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SIDS and Other Sleep-Related Infant Deaths

Expansion of Recommendations for a Safe Infant Sleeping Environment
Pediatrics; originally published online October 17, 2011;
Task Force on Sudden Infant Death Syndrome

Bumper Pads and Similar Products are not Recommended

Bumper pads and similar products that attach to crib slats or sides are frequently used with the thought of protecting infants from injury. Initially, bumper pads were developed to prevent head entrapment between crib slats. However, newer crib standards that require crib slat spacing to be less than 23⁄8 inches have obviated the need for crib bumpers. In addition, infant deaths have occurred because of bumper pads.

A recent report by Thach et al, who used CPSC data, found that deaths attributed to bumper pads were from three mechanisms: (1) suffocation against soft, pillow-like bumper pads; (2) entrapment between the mattress or crib and firm bumper pads; and (3) strangulation from bumper pad ties. However, the CPSC believes that there were other confounding factors, such as the presence of pillows and/or blankets, that might have contributed to many of the deaths in this report. Thach et al also analyzed crib injuries that might have been prevented by bumper pad use and concluded that the use of bumper pads only prevents minor injuries. A more recent study of crib injuries that used data from the CPSC National Electronic Injury Surveillance System concluded that the potential benefits of preventing minor injury with bumper pad use were far outweighed by the risk of serious injury such as suffocation or strangulation.

In addition, most bumper pads obscure infant and parent visibility, which might increase parental anxiety. There are other products that attach to crib sides or crib slats that claim to protect infants from injury. However, there are no published data that support these claims. Because of the potential for suffocation, entrapment, and strangulation and lack of evidence to support that bumper pads or similar products that attach to crib slats or sides prevent injury in young infants; the AAP does not recommend their use.

Wedges and Positioning Devices are Not Recommended

Wedges and positioning devices are often used by parents to maintain the infant in the side or supine position because of claims that these products reduce the risk for SIDS, suffocation, gastroesophageal reflux. However, these products are frequently made with soft, compressible materials, which might increase the risk of suffocation.

The CPSC has reports of deaths attributable to suffocation and entrapment associated with wedges and positioning devices. Most of these deaths occurred when infants were placed in the prone or side position with these devices; other incidents have occurred when infants have slipped out of the restraints or rolled into a prone position while using the device. Because of the lack of evidence that they are effective against SIDS, suffocation, or gastroesophageal reflux and because there is potential for suffocation and entrapment, the AAP concurs with the CPSC and the US Food and Drug Administration in warning against the use of these products. If positioning devices are used in the hospital as part of physical therapy, they should be removed from the infant sleep area well before discharge from the hospital.

~This is only an excerpt from the 29-page document. Please refer to the article for more of the most recent finding from the Task Force on Sudden Infant Death Syndrome.

The online version of this article, along with updated information and services:

For more information on safe sleep and reducing the risk of SIDS contact 4C's Infant Toddler Specialist at or 866-200-5909 or register for a Safe Sleep workshop by clicking on the training calendar above.

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