By Rabiya Bilfaqi, 2nd year law student, DePaul University College of Law
and Ben Margolis, M.D.

Introduction
Accidents are among the leading causes of infant deaths nationally.  In Illinois in 2010, 55 out of 1116 infant deaths were from accidents.¹  The importance of cribs and play environments is highlighted by product recall statistics.  In the last two years, the US Consumer Product Safety Commission has recalled more than 5 million cribs, bassinets and play yards.  Illinois House Bill 5348 seeks to eliminate accidental infant deaths due to one such product – crib bumpers pads. The bill amends the Child Product Safety Act and bans the sale of this product entirely.

What is the Child Product Safety Act?
The Child Product Safety Act regulates products that pose safety hazards to children. The Act covers car safety seats, children’s toys, and children’s furniture. The crib bumper ban pertains to the last category.

What is a crib bumper?
A crib bumper is a set of four pillow-like pads that are tied to the inside of a crib above the mattress.

What do we know about crib bumper dangers?
A baby can suffocate when wedged against a padded crib bumper or strangle by a bumper tie around the neck.  Between 2008 and 2011, the National Center for Child Death Review received 14 reports of infant suffocation in which a bumper was relevant in the death.² A study in the Journal of Pediatrics (2007) looking at coroner and medical examiner reports of 27 accidental infant and toddler deaths concluded that “[crib bumper] use prevents only minor injuries. Because bumpers can cause death, …they should not be used.”³  The American Academy of Pediatrics notes that “there is no evidence that crib bumper pads protect against injury, but they do 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.”⁴

History of Crib Bumper Pad Legislation
In 2010, the Chicago Tribune reported that federal regulators failed to warn parents that crib bumper pads pose a suffocation risk to infants even though they knew about the hazard.⁵ Subsequently, the Food and Drug Administration reported the known risks associated with bumper pads including suffocation. In 2011, Chicago became the first city in the United States to ban the sale of baby crib bumper pads. This helped set the stage for the statewide ban on crib bumper pads and helped to raise awareness of the suffocation risk that crib bumper pads pose. There is an ongoing effort nationally to implement crib safety laws. In 2013, Maryland became the first state to enforce a complete ban on the sale of crib bumper pads. States like Texas, California and New York all have general crib safety standards, although they do not yet have laws specific to crib bumpers.

What does a safe crib look like?
Many states classify a safe crib as one that meets the following safety standards⁶ :
•smooth corner posts that extend 1/16-inch or less above end panels
•slats narrower than 2-3/8 inches apart
•a secure mattress support that does not release easily from corner posts
•no cutout designs on the end panels
•no tears in mesh or fabric
•no cracked or peeling paint to prevent lead poisoning
•no missing or loose screws, bolts, or hardware
•wood surfaces that are smooth and free from splinters, splits or cracks; no sharp edges, points, or rough surfaces

Comment on Sudden Unexpected Infant Death Initiative
Medical examiners and coroners have moved away from classifying deaths as Sudden Infant Death Syndrome (SIDS). They are more likely to classify deaths as accidental, suffocation-related or with an unknown cause. SIDS is now being called Sudden Unexpected Infant Death Syndrome (SUID). The Center for Disease Control (CDC) states that “inconsistent practices in cause-of-death determination hamper the ability to monitor national trends, ascertain risk factors, and design and evaluate programs to prevent these deaths.”⁷ The CDC’s research on SUID focuses on efforts to improve data collected at infant death scenes and to promote consistent reporting of cause and manner of death for SUID cases.

Final Comment
At Autopsy Center, we know what families go through when they experience a loss.  And, in the world of grief, parental loss is profound.  Our goals is not only to support families during a loss, but to work to prevent such losses.  We support public health initiatives, such as HB5348, which save lives.

Resources
Product Safety Recalls
Resources for Bereaved Families

References
¹ Leading Causes of Infant Death 2010. Illinois Department of Public Health website http://www.idph.state.il.us
² http://www.childdeathreview.org/home.htm
^3,4 Thach, Bradley T., George W. Rutherford, and Kathleen Harris. Deaths and Injuries Attributed to Infant Crib Bumper Pads. The Journal of Pediatrics 151.3 (2007): 271-74.e3. Web.
⁵ Gabler, Ellen. Federal Regulators to Study Safety, Suffocation Hazard of Crib Bumpers. Chicago Tribune., 12 Dec. 2010
⁶ http://www.freecasereview.com/InjuryLawArticles/cribsafetytips.htm
⁷ CDC’s Sudden Unexpected Infant Death Initiative. Centers
for Disease Control and Prevention. 10 May 2011. Web. 7 Sept. 2014.