Infant seat in front seat? How bad?
February 24, 2011 10:25 PM   Subscribe

Apparently apnea monitors aren't reliable in moving vehicles, and I may have to put my 11-day-old in the front seat to be able to see that she's still breathing. Anybody have experience or expertise?

I'm terrified. The apnea monitor has brought us some limited peace of mind since a dreadfully close call on day 6. But infant, toddler and adult can't all fit in the back seat. And there will certainly be times when the infant and a single driver are in the car. Web searches don't yield specific answers, just strong recommendations against front-seat positions, which increase the chance of injury in an MVA. On the other hand, breathing trumps all. Has anyone else encountered this?
posted by wjm to Health & Fitness (24 answers total) 1 user marked this as a favorite
Back in the good old days when my daughter was a baby, people didn't even use car seats a lot of the time (one parent would just hold the baby while the other drove). And if you were alone with the baby, the car seat definitely went in the front seat, so that you could see the baby. Most people didn't wear seatbelts, either. While I agree that seatbelts, car seats, and putting car seats in the back seat are all great ideas, the fact is that millions of us survived before any of that became standard procedure. Just make sure you drive defensively.
posted by MexicanYenta at 10:38 PM on February 24, 2011

The odds of injury are drastically higher for your kid in the front seat. I encourage you to try a different option. We rigged up a mirror briefly when we were in your situation, and that was some degree of peace of mind. I am sure you know this, too, but if you've got a breathing compromised kid you're probably not going to want to be taking them out of the house that often during flu/RSV season. And yep, pretty experienced with this; 23 week preemie son came home on O2 and monitors four years ago. MeMail me if you want to chat offline.
posted by norm at 10:39 PM on February 24, 2011

Remember to turn off the passenger side airbag
posted by bottlebrushtree at 11:02 PM on February 24, 2011 [11 favorites]

Answer from a friend of mine who had a similar problem with her child: She bought this product on Page# 3 (inside the PDF). I couldn't find this product in the main site, though, so you might have to contact them for the price.

I don't think this comes cheap, so you might want to see if the video on your IPhone works ok for you (attach it to a suction cup) or hookup a cheap webcam to a large LCD screen in the front.

It is tough enough to watch your child have some illness, but lack of support systems increases the difficulty. Hang in there.
posted by theobserver at 11:07 PM on February 24, 2011

While I agree that seatbelts, car seats, and putting car seats in the back seat are all great ideas, the fact is that millions of us survived before any of that became standard procedure.

In those days, the front seats of cars didn't include an explosive device set to explode at the child in the event of an accident.

So make sure you turn off the passenger airbag. And I would also recommend looking into local laws to make sure that you do whatever is necessary to make sure that you have legal approval to carry the child in the front seat.
posted by The World Famous at 11:08 PM on February 24, 2011 [2 favorites]

Are you going to be able to drive effectively while you're checking the baby? I mean absolutely no snark or judgment at all, I just can't imagine being able to focus on the road in that situation.

Can you get someone to jig up a pulse oximetry device with a sensitive alarm? Pricey, but you might be able to borrow one or get your insurance to cover it. A lack of adequate perfusion (and drop in pulse ox) would occur pretty much simultaneously with a noticeable lack of breathing.

I can't imagine how terribly scary this must be. I hope that you find a good solution that works for your family.
posted by charmcityblues at 11:35 PM on February 24, 2011 [1 favorite]

I know my cousin (who had a healthy baby) bought a double-mirror system at some place like Babies-R-Us... one mirror goes on the back seat and one mirror hangs underneath your rearview mirror, and you adjust them until you can see the baby's face.

Here's something that apparently works similarly but is only one mirror (the one on the backseat), and you actually use your rearview mirror for it. You could easily buy the under-rearview mirror separately if you can't see the road and the baby both in the rearview mirror.
posted by IndigoRain at 12:46 AM on February 25, 2011 [1 favorite]

If a pulse oximetry monitor like charmcityblues mentions is what you need (which is something adults use to monitor for sleep apnea events) I cut down costs by finding this one on eBay for about a hundred USD plus shipping. It doesn't have any display of its own but can attach to a Windows-based laptop. The software doesn't have its own alarm system but possibly someone clever with computers could rig something up.
posted by XMLicious at 2:47 AM on February 25, 2011

If a baby has been diagnosed with apnea, shouldn't the physician have prescribed an oximeter? I ask this because our daughter was on O2 for the first 6 months of her life and the hospital was going to provide one when she was getting out of the NICU (we refused since she did nothing but kick it off causing false alarms). If not, you should ask her pediatrician.

We used a car mirror - one that mounted securely from the headrest.
posted by plinth at 3:01 AM on February 25, 2011

posted by k8t at 3:36 AM on February 25, 2011 [2 favorites]

Will a common baby monitor pick up her regular breathing, if set to high gain or max volume?
posted by Harald74 at 4:16 AM on February 25, 2011

norm: the odds are a bit different in this case. Normal children don't carry a significant risk of dying whilst just sitting in the car seat.

OP: just to underline what everyone else has said, if you put the child in the front, you must turn off the passenger airbag: it is capable of killing a child in a rear facing car seat if it goes off all by itself.

