To Monitor Or Not To Monitor?...That Is The Question

You're having a baby.. .as exciting as this news is for most, some parents need to deal with other emotions and questions. Far more reaching than the common questions that usually go hand in hand with the preparations for having a baby, is the decision of whether or not to monitor the baby. This decision is pertinent to a family that experiences an infant death.

As nurses who have been involved in the CHIME project and directly involved with the infant monitor program, we have been able to see both sides of this question while recruiting for the subsequent SIDS sibling. Having net with families and discussed the decision to monitor, we have found each family's perceptions about monitoring to be unique and based on their individual coping.

There are families that choose to monitor because it gives them peace of mind; they feel it's what should be done or they are being told so by those around then. And then there are families who choose not to monitor because they feel it will label the baby as "sick." The monitor can be a constant reminder of the death of their baby or it may imply that something else could have been done to save their baby who died.

The facts are that the chance of having a subsequent SIDS are extremely low. Monitors are not designed to save lives, but to alert the caregiver to a potential problem.

Risk factors for SIDS are nationally published. Parents are made aware of the circumstances that can be potentially harmful to the baby, both prenatally and in the first year of life. For those families that do not fall into the risk group, i.e., smoking moms, lack of prenatal care, etc... choosing to monitor may be the only thing they would do differently.

Although the family's coping methods may be successful, the medical uncertainty of the cause of SIDS may continue to leave the family unsettled. In this unrest, parents may feel the need to shape their decision based on their personal experience. Therefore, the decision to monitor should be the choice of the family.

Monitoring can increase or decrease the parents' stress. The monitor can either be an inconvenience or a security. It can allow the parent restful sleep or it may alarm and disturb their sleep. Monitoring may be viewed as invasive or inviting. The monitor can be seen as altering parent-infant attachment or it can be incorporated into the infant's sleeping routine. Monitoring can be a love or hate relationship.

We realize that having survived the tragic death of an infant, families are not only dealing with the emotions surrounding this pregnancy and birth, but with the questions and emotions left unanswered. Therefore, it is our goal, as health care providers, that each family's individual needs and decisions be respected and supported.

It is our recommendation that with the preparations for your new baby, the decision to monitor be discussed before your baby arrives. Make a list of pros and cons of monitoring. Then schedule an appointment with your family doctor or pediatrician, where you can discuss your decision on whether or not to monitor and for how long. This will help alleviate any additional stress of decision-making at the time of your baby's birth.

--Jane Durham, RN, NS; and Suzy Guess, RN, MSW are both Clinical Nurse Specialists who have been involved in the NIH research project, CHIME. Their backgrounds are in pediatric and neonatal intensive care. They are certified in areas of developmental assessment and parent/child interaction.

Reprinted from the NW OHIO SIDS SUPPORT NETWORK NEWSLETTER Volume 3, Issue 12, MAY 1998