In a recent study, Scheers, Woodard, and Thach (2016) examined data from the United States Consumer Product Safety Commission (CPSC) on crib bumper-related deaths from 1985 to 2012 and crib bumper-related injuries from 1990 to 2012. There was a threefold increase in crib bumper-related deaths in the past 7 years as compared to an average of eight such deaths in each of the previous 7-year spans. Crib bumpers caused 48 suffocations, 67% of which were caused by the bumper alone and 33% by the infant being wedged between a bumper and another object in the crib. Mean age at death for these 48 cases was 4.6 months with 50% less than 3 months and 90% less than 7 months. Data from the National Center for the Review and Prevention of Child Deaths showed an additional 32 bumper-related deaths from 37 states from 2008 to 2011 (Scheers et al.).

These study findings are quite alarming considering that public health initiatives to ban use of crib bumpers have been extensive. Although bumpers were originally designed to stop babies from slipping between the crib railings and falling out of bed, manufacturing regulations since the 1970s have required crib slats to be narrower or 2 3/8 in. (Rosen, 2016). Both the American Academy of Pediatrics (AAP, 2011) and American SIDS Institute (2016) have issued warnings about crib bumpers but there have been no federal regulations issued against the use of crib bumpers.

Concerns about crib bumper safety started in 2005 after AAP recommended using thin, flat, and well-secured bumpers only. Antibumper sentiment accelerated in 2007 when a study reported 27 accidental deaths related to crib bumpers between 1985 and 2005 (Thach, Rutherford, & Harris, 2007). However, those findings were not enough to ban crib bumpers. Several voluntary standards were since announced including decreasing thickness of crib bumpers to <=2 in. and banning sale of crib bumpers in Chicago (Ortiz, 2015). The CPSC is currently developing a recommendation that "Bare is Best" and that the safest way for a baby to sleep in a crib is in a sleep sack on a tightly fitted sheet (Ortiz).

So, why are bumpers still so popular? Any catalog or store that is selling cribs displays beautifully decorated cribs with sheets and bumpers that lead parents to ask: "If bumpers are so unsafe, why are they still being sold?" Until we have federally mandated regulations banning the use of bumper cribs, parents need to know that "bare is best." In addition to educating parents on the dangers of using crib bumpers, nurses are in the perfect position as pediatric experts to advocate for legislation and regulation through professional associations and with their legislators. There is no need for more infants to die before we take action.

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