How Accurate Are Oxygen Readings On Wearable Baby Monitors Like The Owlet?

In a world of wearable technology that gathers data about our sleep, activity levels, heart rate, and more, it’s no wonder we now have so many smart gadgets for nurseries that can do the same for our newborns. Especially when it comes to preventing sudden infant death syndrome (SIDS), having a baby monitor that tracks your baby’s pulse and oxygen saturation just feels like an added protection against every parent’s worst nightmare. But are pulse ox baby monitors the solution to parents’ anxieties? Can these wearable monitors actually prevent SIDS? It’s natural to reach for a product that might protect your baby, but when you hear about how often they can cause false alarms (and more anxiety than comfort), you might hesitate.

Smart baby monitors connect to parents’ smart phones, allowing you to see and hear your baby from anywhere. They usually include some extra sensors to read the room’s temperature and humidity. Some smart monitors include wearable pulse oximetry sensors, which track your baby’s heart rate and blood oxygen saturation levels. Many parents hope that being alerted to changes in their baby’s vital signs could help them prevent SIDS, which might make them more likely to add a pulse ox baby monitor to their registry. But can it actually help?

Should I get a pulse ox baby monitor for my baby?

Right now, there’s not enough evidence that pulse ox monitors are helpful to families to outweigh the stress they might cause, according to experts. There is currently no evidence that using these wearable baby monitors can prevent SIDS, or uncover any sort of undetected medical condition, says Dr. Michelle Hjelm, M.D., board-certified pediatric pulmonologist and sleep physician at Cincinnati Children’s Hospital.

“The American Academy of Pediatrics hasn’t recommended these devices for standard use,” says Hjelm. “I understand the questions that families and parents are asking of these devices, but I just don’t think they’re giving the answers that we want. Can you protect your kid from everything every minute of the day? No. And can we truly have a sense of a diagnosis from these devices? I don’t think that’s true.”

“I definitely cannot recommend them with the information I have right now,” says Dr. Sharada Gowda, M.D., a board-certified neonatologist at Texas Children’s Hospital. “From reports that I have been reading, and delving into all the mommy groups, as well as the parental support groups, the parents that are utilizing these are first-time parents, or well-meaning parents with a lot of anxiety about the safety of their babies. But if the alarms keep going off, then they might actually be hurting more than helping themselves and the baby.”

Owlet’s monitors have come under fire before for sending false alarms to parents (oftentimes about low oxygen readings, and having app glitches that caused readings for pulse and oxygen saturation to disappear. This not only causes anxiety for parents, but can lead to alarm fatigue — when monitors are constantly alerting you to potential problems, and eventually, you stop responding with the same urgency you should.

Why would a baby need a pulse ox monitor?

In rare instances, doctors will send a medical-grade pulse ox monitor home with babies who have certain health conditions. This includes babies who have tracheostomy tubes to help them breathe and those born with congenital heart defects, Gowda says. Hjelm says they’re also useful for babies with lung disease or sleep apnea.

If you’re prescribed one for your baby, you’ll receive training from nurses about how to use it, any troubleshooting you may have to do on the machine itself, and how to help your baby if their oxygen saturation does dip. Gowda says her patients also receive the phone number to a hotline that connects to the baby’s care team in case of emergency.

“The biggest piece is going to be the educational aspect, and preparing the parents, if they were to have major desaturation, to act on behalf of the baby at that point, stabilize them, and also be ready to call the medical team who took care of the baby,” she says.

Pros & cons of using a pulse ox smart monitor

Pros:

• For some parents, these devices provide peace of mind that their baby is being supervised while they sleep.
• If your baby has a medical condition, pulse ox monitors can help you care for them at home and alert you if they need intervention (but you should be using a hospital-grade device provided by your doctor).
• Aside from the pulse ox and other health-related readings, they usually have interesting features you might enjoy, like tracking your baby’s movements through the night or being able to take videos with your monitor camera.

Cons:

• They haven’t been proven to prevent SIDS, which is what many parents hope they’ll do.
• They can cause increased anxiety and reduced sleep for parents if the alarms go off unnecessarily.
• Wearable smart monitors with pulse ox sensors are generally more expensive than standard baby monitors.

Are pulse ox baby monitors accurate?

Gowda and Hjelm agree that right now, they just can’t say that commercially available pulse ox monitors are reliable. “No matter what, it’s very hard to predict when bad things are going to happen, even with these types of devices,” Hjelm says. “The best thing you can do is follow the safe sleep recommendations that have been shown to reduce the risk of SIDS. These [monitors] just don’t look to be that answer or that safety net that we want them to be.”

There are wearable baby monitors that have or are close to getting the FDA’s stamp of approval like Owlet’s BabySat, which is FDA-cleared (meaning it’s an approved medical device) and available via prescription only. The company’s Dream Sock received FDA clearance on November 9, 2023 and can be purchased over-the-counter. The Masimo Stork monitor is also undergoing FDA review. For her part, Hjelm is hopeful that models like these can give families who need it a medical-grade wireless pulse ox monitor to use at home, one that connects to their phones instead of being a “constant beeping thing in your house” like the ones she prescribes today.

Gowda says no matter how sophisticated the devices themselves are, parents need more working knowledge of how the pulse ox sensors should be applied to get accurate readings.

“The thickness of the skin, the surface on which these monitors are placed, and the color of the skin all play an important role. You need to have accurate knowledge of, okay, it has to be on the toe, or maybe it should be on the palm. A lot of times, I place it on the radial artery directly. Knowledge like that is important. It’s not just [about] the piece of equipment,” she says.

So, do you have to have a pulse ox baby monitor for your little one? No. In fact, doctors feel they’re more likely to cause you undue stress than be helpful. If your baby needs to have their oxygen saturation monitored, you’ll get a hospital-grade monitor and lots of training straight from their doctor.

Experts:

Dr. Michelle Hjelm, M.D., board-certified pediatric pulmonologist and sleep physician, and assistant professor at Cincinnati Children’s Hospital

Dr. Sharada Gowda, M.D., a board-certified neonatologist at Texas Children’s Hospital and an assistant professor at Baylor College of Medicine