Recommendation that parents not use bumper pads in cribs or bassinets

Although bumper pads are theoretically designed to prevent injury to a baby while in the crib or bassinet, the risk of accidental death or injury to an infant from using them outweighs their possible benefits, according to a new study by pediatric researchers at Washington University School of Medicine in St. Louis.

In the study, which appears in the September 2007 issue of The Journal of Pediatrics, the researchers reviewed three U.S. Consumer Product Safety Commission databases for deaths related to crib bumpers and crib-related injuries from 1985-2005. They found 27 accidental deaths reported by authorities of children from 1 month old to 2 years old that were attributed to suffocation or strangulation by bumper pads or their ties. They also found 25 non-fatal injuries in infants attributed to bumper pads.

Of the deaths in which there was a formal investigation, 11 infants likely suffocated when their face rested against the bumper pad, 13 infants died from being wedged between the bumper pad and another object and three infants died from strangulation by a bumper tie.

"Many infants lack the motor development needed to free themselves when they become wedged between the bumper pad and another surface," said Bradley Thach, M.D., professor of pediatrics and staff physician at St. Louis Children's Hospital who researches infant apnea and Sudden Infant Death Syndrome. "They are likely to suffocate because they are rebreathing expired air or their nose and mouth are compressed."

Thach said both soft or firm bumper pads pose risks. "If the pads are too soft, the baby's nose or face can get pressed up against it, and the baby suffocates," he said. "If they are too firm, the baby can climb up on the pads and fall out of the crib."

The researchers examined 22 retail crib bumpers for features that could be hazardous to infants. They graded the bumpers for softness and measured the potential space between the bottom of bumper and mattress, the width of the bumper pads and the length of the fasteners that attach the bumper to the crib. Current manufacturing standards state that bumper pads should not have ribbons, strings or ties longer than 9 inches, but the researchers found two with fasteners longer than 9 inches.

Thach said all of the retail bumper pads they examined were hazardous because they all potentially leave a space between the pad and the mattress where babies can get their heads wedged.

The researchers indicated that their study is limited because of underreporting of cases and lack of a consistent protocol of scene investigations and autopsies.

Thach recommends that parents not use bumper pads in cribs or bassinets.

"I don't think bumper pads are doing any good," he says. "Although the deaths and injuries may be rare events, they are preventable by eliminating the use of bumper pads."

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