Experts call for ban on deadly crib bumpers

"A ban on crib bumpers would reinforce the message that no soft bedding of any kind should be placed inside a baby's crib," says Bradley T. Thach. "There is one sure-fire way to prevent infant deaths from crib bumpers: Don't use them, ever." (Credit: iStockphoto)

Crib bumpers have caused significantly more infant deaths and injuries in recent years, prompting some experts to call for a nationwide ban.

The findings of a new study indicate that in the majority of incidents, crib bumpers were the sole cause of harm, rebutting claims that other items in cribs, like blankets, pillows, and stuffed animals, were to blame.

The 23 crib-bumper deaths reported to the US Consumer Product Safety Commission over a seven-year span—from 2006 through 2012—were three times higher than the average of eight deaths reported in each of the three previous seven-year time spans. Further, researchers say the actual number of related deaths and injuries is likely much larger than what is currently known.

“Crib bumpers are killing kids,” says senior author Bradley T. Thach, professor emeritus of pediatrics at Washington University in St. Louis School of Medicine. “Bumpers are more dangerous than we originally thought. The infant deaths we studied could have been prevented if the cribs were empty.”

“Crib bumpers are killing kids.”

There are no federal regulations regarding crib bumpers. In 2012, a voluntary industry standard was revised to improve crib-bumper safety by limiting thickness. And in 2013, the CPSC directed its staff to explore rule-making options, suggesting change, but that has not resulted in any federal action.

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According to the new research, published in the Journal of Pediatrics, a review of CPSC data showed that 48 infant deaths from 1985-2012 were specifically attributed to crib bumpers. An additional 146 infants were involved in incidents in which the babies nearly suffocated, choked, or were strangled. The mean age of death was 4.6 months, with an age range of one to 22 months. Documents reviewed included death certificates and autopsy, death scene, and other investigative records.

The study’s findings showed that 32 of the 48 deaths examined could have been prevented if crib bumpers had not been used in the cribs. Most of those infants died due to suffocation because their noses and mouths were covered between a bumper and a crib mattress.

“When a baby’s nose and mouth is covered by a bumper, the infant can suffocate when his or her airway becomes blocked, or from breathing oxygen-depleted air,” says N.J. Scheers, lead author and former manager of CPSC’s Infant Suffocation Project. “So if bumpers had not been in the cribs, these babies would not have died.”

Regarding the other 16 infant deaths, babies were wedged between a bumper and a pillow, recliner used to elevate an infant’s head or, in one instance, a twin sleeping in the same crib. Had the bumpers not been in the cribs, the babies would not have been wedged into such positions and would have survived.

The researchers linked more deaths to crib bumpers than the 48 indicated in the CPSC data. A review of data from the National Center for the Review and Prevention of Child Deaths revealed reports of 32 additional bumper-related deaths from 37 states from 2008-2011. That puts the number of fatalities tied to crib bumpers at 77—and suggests the actual number is much higher.

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“This highlights the most important limitation of the study,” Scheers says. “CPSC relies on death certificates to identify deaths caused by specific products. Bumper involvement is often not specified on death certificates, so it is highly likely many deaths caused by crib bumpers are missed.”

Of the 146  incidents, researchers say most were caused by poor bumper design or construction. For example, near-suffocations resulted from a lack of bottom ties or not enough ties, which allowed infants’ faces to get trapped in the bumpers. Incidents involving choking and strangulation occurred because of detached bumper ties and decorations, frayed ribbons and loose stuffing.

Infant deaths and injuries occurred with thick pillow-like bumpers and thin bumpers, the latter of which some manufacturers have touted as being safer than plush ones. Newer mesh bumpers and vertical bumpers that wrap crib slats were not included in the study because there isn’t enough information about them. “They should still be watched,” said Thach. “Crib bumpers serve no purpose.”

Originally designed to protect infants from slipping through crib slats, entangling their limbs in rail gaps, or bumping their heads, many parents consider bumpers as necessary safety precautions. However, since 1973, federal regulations have required that crib slats be narrow enough to prevent a baby’s head from going through.

“Ours is the first study to document that slat entrapments and infants hitting their heads also occurred with bumpers in the crib,” says Scheers, adding that sleep sacks prevent a baby’s limbs from getting tangled in the slats. “It’s also unlikely that a baby hitting her head on the crib sides would result in serious injury.”

The study recommends the CPSC follow the lead of Maryland and Chicago by banning the sale of crib bumpers. The state of Maryland banned their sale in 2013; the city of Chicago did so in 2011.

The American Academy of Pediatrics, Canadian Pediatric Society, the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention have recommended against the use of crib bumpers. Ultimately, the CPSC is the only agency with the power to institute a nationwide ban.

“A ban on crib bumpers would reinforce the message that no soft bedding of any kind should be placed inside a baby’s crib,” Thach says. “There is one sure-fire way to prevent infant deaths from crib bumpers: Don’t use them, ever.”

Source: Washington University in St. Louis