Why Do We Use Crib Bumper Pads?Crib bumper pads became popular in older-style cribs where the slats were far enough apart that a baby's head could become trapped between the slats, posing a suffocation risk. Today, all cribs sold in the United States and Canada are required to have slats close enough together that it's nearly impossible for an infant's head to fit through.
So why do we still use the crib bumper pads? For some parents, the reason may be as simple as liking the way the bumper pad looks. The matched crib bedding sets in stores are often cute and the package deal makes for a nice coordinated nursery.
Other parents are worried about their child's arms and legs sticking through the crib sides, and some worry that the baby will hit his or her head on the crib sides and cause injury. According to Health Canada, it is nearly impossible for an infant to hit his or her head hard enough on the crib to cause bruising or injury. Health Canada also reports that serious injury is not likely when a child puts his or her arms and legs through the crib slats. The baby will either remove their arm or leg from the slats if possible, or make enough noise to alert a parent for help.
While SIDS deaths cannot be attributed to a specific cause, we do know that crib bumpers have caused infant deaths due to strangulation or suffocation, which indicates that the dangers may outweigh the benefits. A study from Washington University in St. Louis (PDF) looked at infant deaths attributed to crib bumpers from 1985 to 2005 and found that 27 children under the age of 2 died due to strangulation or suffocation by bumper pads or their ties. The study also found another 25 children who were injured but not killed by bumper pads.
Which Groups Have Recommended Against Bumper Pads?Some major children's safety organizations have recently suggested that parents and child care providers should remove crib bumper pads from baby cribs. The groups include: American Academy of Pediatrics, Health Canada, the Consumer Product Safety Commission, First Candle/National SIDS Alliance, and the National Institute of Child Health & Human Development. Some state and regional Back to Sleep campaigns now recommend removing bumper pads, as well.
Why Do These Groups Recommend Against Crib Bumper Pads?One reason child safety organizations recommend against crib bumpers is that they pose a risk of suffocation. Just like a pillow or thick blanket, crib bumper pads can restrict a baby's breathing if the bumper is up next to the baby's nose or mouth. Suffocation risk is greatest when babies are very young and unable to move themselves away from potential hazards.
A secondary risk with crib bumpers is strangulation. Babies can become entangled in the crib bumper or its ties, or can get between the bumper and the crib. A few crib bumpers have been recalled because of stitching or trim that can come loose. Those loose pieces also could cause injury.
Rebreathing of stale air is another concern with crib bumper pads. The bumper reduces the flow of fresh air around baby during sleep, particularly if his or her face is very close to the bumper. The American Academy of Pediatrics suggests that some infants, when they are overheated or lack sufficient oxygen during sleep, are unable to arouse themselves enough to prevent death. Re-breathing of stale air may be a contributing factor to SIDS.
In the official AAP policy statement on SIDS suggests that some babies are more prone to SIDS due to biological factors such as brainstem development or serotonin levels. However, the policy statement indicates that "more than one scenario of preexisting conditions and initiating events may lead to SIDS." It goes on to say that we cannot focus on only one potential cause for SIDS, because there isn't likely to be just one cause. We cannot know ahead of time whether a baby is predisposed to SIDS due to biological reasons. What we can do, and what AAP suggests, is to reduce all of the other environmental risk factors, including the use of crib bumpers.
SolutionsSince many infant safety organizations now recommend that nothing be inside the crib at all, the safest route for parents and babies would be to remove crib bumper pads altogether. For day care centers, the push for increased sleep safety may soon result in states mandating that child care providers no longer use crib bumper pads. For parents who are still concerned about their child sticking arms and legs through the crib slats, and feel that they must use a bumper pad, there are mesh crib bumpers on the market today that allow more air to flow through the crib.
- Health Canada Policy Statement on Crib Bumpers
- AAP Official SIDS Policy Statement
- First Candle Safe Sleep Guidelines
- American SIDS Institute Prevention Guidelines
- CPSC Crib Safety Tips
- AAP - Crib bumpers in the night: a hazard to infants
- Ask Dr. Sears - Crib Safety
- National Institute of Child Health & Development - Safe Sleep for Baby: Reduce SIDS Risk
- SIDS Mid-Atlantic - New Recommendations