Do high-tech baby monitors cause more harm than good?

Did you consider adding a $350 infant sock that can measure oxygen levels and heart rate to your baby registry? Were you tempted to purchase your own Doppler for at-home fetal heart rate checks? Instead of sticking to sleepers, soothers and diapers, some parents-to-be are stocking up on significantly more sophisticated—and pricey—high-tech baby monitors.

Liz Brown*, a mother of two, relied on these new technologies to deal with the stresses of new parenthood. When she was pregnant for the first time, she used her own fetal Doppler to track her baby’s heart rate at home. “If the baby’s movements were hard to feel, I found it reassuring to check the heart rate,” says Brown, a family doctor who has been trained to find a fetal heartbeat. The device helped her manage some of her worries during an anxiety-ridden pregnancy that followed a few rounds of in vitro fertilization (IVF).

Once Brown’s baby was born, she used the Snuza Hero, a physiological monitor that clips onto an infant’s diaper and triggers an alarm if the baby’s abdominal movements drop to less than eight movements per minute, which indicates that the chest and tummy aren’t moving up and down as she breathes. The Snuza also sounds an alarm if there is no movement at all after 20 seconds.

“Everyone laughs when I tell them, but it really saved me,” explains Brown. “I couldn’t sleep when my daughter was born—I really couldn’t. I would look at the video monitor while she was napping and constantly wonder if she was breathing.” Brown also chose the Snuza setting that offers an audible ticking noise with each abdominal movement, which she could hear through the baby monitor. That way, she could always hear the tick of each breath, even from another room.

Brown used the Snuza until her first daughter was about nine months old and is still using it with her second baby, who is now eight months old. While there were some false alarms with both girls, Brown says that, as a doctor, she knew which warning signs were serious, and her babies were always OK. “I thought it was helpful for me because it helped me manage my anxiety, and I had no other way to control it,” she says. Her husband agrees, saying he wasn’t bothered by the constant beeps and ticks because he knew it was helping his wife deal with her fears.

There is a plethora of products on the market for prenatal and infant monitoring. At-home Dopplers like the Sonoline Pocket Fetal Doppler ($60 to $105), which is similar to what Brown used, detect the baby’s heart rate in utero. The growing “pregnancy wearable” market includes inventions like Bloomlife, a sensor patch you attach to your belly during the third trimester to count and time contractions. (It costs US$49 to purchase and US$24 per week for the real-time monitoring service.) For newborns, the market is even bigger. Like the Snuza, the Angelcare Baby Movement Monitor sounds an alarm if no breathing-related movements are detected after 20 seconds. This product can also track, record and report your baby’s bigger movements, indicating whether she has been restless or had a night of poor sleep. Meanwhile, the Owlet Smart Sock monitors your newborn’s heart rate and oxygen levels while she sleeps, using pulse oximetry embedded in a teeny high-tech sock that costs $340. Then there’s TempTraq, a US$20 patch that is placed in your baby’s armpit. Once you install the TempTraq app on your phone, the patch continuously records and sends alerts about your child’s temperature.

While Brown has found peace of mind using the Snuza, she doesn’t recommend similar physiological monitors to her patients or fellow parents, especially not the at-home Doppler she used during her pregnancies. Why? Because most parents won’t know how to properly use or manage the information output from these devices, she says. This is also partially why she wanted to use a pseudonym for this story. Medical professionals are often uncomfortable recommending specific products, and most of Brown’s colleagues do not recommend investing in or relying on physiological baby monitors.

In fact, in January, an article published in the Journal of the American Medical Association identified this growing trend and outlined why parents should not be using these devices at all. The author, Christopher Bonafide, is a paediatrician at the Children’s Hospital of Philadelphia. “The marketing of these products is really taking advantage of the fear and anxiety that every parent feels,” says Bonafide. “They’re citing statistics for sudden infant death syndrome [SIDS] on their websites and claiming to catch potential problems with the baby. The ads can be predatory toward new parents.”

Bonafide became interested in the effects of physiological monitors when an infant was admitted to his ward after the worried parents had brought their baby to the emergency room, reporting alarms on an at-home device. (The baby turned out to be fine.) He feels that it sets up a domino effect of extreme parental anxiety, which can lead to hospital admissions, unnecessary and potentially harmful tests for the baby, such as needle sticks and blood tests, or radiation exposure from X-rays.

Most of these consumer products aren’t approved or regulated by the Food and Drug Administration (FDA) or Health Canada, so Bonafide says that the companies can’t guarantee the medical effectiveness or accuracy of the data they produce. “Even if they could prove efficacy, there’s no evidence to say that monitoring a healthy baby at home helps prevent anything, whether it’s SIDS or any other adverse health problems,” he says.

If your child has a serious health issue that warrants monitoring, a paediatrician would likely prescribe you a medical-grade monitoring device and train you on its use. “It would be completely customized,” says Bonafide.

