The quantified baby: real-world use of infant sleep monitoring technologies and its impact on parent mental health and medical decision-making.

Background: Managing sleep is a challenging experience in early parenthood, and infant sleep problems are associated with negative outcomes within the family. A large market of devices to monitor infants' real-time health information during sleep has emerged, including smart cameras, under-mattress sensors and wearable devices. The impacts of these products on maternal and parental mental health and medical decision-making are poorly understood.

Methods: We performed a systematic search for products detecting health data from sleeping children on the global retail platform Amazon in March 2023. A total of 11 262 unique reviews from 48 eligible products were retrieved from the USA, Canada, UK, and Australia sites and subjected to sentiment and thematic analyses to capture the characteristics of user families, contexts of device use and impacts on maternal and child health.

Results: Parental anxiety and infants' high-risk medical status were cited by families as the main reasons to purchase products. When devices worked well, their use was associated with improved parental sleep quality and decreased anxiety. However, poor device performance was commonly reported and was linked to increased parental stress and anxiety and disrupted child sleep. Users reported making medical decisions based on device output. Price, privacy, and unsafe use of devices emerged as ethical issues.

Conclusions: Use of a smart sleep device in the home is common and has implications for the health of both children and adults. Benefits and harms must be understood by parents and healthcare providers in order to support evidence-based decision-making around their use.