Trigger warning: This blog post discusses the stoppage of breathing and some other sensitive topics that may be upsetting to some readers.
Perhaps one of the most important topics we will ever speak about here at Coping With LM is the danger of using a smart baby monitor on a baby with an airway disorder. The airway disorder, malacia, causes an airway obstruction and because of that, patients with moderate to severe cases should use a hospital grade monitor with rescue oxygen, and all caregivers should receive CPR training along with proper medical support to ensure the baby thrives without any complication.
1. NO RESCUE OXYGEN
It's 2:00 AM and the monitor is alarming. Your baby is blue and not breathing. You call 911 but it will be a few minutes before paramedics arrive. Rescue oxygen is a must anytime a child with a compromised airway is being monitored.
2. LIMITS ARE NOT CORRECT
Typically, the prescribing doctor will set limits (when to alarm at slow heart rate, fast heart rate, and lung movement) on the monitor prior to first use. The alarm limits are decided by the baby's age are lowered as the baby gets older. Smart baby monitors normally have very low limits that cannot be changed.
3. UNRELIABLE
Smart baby monitors are not made for prolong use, they break quickly which may cause unreliable readings.
"I can also confirm that it’s not accurate. My baby was in the hospital for a week and multiple times dropped sats to 70’s with good waveform so we knew it was accurate and the Owlet would still be around 98%."- Nikki4. WHO'S IN CHARGE?
When a hospital-grade apnea monitor or pulse oximeter are prescribed, there is a doctor overseeing your child's care and reading the information collected from the medical equipment. For babies with airway malacia this is normally an ear, nose, and throat doctor or a pulmonologist. This doctor becomes your go-to-person for any questions, concerns, and future treatment options regarding your child's breathing.
5. LACK OF EDUCATION
When a baby is prescribed a hospital grade apnea monitor or a pulse oximeter, the medical supply company comes to the house, gives a CPR class to the parents and caregivers, offers education on how to properly use the machine along with providing parents with plan of action, should their child stop breathing.
6. NOT AS SENSITIVE
Smart baby monitors are known for not detecting actual events.
"I would regularly witness my son stop breathing and the lights flashed green as if everything was fine. Around nine months old we found out he had moderate to severe sleep apnea and would have frequent pauses in breathing over 25 seconds in length which should have set the alarm off, but never did."-Megan 7. POOR FIT
Hospital grade apnea monitors and pulse oximeters are made to fit growing babies. As the baby grows, the medical supply company supplies new leads and equipment to ensure an accurate read.
"We tried a store bought monitor but the elastic dug into my son's skin and I had trouble getting it to read." -Christina 8. FALSE SENSE OF SECURITY
Caregivers see the monitor flashing green, not alarming, and believe everything is alright. Significant apnea can go undetected by using a smart baby monitor.
"I used the Snuza on my daughter (LM & TM) and it would alarm once every few days. A few weeks later she had a sleep study that showed severe central sleep apnea along with seizures. My child was literally seizing in her sleep and not breathing and the Snuza was not alarming!"-StephanieIt is important to understand the Snuza is designed to alarm twice, once at 15 seconds and then again at 20 seconds after no movement is detected. While this can be beneficial for an otherwise healthy baby, in a deep sleep who needs to take a nice deep breath, it probably won't detect obstructive sleep apnea (a symptom of an airway disorder) since movement is almost always associated with OSA. i.e. gasping, choking, flailing of the arms, kicking of the feet.
9. THEY DON'T MONITOR EVERYTHING
Hospital grade apnea monitors monitor heart rate (slow and fast) and lung movement. Smart baby monitors don't normally monitor all three. Some just monitor breathing while others just monitor movement.
10. NOT MADE TO DETECT APNEA
For a baby without an airway disorder, a smart baby monitor is probably a good way to ease a new parent's mind. The truth of the matter is, smart baby monitors are not made to detect apnea (stated by Owlet, Snuza, and Wellue), which is a symptom of airway malacia. While it may be easier to purchase a smart baby monitor online than to bother your baby's doctor (or even have a sleep study done) the reality is, it's not worth it. Severe, untreated apnea can cause life altering complications that can be prevented by using a hospital grade apnea monitor.
"Accuracy testing of 2 Spo2-based baby monitors that are not FDA-regulated revealed concerning findings. Monitor A detected hypoxemia but performed inconsistently. Monitor B never detected hypoxemia and also displayed falsely low pulse rates. Beyond their accuracy, other concerns about consumer monitor use include the lack of medical indications for monitoring infants at home, the absence of FDA oversight, and the potential for unintended consequences."- JAMA Network Accuracy of Pulse Oximetry-Based Home Baby Monitors Study If you believe your baby stops breathing during sleep please call his/her doctor immediately and ask for a sleep study.
If you have any questions or comments regarding this post please email us at hi@copingwithlm.org and a volunteer will be in touch.
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#laryngomalacia #tracheomalacia #bronchomalacia #pharyngomalacia #smartbabymonitor #sleepstudy #cpr #apnea #snuza #owlet