While regular video and audio monitors are fine, the American Academy of Pediatrics recommends against using at-home physiological baby monitoring technology, stating that “the use of cardiorespiratory monitors has not been documented to decrease the incidence of SIDS.” (Note: In Canada, the term SIDS is slowly being replaced with the designation “undetermined.”)

The Canadian Paediatric Society has no official stance on physiological monitors. Health Canada refers parents to its safe sleep recommendations—not technological interventions—as the best way to reduce the risk of SIDS. (It recommends always placing your child on his or her back in a completely empty crib, cradle or bassinet without bumpers, stuffies or blankets. Also, it’s best to room-share—but not bed-share—for the first six to 12 months.)

“In my opinion, the biggest risk is that parents may have a false sense of reassurance that the devices will alert them to problems with their babies,” says Robert Everett, a paediatrician in the Newborn Care Program at BC Women’s Hospital. “This could make parents feel more comfortable putting their babies to sleep in a manner that we would consider unsafe, such as sleeping on their tummies instead of on their backs.”

Bonafide echoes this concern: Be wary of trusting technology over other, more subtle and natural cues that parents have when it comes to their children. “There’s an awful lot more to taking care of babies than just looking at their heart rates and their numbers,” he says.

Ken Lim, the division head of Maternal Fetal Medicine in Obstetrics and Gynaecology at BC Women’s Hospital, is also concerned with the unintended consequences of parents attempting to interpret too much information or panicking when the technology malfunctions. “Even trained professionals with a lot of experience can have trouble finding a heartbeat during fetal monitoring,” says Lim. “If a parent can’t find the heartbeat, which is quite possible, this creates anxiety as to the health of the baby.” Studies of people who used at-home uterine monitoring have found that it can lead to unscheduled visits to the doctor or emergency room, burdening the healthcare system and leading to unnecessary follow-ups, he adds.

There’s another reason why parents shouldn’t constantly Doppler themselves at home with an over-the-counter product: There’s a slight risk of “warming the tissue” underneath the device. Some animal studies have suggested that, with sufficient output power for enough time, ultrasound can subtly change nerve migration in the brain of the baby. Don’t worry: Your regular, prescribed prenatal ultrasounds are still considered safe during pregnancy, but it’s a good idea not to go overboard. In 2014, the US FDA put out a consumer update regarding their use, citing that ultrasounds (both the fetal imaging ones and the sound-only fetal heartbeat kind) can heat tissues slightly and, in some cases, produce extremely small bubbles in some tissues, of which the long-term effects aren’t known. “Ultrasound scans should be done only when there is a medical need, based on a prescription, and performed by appropriately trained operators,” states the FDA consumer alert, which also discouraged extra “fetal keepsake video” services like the 3-D and 4-D ones offered at private ultrasound clinics (these run somewhere in the range of $70 to $180, depending on the package you buy). While some of these reports have been inconsistent and final conclusions are yet to be drawn, says Lim, it’s worth avoiding the risk unnecessarily, especially if you aren’t a trained technician.

Meghan Mann, a 33-year-old mother of two in Toronto, says she wasn’t interested in using any monitoring devices when her children were newborns. While she did have an audio baby monitor with her first child, it broke within a few weeks and she wasn’t interested in getting another one. “The fewer devices, the better,” she says. “The house was so small, we could hear her cry, so we didn’t need it,” she says. Mann followed safe sleep guidelines and wasn’t overly concerned about her infants’ health otherwise. “I think if you are a stressed-out parent, you’re going to have a stressed-out baby,” she says. “If you have all of these devices beeping and telling you what’s happening everywhere, you’re going to be freaking out all the time.”

If anxious parents really want to use at-home monitoring devices, Bonafide recommends that they speak to their paediatricians first about how to manage the information. “Make a plan,” he advises. If the monitor goes off in the middle of the night, how are you going to react? If your child seems completely fine, are you going to take her to the emergency room?

“I know that the parents who are buying these monitors want to do everything they possibly can to keep their babies healthy, and I think that sentiment is great,” says Bonafide. “But the reality is that healthy children are at such low risk of cardiorespiratory events. It offers a false sense of security that can have other consequences.”

Plenty of baby-gear inventions are great advancements—parents everywhere are grateful for the automatic baby swing, and let’s send a huge thank you to whoever invented the electric breast pump—but creating a nursery with enough beeps and wires to resemble a neonatal intensive care unit can be a hindrance to your family’s health—and your own sanity. Childrearing can’t be reduced to data and stats, even if it helps new parents feel like they’ve regained some semblance of control in this often uncertain, chaotic phase of life. Before you add that high-tech monitor to your registry, think long and hard about whether it will truly give you peace of mind.

*Name has been changed

Read more: 7 sleep mistakes new parents make The 10 most dangerous baby products SIDS deaths are now considered “undetermined”