Maryland health officials continued their push to become the first state to ban the sale of bumper pads that line the inside of baby cribs, introducing proposed language Friday for regulations that could go into effect next year.
The regulations would forbid retailers from selling bumpers that run around the mattress and have been linked to infant deaths. It would not apply to vertical bumpers that line the upper rails of a crib or those made from mesh.
Maryland's proposed ban, which would take effect June 21, 2013, comes amid heightened concern about the safety of crib bumpers.
A state task force found last year that the pads, often included as part of bedding sets, can suffocate or strangle babies. Based on recommendations from the panel, the Maryland Department of Health and Mental Hygiene announced a few months later its intention to propose a ban. This latest step Friday set the process in motion to formally regulate the restriction.
"Our review of evidence and public input has led us to the conclusion that these products are risky for young infants," Maryland Health Secretary Dr. Joshua M. Sharfstein said. "We want Maryland babies to sleep safely. Which means alone, on their back, in their crib."
The American Academy of Pediatrics has also warned against using bumpers, as part of updated sleep guidelines for parents aimed at reducing sudden infant death syndrome and other deaths. The 2011 guideline was more stringent than the academy's previous recommendation that allowed for bumpers that were firm and staying away from those that were pillow-like.
Manufacturers of the bumpers have argued that there isn't enough evidence proving babies are suffocated and that if used correctly bumpers are safe. The Juvenile Products Manufacturers Association has said the bumpers can keep infants from bruising their heads and can prevent entrapped limbs.
Instead of a ban, the group favors offering consumers a better distinction between the more hazardous, soft pillow-like bumpers and what they call safer traditional bumpers. They have petitioned the Consumer Product Safety Commission to pass a rule to define the difference.
The group worries that if there is a ban, parents would create their own makeshift bumpers, which could be more dangerous.
"Parents will benefit from a clarifying standard when shopping in the marketplace for products that protect babies from limb entrapment, abrasions and contusions when safely placed in cribs on their backs to sleep rather than a ban that can lead to unintended hazards from makeshift and unsafe sleep environments," Michael Dwyer, executive director of JPMA, said in a statement.
Maryland will go forward with its attempts to pass a ban despite the petition. Sharfstein can lift the ban if federal regulators find the benefits of bumpers outweigh the risks.
Maryland would be the first state to institute a ban on bumpers. Chicago's City Council passed a ban last year. Maryland's regulation is aimed at retailers and would not punish parents who use bumpers.
The proposed regulation will be published in the Maryland Register and reviewed by a legislative committee before it is enacted. The public has until Aug. 13 to comment.
Retailers, including Internet sellers, would receive a warning for a first violation of the rule and fined up to $500 for each baby bumper sold after that.
The ban would include a plan to educate parents on safe sleeping practices, such as removing blankets, stuffed animals and other objects from the crib. About 50 infants a year in Maryland die of sudden infant death syndrome.
Members of the state task force said that the bumpers serve more as a decoration than a safety device. Chief medical examiner of Maryland David F. Fowler has said that babies don't have to have their mouths or noses covered to suffocate. Being close to a stuffed animal or bumper may slow air movement, he said.
Some studies have shown that babies can roll into the bumpers and get their faces stuck, causing them to suffocate. Others have been found dead with the ties from the bumpers wrapped around their necks.
Fowler has identified one infant fatality in Maryland directly related to a bumper and nine where a bumper was present and cause of death was likely asphyxia.
The proposed ban is supported by local pediatricians, including the Maryland Chapter of the American Academy of Pediatrics.
"These aren't sick kids," said Scott Krugman, chair of the Department of Pediatrics at MedStar Franklin Square Medical Center and the academy's incoming chapter president. "These are healthy kids who are dying unnecessarily, and anything we can do to reduce that risk is worthwhile."
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