This must be a really stressful time for you. My best wishes for you & your baby.
posted by pharm at 4:41 AM on February 25, 2011

Is there a reason you can't rent a minivan, SUV, or other vehicle that could fit your baby, toddler, and an adult in the backseat or middle and back rows?
posted by Meg_Murry at 4:42 AM on February 25, 2011 [2 favorites]

Your most local Children's Hospital or, possibly, the hospital where you gave birth will have a child passenger safety group whose job it is to problem solve these exact sort of scenarios, including providing necessary safety equipment. The unit I am currently rotating on, in a Children's hospital, has to routinely send kids home with all kinds of scenarios that potentially compromise passenger safety (external ventricular shunts, severe apneas, etc.) and part of their discharge is consultation with passenger safety who do everything from top to bottom (kid, equipment, exemption documents, car, etc.)

I assume you baby passed her carseat challenge before she went home (where baby is strapped into a standard carseat on a monitor and must not desat for at least 30 minutes)? If so, this is reassuring and gives child passenger safety a place to start. If not, or if she wasn't challenged, I would get your ped to refer you to your local Children's just for this. If you're far from a Children's, call your closest and ask for the passenger safety people and explain your situation, or make your ped do it.

The point is, this isn't something you should remotely have to figure out on your own or on the Internet or from folks who may have had a similar sitch, but not you exact kid. It's a real specialty, and complicated, and your job is to enjoy that baby!

Contests--memail me if you have follow-up questions.
posted by rumposinc at 4:42 AM on February 25, 2011 [12 favorites]

Rather, congrats (not contests, damn auto correct). Babies are not a contest!!
posted by rumposinc at 4:47 AM on February 25, 2011

If you're in the US, it's pretty likely that having your infant in the front seat is illegal. If someone calls the cops to report you (I know a couple people who do this any time they see an infant in the front seat), you could wind up with a very large fine and possibly being investigated for some sort of child endangerment.
posted by chiababe at 4:47 AM on February 25, 2011

I think you need to think outside the box for this question.

First - where are you going? How long will the baby be in the car? How frequently? Is there another adult in the household who will be driving with you all the time or are you asking about how you can both drive and keep an eye on the baby?

Some possible answers:

- If an adult is always available but just can't fit in the back seat: get a bigger car.
- If it's just you and you are driving the kids to daycare every morning/evening for a 15-minute drive: find a high school kid in your neighborhood who needs a ride to/from school everyday. Put that kid in the back seat to watch the baby until you drop them off and then you drop them at school. Or, honestly, think about whether you need to be working everyday or if you can stay home with the baby (I don't mean this to be snarky - maybe you do need to work, and that's a valid decision.)
- If you are talking about random trips to the store throughout the day: find someone to stay with the kids while you run errands. Or reevaluate whether the errand is truly necessary or can it wait until you can arrange to find someone.
- If you are talking about long trips to grandma's house: maybe you do need some of the technical answers above for monitoring the baby in the car, but maybe you also need to just tell grandma that baby is not allowed to travel for XX months and she'll have to visit you.

Everything about this issue is related to calculation of risks. You can take the risk of putting the baby in the front seat, or the risk of spending money on a new car, or the risk of equipment that may/may not work in a car, or the risk of offending people who want you to travel, or the risk of having less income if you quit a job; then pit all that against the risk that your baby may have a life-threatening incident.
posted by CathyG at 7:01 AM on February 25, 2011 [3 favorites]

I was coming in to say exactly what rumposinc said. Your physician, your local children's hospital, your baby's pulmonologist (I assume you have one) all will be able to help you with this. Start making phone calls and keep at it until you get the answers that will give you peace of mind.
posted by cooker girl at 7:40 AM on February 25, 2011

the fact is that millions of us survived before any of that became standard procedure

This is a poor argument. Millions of us survived before antibiotics. Millions of us survived before doctors washed their hands before assisting in childbirth. Millions of us survived before we learned that diseases were spread by water carrying bacteria. None of this matters when it's your child at risk.

What rumposinc and cooker girl said is exactly right. You need to enlist the help of the physicians and the patient advocates. You cannot be the only person to have had to deal with this issue! And having a letter from the physician stating why your infant needs to travel in the front seat can only be helpful if you're stopped by a police officer to whom it looks like you're doing something unsafe (even though you will have taken all the steps necessary to maximize your baby's safety, like disabling the airbag and acquiring whatever additional equipment is needed to stabilize the car seat in the front).
posted by Sidhedevil at 7:52 AM on February 25, 2011

[This is a reply from an anonymous answerer.]
My first born was on an apnea monitor due to a very similar situation. Essentially he was a SIDS baby that got caught in time in hospital and was resuscitated.

He stayed on his monitor for ten months and we had exactly the same concerns that you do. We were told by his SIDS specialist paediatrician that they don't fall in to deep enough sleeps in these situations, also in baby carriers, that they ate slightly stimulated and that they are VERY, VERY, VERY unlikely to be able to get in to the deep "dangerous" sleep.

