Crib protect by removal of bumpers: AAP

The American Academy of Pediatrics recommended Tuesday that parents stop using all bumper pads in cribs because of the risks to infants. The academy previously warned only against pillow-like versions of these cushions attached to crib slats. Last month, Chicago banned the sale of all bumpers, and Maryland health officials proposed a statewide ban.

The Consumer Product Safety Commission said 52 infant deaths involved bumpers from 1990 to May 2010. In April, the Juvenile Products Manufacturers Association (JPMA) released its own report that refuted the causes of deaths in a previous report and claimed bumpers prevent injuries to children from limbs getting trapped in slats.

AAP said there is “no evidence that bumper pads prevent injuries, and there is a potential risk of suffocation, strangulation or entrapment.” 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.”

Instead of a ban, JPMA wants a voluntary standard to set a maximum thickness for traditional bumpers. JPMA's Lauren Pfeiffer says the vast majority of bumpers on the market are not pillow-like. But Nancy Cowles, executive director of the children's product safety group Kids In Danger, says there's “no evidence that the traditional ones were any less likely to cause suffocation than the fatter ones.” Early this year, CPSC Chairman Inez Tenenbaum asked the commission's staff to review its files and studies to take a “fresh look” at crib bumpers, says spokesman Scott Wolfson. The commission also plans to set up an expert panel to analyze the staff's findings so parents have confidence in any recommendation CPSC makes, he says.

At least $50 million worth of infant bedding sets that include bumpers are sold each year, along with more than 200,000 bumper pad sets, JPMA says. “Our fear is that the recommended elimination of bumpers from the marketplace will lead to unintended consequences and may encourage parents to use towels, adult blankets or pillows as a protective barrier from the hard wooden surface of the crib slats,” says Michael Dwyer, who is executive director of JPMA.

Bedding makers that are members of JPMA will continue to offer traditional bumper pads, says Dwyer. Cowles says that's a mistake, “All major safety and health groups now agree — bumpers are an unnecessary and dangerous crib accessory.”

“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, 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.”

AAP on media use in toddlers

Regarding media use in toddlers and babies between 0 to 2 years AAP made its original recommendations in 1999. Passive entertainment screens — televisions, DVD players, computers streaming video — have become ubiquitous, and the average 12-month-old gets between one and two hours of screen time per day.

“There have been about 50 studies that have come out on media use by children in this age group between 1999 and now,” said Ari Brown, a pediatrician and member of the AAP committee that wrote the new report. Those studies have found that children don’t really understand what’s happening on a screen until they’re about 2 years old. Once they do, media can be good for them, but until then television is essentially a mesmerizing, glowing box.

Used at night, TV might help kids fall asleep, but that appears to come at a delayed cost of subsequent sleep disturbances and irregularities. While the result of TV-induced sleep problems hasn’t been directly studied, poor sleep in infants is generally linked to problems with mood, behavior and learning.

At other times, media consumption comes with opportunity costs, foremost among them the silence of parents. “While television is on, there’s less talking, and talk time is very important in language development,” said Brown. Even when media plays in the background, it distracts babies from play, an activity that is known to have deep developmental benefits. And for parents who use media to carve out a few precious, necessary free minutes in busy schedules, Brown recommended letting kids entertain themselves.

“We know you can’t spend 24 hours a day reading to your child and playing with them. That’s okay. What’s also okay is your child playing independently,” she said. “That’s valuable time. They’re problem-solving. They’re using their imagination, thinking creatively and entertaining themselves.”

“The way these kids’ programs came out was, ‘These are really educational! They’re going to help your kids learn!’ Well that’s great, but prove it. Show me the science,” Brown said. “I don’t have a problem with touch screens, and they’re not necessarily bad. But we need to understand how this affects kids.”

Dr. Ananya Mandal

Written by

Dr. Ananya Mandal

Dr. Ananya Mandal is a doctor by profession, lecturer by vocation and a medical writer by passion. She specialized in Clinical Pharmacology after her bachelor's (MBBS). For her, health communication is not just writing complicated reviews for professionals but making medical knowledge understandable and available to the general public as well.

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