Are crib bumpers safe?

True confession: I used a crib bumper with my first child– I even made it myself to match my nursery decor. I got rid of it when I found out the real risk of infant death associated with crib bumpers, but then I had a new problem. There is a time around 7-9 months when babies get their feet or legs stuck between the slats of the crib and can't get themselves unstuck. My baby would keep getting her feet stuck, then cry until I got them unstuck. What's a parent to do? Use a crib bumper and risk suffocation or sudden infant death syndrome (SIDS), or let baby get stuck and cry?

How dangerous are crib bumpers, anyway?  Although uncommon, infant deaths attributed to the presence of a traditional (non-breathable) crib bumper do occur. A total of 77 deaths attributed to crib bumpers were found in a recent review of U.S. databases. Pediatricians from St. Louis Children's Hospital and Washington University School of Medicine contributed to this study. The details for this study are published in the Journal of Pediatrics. I will summarize their findings:  

• According to the Consumer Products Safety Commission database, between 1985 and 2012, crib bumpers were attributed to 48 suffocations in the United States. 67% of these deaths were caused by a bumper alone, and 33% by wedgings between a bumper and another object such as a blanket, pillow or toy.  
• The number of CPSC-reported deaths was compared with those from the National Center for the Review and Prevention of Child Deaths, 2008-2011; the latter reported substantially more deaths than CPSC, increasing the total to 77 deaths.
• An additional 146 infants sustained injuries from the bumpers, including choking on the bumper ties or nearly suffocating.

The American Academy of Pediatrics recommended against the use of crib bumpers in a 2012 statement on safe sleep environments for infants.

Are crib bumpers associated with sudden infant death syndrome (SIDS)?  Technically, SIDS is not the same thing as infant suffocation, although sometimes it is difficult to differentiate between true SIDS and suffocation. We know that SIDS is more common when soft objects are in cribs, such as pillows, blankets and bumpers. A leading theory is that SIDS is caused by an infant re-breathing exhaled air with low oxygen content and their brain not recognizing the sensation of suffocation due to receptors in their brainstem that are not fully developed. Another theory is that SIDS may be caused by toxic gasses/volatile organic compound (VOCs) that escape from crib mattresses and bumpers manufactured with chemical flame retardants, vinyl, polyurethane foam and products associated with PVC (hyperlink). Although we don't know for sure what causes SIDS, both of these theories suggest that some cases of SIDS may be due to crib bumpers.  

But now, finally, several companies are making breathable crib bumpers, so baby's feet won't get stuck and everyone can sleep well knowing that baby can breath. And yes, they come in all the colors and designs to match your nursery decorating scheme. Breathable crib bumpers have not been around long enough for us to really understand their safety. But theoretically they should reduce the risk of suffocation. Another option to prevent feet from getting stuck is to use a sleep sack. This keeps baby warm but makes it harder for her to move in the crib. To date, sleep sacks seem to be very safe and may even prevent deaths from SIDS.  

Are you having trouble getting your infant to go to sleep?  Here are some tried-and-true tricks to help your both sleep well.  Considering melatonin for sleep?  Read this first.  

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