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Comment by hessenwolf | Hacker News Reader

http://www.childtrends.org/?indicators=infant-child-and-teen...

Looks to me like infant mortality (under age one) has halved between 1977 and 2013. I understand the argument of "it worked fine for me", but, well, on a portfolio basis, you and I were dying a bit faster back then.

Outpatient care is a big field these days. Something that, with extremely little effort, can reduce the odds of death or disability, is quite tempting. A smart nappy/diaper with a disposable nutrition-analysing smart-chip is not that far off.

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That's not fair. He didn't say "children should be raised to exactly the same standards as they were in 1977". He said "we were raised without the benefits of smart-onesies, and we came out fine". Those are two different arguments.

Meanwhile, the reality is that the bulk of the decline in US infant mortality is attributable to improved prenatal care. If you want to keep arguing about the value of modernizing parenting, can we start with statistics broken out by income level? Has infant mortality among the children of well-off parents declined sharply as well? If modernization is saving children, that statistic should reveal it.

It's not 'unfair'. (are you implying I was unduly harsh on the gent?)

Let's take sudden infant death syndrome (SIDS). Because of SIDS, it is now recommended in the videos I watched yesterday, that infants be put down on their backs with no pillows in the parents' bedroom but not in their bed. This has no bearing on prenatal care or wealth, but has an effect, which could probably be enhanced by a smart baby monitor.

So you disagree with articles like http://www.slate.com/articles/life/family/2014/02/mimo_and_o... "Selling Fear: Smart monitors cannot protect babies from SIDS, so what are they for?" Or the Policy Statement at http://pediatrics.aappublications.org/content/128/5/1030.ful... which says:

> Do not use home cardiorespiratory monitors as a strategy to reduce the risk of SIDS—Although cardiorespiratory monitors can be used at home to detect apnea, bradycardia, and, when pulse oximetry is used, decreases in oxyhemoglobin saturation, there is no evidence that use of such devices decreases the incidence of SIDS.84,–,87 They might be of value for selected infants but should not be used routinely. There is also no evidence that routine in-hospital cardiorespiratory monitoring before discharge from the hospital can identify newborn infants at risk of SIDS.

When you say "probably be enhanced", was that speaking only from optimism in technology, or did it have some other basis?

It's not possible to lay an infant on its back if it's wearing a dumb onesie?

14-16 years ago, it wasn't even possible to get out of a hospital without having this explained to you in detail. I can only imagine what it's like now.

"Smart onesies" are silly.

Biometric monitoring for at-risk individuals is patently not silly. As a percentage, more babies are at-risk than young adults.

The question we should be asking is whether a smart onesie improves outcomes compared to existing best practices. If there's not a statistically significant difference and you divert money from things that would help, then pushing these onesies isn't benign, it's actively harmful.

The point as I see it being got at here is that changes in the approach to raising a child has resulted in fewer SIDS over the past 30 years [1].

Introducing new technology, or techniques, regardless of how absurd it appears, needs the data to identify whether it really does have an improvement in child safety.

Simply saying my generation (born in the 80's) turned out just fine so why change is actually incorrect. The rate of deaths was higher in the 80's compared to now and changes were made in advice that has reduced death rates.

Technology could be used to reduce this further, but we don't know until we have the data. Do I think it's likely that an IoT onesie will make a difference? Not really, purely because the cost and adoption rate would probably make it impossible to detect its impact as safety concious parents who would buy it would probably have mitigated most risks anyway. The chance of getting a significant number of would-be SIDS outcomes to be using such a device would, in my opinion, be extremely small.

[1] http://www.babywill.org/sids-information/what-is-sids/sids-s...

Again: the dominant factor in reducing infant mortality in the US has been prenatal care. Infant mortality in the sense described upthread is not about SIDS.

The latter half of your comment is a bit hand-wavy. "Purely" because of adoption numbers? What does a "smart onesie" actually have to do with SIDS? Companies have been selling ever-more-complicated baby monitors to parents for years using fear of SIDS, but SIDS is not a problem of monitoring.

Same argument as "we rode on the back dashboard with no seat belts as a kid and we survived". Completely ignoring the hundreds of thousands of kids who didn't survive. Because the ones who were killed doing something dangerous aren't around anymore to tell you not to do it. Doesn't mean we should roll back the clock on car safety.

That's different because there's a clear mechanism and the data supports it. Is there a real study with a large enough sample size showing anything similar or is it just the usual convenience and artfully vague claims?

I understand your desire for hard data, and I'll admit I doubt it's there. However it's not that much of a stretch to follow from "babies survive better when people are watching them" to "it's easier to watch a baby when there are multiple people taking care of it" to "it doesn't have to be people, necessarily" to "what if sensors could do it" to "babies live longer because sensors are watching them when humans might not be".

