Home Monitors Don't Appear to Predict SIDS
May 1, 2001 -- Proper positioning of babies when they sleep --
not the use of home monitors -- still appears to be the best way to prevent
sudden infant death syndrome (SIDS), or "crib death," experts say.
"For a long time it has been recognized that certain
infants are at risk for SIDS," George Lister, MD, tells WebMD. "We have
also realized that many of these infants have episodes when they stop breathing
or their heart rate decreases to what seems to be a dangerously low pace. The
idea has been that if they were monitored at home with devices capable of
counting the duration of these episodes and sounding an alarm, the warning
would interfere with the event and save the child from sudden death."
But Lister says that hope, which is supported by a flourishing
industry of home monitoring manufacturers, does not appear to be borne out.
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A large study of home monitors designed to prevent SIDS found
that many of the heart and breathing irregularities that set off monitor alarms
-- and which may be precursors to crib death -- occur commonly both in healthy
and in at-risk infants.
What's more, those irregularities don't appear to be related to
SIDS, according to a report appearing in the May 2 edition of TheJournal of the American Medical Association.
Lister, an author of the report, tells WebMD that the study
sheds some doubt on the usefulness of home monitors in predicting or preventing
"What we found is that not only were the events currently
being detected by monitors very, very common, they were occurring in healthy
infants as well as infants at risk," Lister, a professor of pediatrics at
Yale University School of Medicine in New Haven, Conn., tells WebMD.
In the study, nearly 1,000 infants -- including healthy babies
and babies born prematurely -- were observed using home monitors for the first
six months after birth. The babies had no or varying degrees of risk for
The monitors were used to detect episodes of apnea -- or a
sudden halt in breathing lasting at least 20 seconds -- as well as decreases in
heart rate. Researchers also used a specially designed monitor to detect
"extreme events" -- more severe apnea and more severe decreases in
heart rate -- not commonly detected by commercial monitors.
The results showed that there were nearly 7,000 events that
would have caused a conventional commercial monitor to sound the alarm,
occurring in 41% of all the infants. Even the "extreme" events, though
far more common in preterm infants, were fairly frequent in both healthy
infants and infants at risk for SIDS.
Because only six infants in the study died from SIDS, the study
cannot be used to determine an association between the events and risk for
death. But Lister points out that the extreme events tended to occur very early
in infants' lives -- much earlier than SIDS typically occurs. SIDS rarely
occurs before one month of age. It is most likely to occur when infants are 2-4
months old, with 95% of cases occurring by 6 months of age.