Get bumpers out of cribs, doctor group urges

The AAP now recommends that infants sleep on their backs on a firm mattress, without any soft objects or loose bedding.

Story highlights

  • No evidence bumpers protect against injuries, American Academy of Pediatrics says
  • Recent studies have shown bumpers may be more hazardous than thought
  • National Center for Child Death Review has received 14 reports of infant suffocation
Bumper pads should never be used in infants' cribs, according to new guidelines released by the American Academy of Pediatrics.
This recommendation, issued as part of an updated and expanded set of guidelines on safe sleep and SIDS prevention for babies, is the first time the AAP has officially come out against the use of crib bumpers. According to the AAP, there is no evidence that crib bumpers protect against injury, but they do carry a potential risk of suffocation, strangulation, or entrapment because infants lack the motor skills or strength to turn their heads should they roll into something that obstructs their breathing.
When the AAP issued its last policy statement on sudden infant death syndrome in 2005, it recommended using bumpers that were thin, firm, well secured, and not "pillowlike."
What's behind the change in thinking to remove bumpers altogether? Recent studies have shown that bumper pads may be far more hazardous than previously thought. "In 2005, when we last published a policy statement and recommendations, we had some concerns about bumper pads, but we didn't really have a lot of evidence that this was a real problem," said Rachel Moon, M.D., FAAP, of the Children's National Medical Center in Washington, D.C, chairperson of the AAP SIDS task force and lead author of the new guidelines. "Since then, there have been some published studies looking at bumper pads, and we concluded that if there's no reason for them to be in the crib, it's better to just have them out of there, particularly in light of the deaths that have been reported, that have been associated with the bumper pads."
Since the AAP released its landmark guidelines in 1992 that all babies be placed on their backs to sleep, deaths from SIDS dramatically decreased initially, but have plateaued in recent years. At the same time, sleep-related deaths from other causes, including suffocation, entrapment and asphyxia, have increased.
Anti-Bumper Sentiment Growing
One of the major turning points in the medical community's attitude toward bumpers was a study published in the September 2007 issue of The Journal of Pediatrics that examined deaths and injuries attributed to infant crib bumper pads, based on information from the Consumer Product Safety Commission for 1985 through 2005. Researchers found reports from medical examiners and coroners of 27 accidental deaths of children ages 1 month to 2 years, that were attributed to suffocation when they became wedged against a padded bumper or strangulation by a bumper tie around the neck. Eleven of the infants who died most likely suffocated when their face rested against the bumper pad, 13 infants died when they became wedged between the bumper pad and another object, like the crib mattress, and three infants died when they were strangled by a bumper tie. The conclusion of that study read, "These findings suggest that crib and bassinet bumpers are dangerous. Their use prevents only minor injuries. Because bumpers can cause death, we conclude that they should not be used."
The CPSC initially interpreted this data differently and in the summer of 2010, reached the same conclusion as the Juvenile Products Manufacturers Association, which had conducted its own analysis of an unpublished CPSC review of crib deaths involving suffocation or strangulation. The JPMA asserted that other factors, like babies sleeping on their stomachs or a crib filled with pillows, might have been a factor in those deaths instead of the bumpers. Less than a year later, the CPSC announced it would take a closer look at crib bumpers in response to consumer advocates and news reports, especially those from the Chicago Tribune, highlighting potential dangers, as part of a broader regulatory crackdown on an array of baby sleep products blamed for injuries and deaths. As part of that crackdown, in September 2010, the CPSC along with the Food and Drug Administration warned parents of the dangers of infant sleep positioners,