise recommends against commercial devices marketed as reducing the risk of SIDS or other sleep-related deaths.

The NIH Safe to Sleep campaign states that monitors tracking a baby’s heart, breathing or motion are not effective at detecting or preventing SIDS, and it does not recommend them as a way to lower that risk.

Common kinds of monitor

If hard nights are what has you browsing monitors, a new monitor won’t make those nights easier. Actually Sleeping tackles the reason your baby is waking, through a plan written specifically for your baby.

Research on consumer oxygen monitors

In a 2018 JAMA study, researchers compared two consumer pulse-oximetry baby monitors with a hospital monitor in 30 hospitalized infants aged 0 to 6 months. One of the consumer monitors failed to detect low oxygen at all. The second caught low oxygen in every infant who had it, yet sometimes displayed normal readings during those same episodes. The device that missed low oxygen also wrongly reported a low heart rate in 14 babies whose actual heart rate was normal. The authors advised caution about relying on these monitors’ data for medical decisions.

Because products and software get updated, those specific findings may not hold for every model on the market now. The central lesson still holds: an app reading is not a diagnosis, and no monitor stands in for a safe sleep space.

False alarms and the toll on parents

On its page about home apnea monitors, the AAP points out that these devices set off many false alarms, that the noise can leave parents overly worried and short on sleep, and that one study found parents of monitored infants felt more depressed. A device that keeps you up checking an app is costing your household sleep without reducing your baby’s risk.

Monitors prescribed by a doctor

Occasionally a doctor recommends a home monitor for a particular medical reason, such as a baby on home oxygen or one with serious breathing problems. In that case it is a medical device used as part of a care plan, which is not the same thing as a consumer gadget bought for reassurance. If your baby spent time in the NICU or has a breathing condition, check with your pediatrician about whether monitoring is needed.

Using an everyday monitor safely

• Keep cords well clear of the crib. The CPSC warns never to put corded cameras within three feet of a crib, since cords can strangle infants and toddlers. Mount the camera on a wall or a high shelf.
• The fundamentals are what protect your baby: back to sleep, a firm, flat surface with nothing but a fitted sheet, room sharing for at least the first 6 months, no smoking, and no bed sharing.

A monitor shows you the waking; it can’t change it

When nights get tough, lots of parents upgrade their monitor in the hope that more data will explain the wake-ups. A monitor can tell you your baby is awake. It can’t tell you the reason, and it can’t teach your baby to settle back to sleep. Babies who wake many times a night generally need help getting back to sleep between sleep cycles, and that piece can be fixed. That is the work Actually Sleeping does: Dr. Sam writes a plan for your baby, we coach you bootcamp-style before the first night, and we check in 1:1 every day. During a plan, a video monitor can actually help, since you can confirm your baby is safe and settling without opening the door. Parents talk about the difference in our 129 client video reviews.

If you spend more time watching the monitor than sleeping, book a free consultation with Actually Sleeping.