"The study results are interesting in producing a statistically significant result that does not appear to have any clinically significant implications," said Dr. Steven Donn, a neonatologist and professor of pediatrics at the University of Michigan in Ann Arbor.
Though the authors suggested a link in older children between low oxygen levels with behavioral and intellectual changes and pointed out that the mechanism described in the study could have been partially involved in some rare cases of infant deaths in car seats, none of the experts were able to remember a single case in their clinical experiences in which lowered oxygen levels directly led to injury or death in a newborn.
"I am less concerned than the authors seem to be about long-term consequences of these relatively mild degrees of desaturation," said Dr. Ian Holzman, professor of pediatrics and chief of newborn medicine at Mount Sinai School of Medicine in New York. "To suggest that this may influence future developmental indices seems a bit unlikely and probably does a disservice to an otherwise important safety device."
This sentiment was echoed by Dr. Ira Rubin, a pediatrician in practice in Naperville, Ill. "I don't think that the oxygen saturations mean much since they were not less than 90 percent, and many newborns will be fine if the oxygen saturations are just better than 80 percent," he said.
Pediatricians also noted that in order to realistically scrutinize how a baby's posture in a car seat affects its breathing, one must also look at other postures the baby attains during other activities.
"We also don't know about what [oxygen] saturations are like in any number of other routine circumstances," Krane said, adding that the precise position of the newborns in each of the three devices and the phase of their sleep cycles could also change the measured values.
Dr. F. Sessions Cole, professor and vice chairman of pediatrics and director of newborn medicine at Washington University School of Medicine, pointed out another possible untoward conclusion of the study. "Unfortunately, many parents hold infants in a car seat like position," he said. "I would hesitate to suggest not holding infants based on this study."
Like the experts, first-time mom and anesthesiologist Nair said she understood the theoretical concerns brought to light by the authors. However, despite knowing these risks, she said she feels that in this case, the benefits of her daughter's car seat outweigh the suggestion of risk.
"I'm much more worried about a car accident," she said.