Please — No Bumpers

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They’re pretty and they surely enhance the look of your baby’s room. Yet I respectfully request that you refrain from indulging in crib bumpers, also known as “bumper pads” used in infants’ cribs.

True confession: All seven Lightman children luxuriated in cribs festooned with bumpers. The youngest Lightman was born in 2003, two years before the 2005 recommendation of the American Academy of Pediatrics (AAP) against bumpers. When spring cleaning several years ago, my wife found and destroyed them and then bagged them for the garbage. There’s no way we would endanger other babies. Thank G-d, our grandchildren’s parents have chosen not to  have bumpers in their cribs either.

Intuitively, crib bumpers feel like a way to protect babies from injuries. In reality, a safe crib without bumpers is the best way to go because bumpers increase the risk of Sudden Infant Death Syndrome (SIDS).

A brief background is in order here.

Fact:  Between 1985 and 2012, there were 48 infant deaths and 146 injuries related to suffocation, strangulation and entrapment.

In 1992, the American Academy of Pediatrics (AAP) released guidelines that all babies be placed on their backs to sleep. The result: Deaths from SIDS decreased. Such deaths have plateaued in recent years, while sleep-related deaths from other causes including suffocation, entrapment and asphyxia, have increased.

In 2005, the AAP recommended against the use of crib bumpers. This was part of its campaign for safe sleep and SIDS prevention for babies. The guidelines state that crib bumpers carry a potential risk of suffocation, strangulation or entrapment, because infants lack the motor skills or strength to turn their heads should they roll into something that obstructs their breathing.

Dr. Rachel Moon of the Children’s National Medical Center in Washington, DC, and chairperson of the AAP SIDS Task Force explains that, in 2005 there were concerns about crib bumpers but not much evidence of a real problem.

“Since then,” Dr. Moon says, “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.”

In the September 2007 issue of the Journal of Pediatrics, results from a study of crib and bassinet bumpers were announced. Based on information from a Consumer Product Safety Commission (CPSC) conducted from 1985-2005, the study showed reports from medical examiners and coroners of 27 accidental deaths of children ages 1 month to 2 years. These deaths were attributed to suffocation because babies were wedged against a padded bumper or strangled by a bumper tie around the neck. This study stated, “These findings suggest that crib and bassinet bumpers are dangerous…Because bumpers can cause death, we conclude that they should not be used.”

Numerous reports by news agencies and consumer advocates against bumpers followed, including a January 2011 article in the Chicago Tribune that delineated the dangers of bumpers.  The same article also reported that, since 2008 the federally funded National Center for Child Death Review received 14 reports of infant suffocation in which a bumper was relevant in the death.

In response, the Juvenile Products Manufacturing Association (JPMA) asserted that other factors like babies sleeping on their stomachs or a crib filled with pillows might have been a factor in those deaths instead of the bumpers. In reaction to this and other news reports and consumer advocates, the CPSC announced it would take a closer look at crib bumpers. Subsequently, both the CPSC and the Food and Drug Administration (FDA) warned parents of the dangers of infant sleep positioners, some of which had been marketed to reduce the risk of SIDS, but had in fact caused up to a dozen suffocation deaths of babies in about as many years.

When crib bumpers are used or there are other objects in the crib, a baby may put his face in it while sleeping. This means the baby may inhale stale air which is not a healthy thing.

With these facts, why are many parents still using bumpers?

Bumpers were first designed to cover the space between crib slats so babies couldn’t fall out or get their heads, arms or legs stuck between the bars. Regulations changed in the 1970s and now slats can be no more than 2-3/8 inches apart. Safety-wise, while it is possible for a baby to get an arm or a leg stuck between crib slats, it’s virtually impossible to break a limb by doing so: The experience will be uncomfortable and upsetting until a caregiver arrives, but it will not life-threatening.

Further, parents buy bumpers because they think they’re supposed to. Walk into most baby furniture stores and you’ll see shelves laden with attractive bedding for the crib – and many are sets that come with bumpers. After all, a bumper set lends the crib a finished look and that can be hard to resist.

The best way for a baby to sleep is on his/her back, alone in a crib that has a fitted sheet on the mattress. There should be no soft objects or loose bedding, as they pose hazards.

Most babies do not move around the cribs until they are about 3-4 months old. Even when moving, it’s highly unlikely a baby will generate enough force to harm himself.

Between 4-9 months, a baby can roll head first into a bumper. This poses some risk for suffocation and my advice is don’t even go near the possibility of it. The consequences are too horrific to contemplate.

After 9-10 months of age, many infants can pull themselves to a standing position in the crib and can step on the bumpers to fall out of the crib. Again – too horrific to contemplate.

I urge you put the bumpers in the garbage or leave them on the stores’ shelves. Knowing that your baby sleeps on his/her back in a crib with a fitted sheet only should give you the peace of mind to sleep well at night. Until they become teenagers and start driving. Then you make sure the car has strong bumpers.

As always, daven.

Dr. Hylton I. Lightman is a senior statesman among pediatricians, an internationally-recognized authority and diagnostician, a public speaker, expert witness and go-to resource for health issues in the Orthodox Jewish community and beyond. Originally from South Africa, he started his current practice, Total Family Care of the Five Towns and Far Rockaway, PC in 1987. Dr. Lightman is a board-certified pediatrician and fellow of the American Academy of Pediatrics (FAAP). Dr. Lightman is a clinical assistant professor of pediatrics at Hofstra Northwell School of Medicine. In addition, he is actively involved in teaching pediatric and family nurse practitioners through Columbia University, Pace University, Lehmann College, and Molloy College, as well as mentoring physician assistants through Touro College. Read more here.

The words of this author reflect his/her own opinions and do not necessarily represent the official position of the Orthodox Union.