Which crib bedding would you choose? Aesthetic or safe?
In the newest topic regarding crib safety, Maryland is considering regulations to ban the sale of crib bumpers. For many years, more and more emphasis has been placed on infants sleeping in safe cribs without any additional “stuff” in them. This has included the elimination of lots of former nursery staples. Baby blankets, stuffed animals, pillows and other loose items have been banned from the crib by safety experts for years. As requirements for cribs have required slats that are closer together, the utility of using a bumper to help a child from getting stuck between crib slats has been eliminated. More recently, the Consumer Product Safety Commission has developed even newer crib safety standards, including eliminating the use of drop-sides, and warned against the use of sleep positioners. Yet, despite the advice to put babies to sleep only on their backs in cribs empty of everything except a well fitting mattress and fitted sheet, many parents and caregivers persist in using other items in cribs. Now, with an increasing number of deaths associated with crib bumpers, Maryland is considering a stronger stance.
Danger of Crib Bumpers
The concern about crib bumpers is that there have been infant deaths associated with suffocation or strangulation and the use of crib bumpers. Some of the deaths are directly attributable to the bumpers (for instance a child found with their head wrapped in the ties of the bumper or their face pressed into the side of the bumper), while others are only potentially related to the bumper use but not definitively so (for instance, children whose death are classified as SIDS, but where bumpers were in use in the crib at the time of death and may have been a contributing factor in the death). This makes the discussion of the dangers muddy – with manufacturers claiming that bumpers are safe and advocates warning against their use to protect against suffocation.
Potential Ban on Sale of Bumpers
When the Baltimore Sun reported on the potential regulations, they mentioned something that gave me pause. They explained that if Dr. Sharfstein, secretary of the state Department of Health and Mental Hygiene, does decide to regulate this issue, the regulations will impact only the sale, not the use of the bumpers. While this makes sense from a policy perspective, the goal is not to punish parents who may not be aware of the safety risks, and from a enforceability perspective, the state cannot possibly enforce a regulation that requires knowledge of whether bumpers are being used in individual homes, the regulation of the sale of the item is going to have some drawbacks.
Will a State Ban Save Lives?
So here are my questions. Will regulations against the sale of these bumpers in Maryland make any difference in saving lives? In this day of internet shopping and wide availability of items through catalogues and easy interstate travel, are Maryland families going to forgo the crib bumper because they cannot be purchased in the local baby store, or are they still going to be buying the bumper with a set of nursery items on Amazon or through a national baby store? Will Internet or national companies without a store presence in Maryland be punished for selling a bumper to a person with a Maryland address? If so, then perhaps the word will get out that these items are dangerous and should not be used. If not, will parents even realize that the goal of the regulation is actually to curb the use of the bumpers. Either way, I guess that by decreasing the number of bumpers in Maryland homes, safety will be increased and perhaps over time, awareness will be increased and other states may follow suit.
Getting the Word Out
My other concern is that if there are parents who are still using bumpers, blankets or other items in their babies’ cribs, is the issue one of parent education? Perhaps the real emphasis needs to be on wider parental awareness of the safety issue. There are lots of great resources available to learn how to put infants to sleep safely:
Since the early 1990s, the emphasis has been on having infants sleep on their backs. This has lead to a dramatic decrease in SIDS deaths since that time. The “Back to Sleep” campaign began in 1994 and continues to this day. However, when reading a 2005 paper from the AAP, I was surprised to read that SIDS deaths are more likely to occur when a baby who is used to sleeping on their back is placed to sleep on their stomach. This suggests that education needs to be of all potential caregivers since an occasional babysitter, grandparent or child care provider who is unfamiliar with the recommendations and the child’s normal sleep position may place the child to sleep on their stomach and cause real risk.
AAP has made many recommendations since 2005 including that children sleep in cribs with only a fitted sheet and without any additional soft bedding. These recommendations have varied somewhat over time on the use of bumpers and sleep positioners. However, the overall advice seems to remain the same – eliminate all soft bedding items. Despite these recommendations, there are still images in popular media of nurseries complete with cribs with soft bedding.
What changes are still needed?
What changes are needed to get the word out? Do you think that there needs to be a stronger effort to change the marketing images for infant products? Do you think that a ban on the sale of bumpers will have a significant impact on child safety? What about an education campaign focusing on caregivers, grandparents and day care providers?
Images from: sidscenter.org, potterybarnkids.com