The new analysis shows that infant deaths due to crib bumper use have significantly increased in recent years.
Image credit: Washington University
Crib bumpers are liners that go around cribs and were originally designed to protect infants' limbs and heads from getting through crib slats.
However, since 1973, federal regulations require crib slats to be narrow enough to keep a baby's head from going through them, rendering the bumpers unnecessary.
Still, new parents-to-be will see bumpers advertised in stores, magazines and catalogues that feature expensive, stylish nurseries.
Researchers from a new study that looks into the deadly cost of crib bumpers - which is published in The Journal of Pediatrics - include Dr. Bradley T. Thach from the Washington University School of Medicine in St. Louis, MO, and two former researchers from the US Consumer Product Safety Commission (CPSC).
"Crib bumpers are killing kids," says Dr. Thach. "Bumpers are more dangerous than we originally thought. The infant deaths we studied could have been prevented if the cribs were empty."
Although the American Academy of Pediatrics (AAP) recommend not using crib bumpers - and a voluntary industry standard in 2012 was revised to improve crib-bumper safety by limiting thickness - there are not currently any federal regulations surrounding them.
Deaths could have been prevented
To further investigate deaths resulting from crib bumpers, the researchers reviewed CPSC data from 1985-2012. Using deaths certificates, autopsy reports, death scene and other investigative records, they were able to get a clearer picture.
They found that during this time, 48 infant deaths were a direct result of crib bumpers, and 146 infants were involved in bumper incidents where the babies nearly suffocated, choked or were strangled.
Of the 48 deaths, 32 could have been prevented if crib bumpers had not been in use, the researchers say. The average age of death was 4.6 months, but the ages ranged from 1-22 months.
Because their noses and mouths were covered by a bumper or were wedged between a bumper and a crib mattress, most of the infants died due to suffocation.
"When a baby's nose and mouth is covered by a bumper, the infant can suffocate when his or her airway becomes blocked, or from breathing oxygen-depleted air," says N.J. Scheers, PhD, former manager of CPSC's Infant Suffocation Project.
"So if bumpers had not been in the cribs, these babies would not have died," he adds.
Infant death number could be higher than reported
The researchers' review of the CPSC data does not give us the entire picture, however.
After reviewing data from the National Center for the Review and Prevention of Child Deaths, the team found reports of 32 more bumper-related deaths between 2008-11, which brings the fatality number linked to crib bumpers to 77, rather than 48.
And this number may be even higher, according to Scheers:
"This highlights the most important limitation of the study. CPSC relies on death certificates to identify deaths caused by specific products. Bumper involvement is often not specified on death certificates, so it is highly likely many deaths caused by crib bumpers are missed."
Most of the 146 bumper-related incidents were down to poor bumper design or construction - for example, a lack of bottom ties or not enough ties.
Some parents may believe that thin bumpers are safer than plush ones - an idea propagated by some manufacturers - but infant deaths and injuries occurred with both thick and thin bumpers.
'Don't use crib bumpers, ever'
As a result of their findings, the researchers recommend that the CPSC ban the sale of crib bumpers. In 2013, the state of Maryland banned their sale, led by the city of Chicago, which first did in 2011.
Dr. Thach and colleagues note that the AAP, the Canadian Pediatric Society, the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) have all recommended against using crib bumpers.
However, the CPSC is the only agency with the power to initiate a ban in the US.
Dr. Thach says:
"A ban on crib bumpers would reinforce the message that no soft bedding of any kind should be placed inside a baby's crib. There is one sure-fire way to prevent infant deaths from crib bumpers: don't use them, ever."
The team's findings show 23 crib-bumper deaths reported to the CPSC from 2006-12; this is three times higher than the average of eight deaths reported in each of the three previous 7-year time spans.
This rise in bumper-related deaths is alarming, and the researchers say the lack of data gathered on crib-bumper deaths and injuries suggests that the actual number is higher.
Coupled with a lack of evidence that bumper pads prevent injuries, the research should serve as a wake-up call to parents who are thinking of using them in their babies' cribs.
Medical News Today recently investigated which baby sleeping position is best.