*3.4. Limitations*

The main limitation of this study is the relatively small sample size, short recording time, and lack of gold-standard comparison. While correlations are encouraging for the 246 time points recorded, the data were limited to a small population and short time period. As the patients in the secondary analysis were both Caucasian, the lack of diversity potentially limits the generalizability of the technology on a broader population level. This limitation may be mitigated by the technology's capacity to detect RR through varied infant attire and different color swaddles. Lastly, by selecting relatively stable infants for 48 h of monitoring, our study was not designed to assess whether video monitoring systems can track clinically significant trends in respiratory rate. As this monitor was not available for the clinical team, it could not be assessed whether it had more or less false alarms or missed apneic or tachypnea events.
