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We read with interest the thought-provoking letter by Clough et al1 and acknowledge the challenges it addressed. Important neonatal seizure research continues to be done using limited montage amplitude-integrated electroencephalography (aEEG).2 3 However, significant resources (including funding and personal efforts) are required for successful completion of trials of antiseizure medication in the newborn period, so reliability of results is important. Although use of aEEG may seem pragmatic, a recent Cochrane review4 includes the statement ‘…cautions clinicians about using aEEG for diagnosing individual seizures and the risk of under‐ or overtreatment with anti‐seizure medications’. Hence, not using the gold standard of continuous video EEG (cvEEG) may ultimately cost researchers dearly. Using a methodology with a reduced diagnostic accuracy impacts trial power for all outcome measures including long-term neurodevelopment. It is not only the reduced number of monitoring electrodes that limits this form of monitoring. Equally important to accurate EEG interpretation are video capability and remote review capability, which are useful to reduce false positives and minimise the risk of overtreatment with medication.