I hope this can give you some peace of mind. Our son is healthy and well and a big boy now, but I well remember the terror of seeing him unresponsive. You are right to be cautious. But please, put your little one in the back seat. Don't go for really long drives, and get your baby out of the car seat as quickly as possible...or only drive when baby is awake.

My very best wishes, luck and congratulations to you.
posted by cortex (staff) at 7:53 AM on February 25, 2011

I have absolutely no experience with this, but was recently told about the Snuza Halo as a product I might look into for when my child arrives (due in May). You might look at it and ask your doctors if this would be negated by the movement of a car.
posted by questionsandanchors at 9:16 AM on February 25, 2011

Our twins were on Respironics SmartMonitor 2 apnea monitors for a year as a precautionary measure (their older sister died of SIDS and they were preemies). They worked perfectly fine in the backseat, and we were encouraged to keep the boys on the monitors for all car trips. Since they never experienced an actual apnea event (lots and lots and lots of false alarms) we eventually stopped using them for short trips because they're incredibly fucking annoying.

Since no one ever mentioned it to us...
  1. Those damn things go off all the fucking time once the kids can move. No matter how tightly you strap them on the little pads will disconnect for just long enough to send everyone into panic mode.
  2. Speaking of movement, once they can move the monitors become a boat anchor that drags everything in your life down. You'll eventually want to just put them on them when they're sleeping or you think they might sleep. This means leaving the terrible straps and pads on them at all times, which also means figuring out new and creative ways of hiding them from your little one.
  3. Your little one will develop terrible rashes and sores underneath where the pads hit. You'll soon be adept and finding the spots on their chest that are just barely healed up. I imagined it was like how junkies deal with finding a good vein. Your pediatrician will give you magic steroid cream that was probably developed to help Barry Bonds cheat; it will do next to nothing to fix some of the sores and others will disappear overnight.
  4. The various bits and bobs will always fail at night. Demand 2-3 extras of everything that is consumable (the straps, pads, etc.) and at least one extra of each of the cords. The boxes they won't give you extras of but they'll die too (for our two boys we eventually went through seven boxes).
  5. The resting heartrate for infants is above 60 BPM, for newborns it's above 80 BPM. That 20 BPM separates good night's sleep from bad, and at some point the tech is going to have to come out to adjust things (for us it was on Thanksgiving day) and wonder why no one bothered to tell you about this. You'll have spent the entire night poking a baby (or in our case two).
  6. The battery life on them is an optimistic 10 hours despite whatever lies they tell you. Plug them in whenever you can.
  7. Keep the number for both the advice nurse and the monitor company handy, you'll need both after midnight at least a half dozen times. Not because of any problem with the baby, but because the monitor is doing some new weird broken thing that is preventing everyone from sleeping.
  8. All of those cute clothes with zippers... they're not going to wear them until they're off the monitor. Return them for things with buttons while you still can.
I'm sure I'm forgetting a ton, feel free to MeMail me if you have any questions, and congrats and good luck.
posted by togdon at 9:46 AM on February 25, 2011 [2 favorites]

Really, seriously consider whether driving alone with a baby that may stop breathing at any time is a good idea. How are you going to pay attention to your child at the same time you are piloting several tons of steel down the road? I know that I couldn't, if my (admittedly future) child was in a similar condition.

Distracted driving is a deadly practice, both for you and for the people around you. Pedestrians and cyclists are killed every day by people who are not paying attention to where their vehicles are going and what is around them. Three days ago, I saw a dad and his infant, who were trying to cross the road in a marked crosswalk, come within inches of being creamed by a distracted driver. As a cyclist, my life is threatened on a near-daily basis by people that are not paying attention to the road.

Cathy G. has some very good ideas. There are also taxies and, depending on where you are, public transportation (a bus is much safer than a car, no matter the situation). For the safety of you, your child, and everyone else on the road, think about what the actual best solution is.
posted by rockindata at 10:45 AM on February 25, 2011

WOW ! The number of concerned folks with helpful information and suggestions is amazing. Thank you all. Lots of things I'll be keeping in mind, and a number of suggestions to look into.

A: minimizing travel - definitely.
B: double mirror system sounds very good.
C: pulse oximeter with loud alarm sounds even better.
D: combining sounds perfect.

E: Regrettably, eliminating travel entirely isn't possible. Always having another adult may not be either. Looking into bigger car, but not hopeful of ability. No Children's Hospital. Good but limited support from local hospital. There was no car seat challenge, for instance. (First I'd heard of it.) Pediatrician expects us to use the apnea monitor for 2 months. I'll push for 6.

Further specifics: Daughter has been four nights on the monitor, with false alarms only on Night 1. No apneic episodes or any problems we've observed.

Car is an older model. No airbags. We're in Alaska, so public transportation is almost nonexistent. Local laws include car seats but do not require back seat. Lots of folks have pick-up trucks as sole vehicles.

I think I'll be less distracted if I'm able to see "pink-skin/blue-skin" at a glance than I would be trying to guess what's going on in the back seat unseen.

Again, thanks everyone. I am grateful for the help and for the good wishes.
posted by wjm at 6:29 PM on February 25, 2011 [1 favorite]

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