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For nearly eight years, a Washington University School of Medicine physician has been trying to alert parents, consumers and regulators to the danger of infant suffocation and injury from crib bumpers.

That alarm first came after his 2007 study attributing 27 deaths to crib bumpers from 1985 through 2005.

Yet, despite repeated statements from the American Academy of Pediatrics advising against their use, the demand for crib bumpers remains high, as does the overall public perception they are safe.

Indeed, the Juvenile Products Manufacturers Association continues to maintain in its formal platform that the organization does “not know of any infant deaths directly attributed to crib bumpers.”

The situation is extremely frustrating, said Bradley Thach, a recently retired Washington University pediatrician and the researcher who authored the 2007 study. So much so that on Tuesday he and two others published a further damning paper in the Journal of Pediatrics arguing crib bumpers are potentially deadlier than any other common items found in a crib such as blankets and stuffed animals.

The study found 77 deaths nationwide attributed to crib bumpers from 1985 through 2012. The paper calls for a nationwide ban on the sale of the crib product.

Chicago and Maryland are the only places in the nation to currently forbid their sale. But nationwide crib bumpers are commonly sold in infant bedding sets and put on display in cribs in some of the country’s most popular children’s retail chains, such as Babies R Us and Pottery Barn Kids. That latter retail chain currently features NBA star Stephen Curry and his pregnant wife, Ayesha, on its website to market a high-end crib decorated with white bumpers and a pillow.

“Parents walk into the store, and they look at the bumpers in the cribs, and they say, ‘Well, if it wasn’t safe, they wouldn’t be selling them. But that’s not the situation,” Thach said.

In the study published Tuesday, Thach and two researchers formerly with the Consumer Product Safety Commission argue the number of deaths caused by the bumpers is higher than first thought.

It goes on to suggest crib bumpers pose a far greater risk for suffocation than items such as blankets and small pillows.

“The Consumer Product Safety Commission has the means and authority to regulate this. If they banned the bumper sales, that would correct the problem largely,” Thach said.

Thach cautioned the findings reported Tuesday in no way condone the use of other items in cribs. He said parents and caregivers should also keep stuffed animals, blankets and pillows out of cribs. This follows the sleep safety recommendations of the American Academy of Pediatrics which essentially says, “nothing but the baby” in the crib.

BETTER REPORTING

The researchers found a three-fold increase in deaths attributed to crib bumpers from 2006 to 2012. The spike may not mean more infants are suffocating, but rather that crib accidents are being more accurately reported.

Many medical examiners, including those in the St. Louis region, now use sleep scene re-enactments to better describe the position of the infant at death, enabling them to more easily determine whether a baby’s mouth and nose may have been enveloped by a bumper.

NJ Scheers, one of the study’s researchers and a former manager of the Consumer Product Safety Commission’s Infant Suffocation Project, warned that even with improved forensics, it’s likely deaths involving crib bumpers are still underreported.

“Bumper involvement is often not specified on death certificates, so it is highly likely many deaths caused by crib bumpers are missed,” she said.

The study focused on data obtained from the Consumer Product Safety Commission and the National Center for the Review and Prevention of Child Deaths which currently collects data from 37 states. Researchers focused on medical examiner reports, death scene re-enactments and other information to determine whether the crib bumper was solely responsible for a suffocation or choking or whether other items in the crib could have been a factor.

In the majority of the 77 deaths, bumpers were found to be the only cause. In the other cases it was determined that other items in the crib — such as a pillow or another child — contributed to wedging the baby’s face against or below the bumper. In those cases, the researchers argue the suffocation would have been prevented if bumpers had not been present in the cribs.

MARKETING CONTINUES

The three researchers were prompted to do the study by the continued marketing of the bumpers and inaction by the Consumer Product Safety Commission to ban them after decades of debate. In 2012 the industry on its own opted to limit the thickness of the bumpers, but the Commission did not opt to regulate that standard.

2012, a voluntary industry standard was revised to improve crib-bumper safety by limiting the items’ thickness. And in 2013, the CPSC directed its staff to explore rule-making options, suggesting change, but it has not resulted in any federal action.

Scheers said within the commission some argue crib bumpers are the scapegoat because they can be the most easily banned, whereas the sale of blankets and stuffed animals cannot.

But Scheers and Thach said their research overwhelmingly proves that the bumpers, regardless of size, are a primary cause of suffocation in cribs.

“Yes, there was clutter in the crib, but it was somewhere else in the crib. It wasn’t where the baby’s nose and mouth were, which was up against the bumper,” Scheers said.

The study also found 146 crib bumper injuries over the past 22 years. Some were caused by ties coming loose, enabling babies to wedge their faces beneath the bottom of the bumper and a mattress. In other cases, ties, stuffing or other decorative elements came loose, causing choking or strangulation.

The research was praised by Nancy Maruyama, executive director for SIDS of Illinois. The organization lobbied successfully in 2011 to have bumpers banned from sales in Chicago. Maryland followed with its ban in 2013.

Maruyama said claims by the Juvenile Products Manufacturers Association that bumpers pose no risk to infants is completely misinformed. She has personal reason to believe this.

Maruyama said in 1985 she found her son unresponsive with his head and mouth up against a crib bumper. His death was ruled sudden infant death syndrome with no clear idea as to what caused it. She said today’s better reporting standards would likely point to crib bumpers.

“I’m sure his death would be ruled accidental suffocation,” she said.

Nancy Cambria is a reporter for the St. Louis Post-Dispatch.

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