Over the last seven years, there has been a three-fold increase in the number of infants who have died as a result of crib bumpers, the pillowy cushions tied to the sides of cribs. The rise comes even as concerns over SIDS — sudden infant death syndrome — have made parents more aware of the dangers cribs can pose.
The risks posed by crib bumpers have been known for years. In 2007 a study documented 27 infants deaths directly attributable to the use of crib bumpers. Now that number has tripled.
“Crib bumpers are killing kids,” said senior author, Bradley T. Thach, MD, a professor emeritus of pediatrics at the Washington University School of Medicine and the author of the 2007 study that first documented crib-bumper deaths. “Bumpers are more dangerous than we originally thought. The infant deaths we studied could have been prevented if the cribs were empty.”
“If bumpers had not been in the cribs, these babies would not have died.”
Bumpers pose a variety of dangers. Infants in cribs with bumpers can suffocate against the bumper or become wedged between the bumper and another object, like a stuffed toy.
“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,” lead author, N.J. Scheers, a former manager of CPSC’s Infant Suffocation Project explained in a press release. “So if bumpers had not been in the cribs, these babies would not have died.”
Researchers looked at data from the Consumer Product Safety Commission and found 48 deaths and 146 non fatal injuries caused by bumpers during the study period. Most of the deaths were judged to have been entirely preventable if the bumpers had not been present. Non-fatal injuries included near-suffocation, entrapment, choking and ingestion of bumper decorations or exposed stuffing, and strangulation from bumper ties and fraying threads. Older infants sustained injuries when they used the bumpers to climb up and try to get out of the crib.
The researchers found that injury and death often resulted from poorly designed and constructed, or improperly installed bumpers. Often the bumpers unravel or tear, lack ties for both the top and the bottom, have poorly secured decorations, ribbons, and ties, and develop holes in seams and fabric where stuffing can come out.
The real danger of head injury appears to come infants using the bumpers as ladders to climb over the sides of the cribs, falling, and hitting their heads on the floor.
There appears to be no safe kind of bumper. Deaths and injuries have occurred with thick pillow-like bumpers and thin bumpers, which some manufacturers have touted as being safer than plush ones. Newer mesh bumpers and vertical bumpers that wrap crib slats were too new to be included in the study. “They should still be watched,” said Thach. “Crib bumpers serve no purpose.”
Bumpers were designed to protect infants from slipping through crib slats, entangling their limbs in the gaps or bumping their heads, and many parents consider bumpers as necessary safety precautions. But since 1974 federal regulations have required that crib slats be close enough to prevent a baby’s head from going through the slats.
One of the motivations for study is that efforts to address the bumper safety issue have been largely unsuccessful to date. Bumpers are not federally regulated and will only be so if the CPSC creates mandatory standards. There was a move to explore this option in 2013 but it has not yet resulted in new requirements. Voluntary standards were introduced by the industry in 2012 and the bumper thickness was reduced to 2 inches. This has not eliminated the risk, and three of the infants who died in the recent study had bumpers that were only two inches thick.
There is only one city, Chicago, and one state, Maryland, that have banned bumper sales. Two newer alternative bumper types, one made of mesh and breathable fabric, and one wrapped individually round each crib slat may be safer and are permitted in Maryland, but are not yet recommended by the AAP or CPSC because there is too little safety information on them at present.
Campaigns by organizations such as the American Academy of Pediatrics have failed to convince the public to abandon bumpers.
It is important to understand what a safe sleeping environment is — and isn't. Parents need to know that the space between crib slats has not posed risk since it was reduced in the 1970s. And when it comes to head injuries, not only have there been no reports of serious head injury from infants hitting their heads against unpadded crib slats, the real danger of head injury appears to come infants using the bumpers as ladders to climb over the sides of the cribs, then falling and hitting their heads on the floor.
The AAP and the CPSC strongly advocate for crib safety by providing an environment free of bumpers, pillows, and potentially suffocating objects. This recent study supports their campaigns. Parents would do well to make their child's crib a clean, safe, environment, and clear it of any and all potential hazards.
The study is published in the Journal of Pediatrics.