Completely pulling numbers out of my ass for sake of argument, for every 1000 babies that survive just fine without baby monitors, there might be one or two that didn't, because mom and dad stepped away and didn't notice the kid stop breathing. Really, people survived just fine without seat belts. We kept enough of the population to survive and even thrive as a species even in incredibly dangerous cars. But now that we have them and we recognize their value, would we go back?

I was looking at the comparison like this:

we knew that many thousands of people were dying in car crashes and also that people wearing seat-belts survived crashes at a much higher rate.

we know that a small number of kids die but we don't have that same level of evidence that the proposed solution actually works.

That's an argument for doing more studies but not for buying a bunch of IoT stuff at steep prices.

Maybe you are right... but a onesie that "knows that when a baby wakes up, the parents will, too -- so it turns on lights and music and even makes the coffee." ... is of no use to fight infant mortality.

That's not all it does, you just picked out the ridiculous part. If you'd quote the entire piece on that onesie you'd see that it actually has a bunch of features that very well might reduce infant mortality.

The author also invokes 'helicopter parenting' as if it applies to taking care of babies. Helicopter parenting is when parents disrupt other caregivers during the care for their child, it has nothing to do with being sure about whether your baby is dying. I am confident parents themselves can configure and determine when and when not to wake up when their baby is awake.

As a non-parent, do parents really drink coffee in the middle of the night when their baby wakes up? That seems like a terrible idea..

The article addresses this point directly, but because you aren't a parent, it may have gone over your head. The real problem with a smart-onesie isn't simply that it's useless, but that infants are restless, and any signal this device carries will be overwhelmed by the noise. When you're the parent of an infant, your #2 goal (after "keep the baby alive") is "ruthlessly attend to your own rest needs".

I fully understand, that's why I called it 'the ridiculous part'. I recognize that a device that wakes you up whenever your baby is awake would be crazy, but surely that isn't what the device is going to do? I read it more as 'when your baby is crying so hard you will most likely wake up, it will turn on lights and soft music to assist you in calming them'.

As a father of two, my youngest being 4 months old, those features sound unusually stupid. When the baby wakes up at 3am, any device that subsequently turned on lights and music would be taken out back and shot. As for the coffee, my bog-standard Philips coffee maker has a built-in timer already, set for 6:30 am.

My baby doesn't need an app to let me know he's up. Generally the piercing fire trunk level scream does the trick. Now, does this smart baby suit help against SIDS? Nope. If there's science to prove me wrong, I will gladly revise my opinion. Honestly though, that baby suit with a built in coffee maker trigger and light turning on capability.. That's just dumb. Do we really want all the lights coming on every time the baby stirs? Is coffee making really what's needed at that moment? The potential for that technology is cool, but the execution just sounds excessively superficial. as far as infant mortality: what are the causes of infant mortality? Certainly not underlit homes and under caffeinated parents.

Mimo monitors breathing, temperature and sleeping position. All of these are factors in cot death according to easily searchable research.

There is no evidence I've found that any monitoring device improves SIDS outcomes, and there is evidence that it doesn't. Forget about the smart onesie: it's difficult to justify even classic baby monitors as a medical intervention.

The decline in SIDS over the last 2 decades tracks the education of parents not to put infants to sleep on their stomachs.

Small note, but there are other major factors in the decline of SIDS besides just not putting infants to sleep on their stomach, although they generally all stem from the idea of educating new parents about basic safety procedures that are not always intuitive.

I'm pretty sure I would be the first to put all kinds of sensors onto my baby, it's toys and environment but I'm also pretty sure I would check on that stuff AND on the baby myself. Also considering the security problems.

Looks to me like a hell lot of problems added to what I would already have with the baby alone. My parents had me in their room and I survived. Others died. Maybe that's just the way it is.

I thought that a cot death meant that this remained unexplained. Now a baby monitor reduces cot deaths? I'm really interested to read about that claim.

It remains unexplained but things are correlated with it, and possibly have an unexplained causal effect.

There are side effects of monitoring.

"Angelcare voluntarily recalled 600,000 under-mattress sensor pads after two infants died of strangulation when the cord attached to the pad wrapped around their necks" - http://www.slate.com/articles/life/family/2014/02/mimo_and_o...

Strangulation by baby monitor is correlated with having a baby monitor.

No, baby monitors have been studied. It's not a big mystery. Monitoring doesn't make a dent in SIDS. Education does. "Don't put infants to sleep on their stomachs".

Yes but this improvement was achieved by improvements (and increased uptake of) the traditional baby monitor. His point that the smart onesy is a bad idea stands irrespective.

> Outpatient care is a big field these days. Something that, with extremely little effort, can reduce the odds of death or disability, is quite tempting. A smart nappy/diaper with a disposable nutrition-analysing smart-chip is not that far off.

Or we could save the money spent on gadget nappies and instead use the money to pay for better/more nursing (and integrating nutritional requirements into patient care).

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