On what would become the worst night of his life, Kyle Maxwell fed his son, Preston, a bottle and rocked the 7-week-old baby to sleep. He put Preston in his crib, took a shower and went to bed.
The next morning, Kyle woke up feeling panicked. Preston wasn't crying or cooing from his crib across the hall. Kyle jumped out of bed and ran the few steps to the baby's room.
"That's where the world turned upside down," he said.
Preston was lying face down in his crib with his nose pressed between the mattress and crib bumper pad. Kyle screamed for his wife, Laura.
"There's no life in him," he remembers telling her, as she sobbed hysterically, holding their son eight months ago.
Preston's autopsy report said he suffocated after his face became wedged between the mattress and bumper pad, which wraps around the inside of a crib and ties to crib slats.
Federal regulators have known for years that bumper pads could pose a suffocation hazard but have failed to warn parents.
The group that sets safety standards for bumpers — and is heavily influenced by bedding manufacturers — has discussed the issue but hasn't taken action either.
Now, in response to weeks of inquiries from the Tribune, the U.S. Consumer Product Safety Commission said it will re-examine the safety of crib bumpers. That includes reopening files on babies' deaths, evaluating the safety of bumper pads on store shelves and rethinking how investigators examine deaths where bumper pads are present.
The Tribune found that while the safety commission acknowledged it has gotten more than two dozen reports of infant deaths associated with bumpers in the past two decades, there could be more deaths that the agency dismissed or did not fully investigate.
The agency has downplayed the risk of bumpers, saying they were a "possible contributing factor" in a number of deaths but weren't necessarily the cause. Such investigations can be complex and can include other products in the crib like blankets or stuffed animals.
For years, bumpers have been a staple in many nurseries. They make cribs look cozy and help prevent babies from bumping their heads or getting their limbs caught in crib slats. Walk into just about any baby products store and bumpers are on every crib.
Preston's mom registered for his checkered bumper because she thought it was cute — and necessary.
"If I had heard one negative thing about a bumper, I wouldn't have used one," Laura Maxwell said.
Three years ago, a Washington University pediatrician sounded the alarm on bumper pad safety. Using data from the safety commission's files, Dr. Bradley Thach concluded that 27 babies' deaths were attributed to bumper pads from 1985 to 2005.
Thach and many other experts said such deaths are underreported because they can be wrongly labeled sudden infant death syndrome, unless a thorough death scene investigation occurs.
Thach said his study was dismissed by the safety commission. The agency has said many deaths cited by Thach had contributing factors or lacked clear evidence that a bumper played a primary role in the death.
But others have warned about bumpers, too.
The American Academy of Pediatrics urged parents not to use the products after Thach's study. The American SIDS Institute and the Canadian Health Department also say parents shouldn't use bumpers. Some states have banned them from day care centers altogether, while Illinois prohibits using them while babies are sleeping.
Many parents still aren't getting the message.
"This is something people are buying and are told is safe to put into their cribs," said Nancy Cowles, executive director of Kids in Danger, a nonprofit group dedicated to protecting kids from unsafe products.
Babies can suffocate because they lack motor skills and strength to turn their heads if they roll against something that blocks their breathing.
It's unclear how many babies have died this way. Medical examiners and coroners aren't required to report deaths to the safety commission.
Since 2008, the federally funded National Center for Child Death Review has received 14 reports of a baby suffocating where a bumper was relevant in the death, the Tribune found.
Meanwhile, the Consumer Product Safety Commission, in a span of 20 years, has received 52 reports of infant deaths in which bumper pads were mentioned but not necessarily ruled as the cause, according to a report released in July.
The agency said 28 of those deaths had been associated with bumper pads, meaning the product played some role in the death.
The remaining deaths might not have been fully investigated, the Tribune found. Commission spokesman Scott Wolfson said the agency would re-examine those files as part of its probe into bumper safety.
In the July report, agency staff said a medical examiner ruled that 24 of the 52 deaths were due to SIDS or entrapments in cribs. The agency declined to say how many of those deaths involved babies' faces being close to, or pressed up against, bumper pads. Several files ruled out bumper pads, such as when a baby suffocated face down in a pillow. The report also said 18 infant death files contained minimal information, but it's unclear if agency staff followed up with police or parents for more details. Manufacturers have cited the Consumer Product Safety Commission's report in claiming bumpers are safe.
The industry, however, was alerted to the safety hazard several years ago with Thach's study. His work was brought to an "infant bedding committee" of American Society for Testing and Materials International, which guides product standards. Bedding manufacturers are major players in the group; representatives of government and advocacy groups sit on the committee, too.
In response to Thach's work, a separate study on bumper pads was spearheaded by the Juvenile Products Manufacturers Association, a trade group representing product manufacturers. The organization said the study isn't public yet and declined to answer questions.
Several retailers say they are aware of the safety concerns but still sell the products. Babies R Us asked manufacturers last year to stop making bumpers more than 1 inch thick, but some older products are likely still sold. Alternatives have popped up in recent years, including mesh liners that babies supposedly can breathe through and bumpers that zip vertically onto individual slats.
There are no safety standards for the thickness or softness of bumpers. Bumpers also don't come with warning tags about the risk of suffocation. The standards group said it is trying to define "pillowy" then would urge manufacturers to avoid making that type of bumper.
'I thought it was necessary'
Crib bumpers have been used for decades, originally as a way to cover space between crib slats and to provide padding if a mattress didn't fit tightly in a crib. Crib regulations changed in the 1970s, mandating less space between crib slats so babies wouldn't get their heads caught.
The government has received reports of injuries where infants got their limbs caught in crib slats, although no fatalities were reported.
Many caregivers think bumper pads are a must.
Tami Vanderwilt wanted her grandson, Aiden Lopez, to have a safe place to sleep.
Last February, Vanderwilt played with the 6-month-old before his afternoon nap.
Around 1:30 p.m., her daughter, Rhiannon Lopez, put Aiden down for a nap in Vanderwilt's guesthouse. An hour later, Lopez burst through the back door, shrieking. Then Vanderwilt saw her daughter holding Aiden.
"His head lolled on her arm. He was just completely limp. But even more alarming was his color. It was ashen. Yellow-gray. A horrible, wrong color," she said, sobbing while she tells the story 10 months later.
Lopez had found her son in the corner of his crib with his face pressed against a bumper. His grandmother performed CPR to try to save him.
According to the medical examiner's report, Aiden suffocated. A detective who examined the scene after the baby was found noted that the bumper pad in the left corner of the crib was pushed down against the mattress.
Vanderwilt had given her daughter the bedding set as a shower gift.
"I bought them the whole coordinated, lovely, deadly, shebang," Vanderwilt said. "I honestly thought it was a necessary part of a newborn nursery, and I hate myself for not doing my homework."
The safety commission wouldn't comment on Aiden or Preston's deaths, but said it can be difficult to determine how or why a child died.
A baby could have been sleeping with a sibling, for example, or pillows or extra blankets could have been found in the crib too, the agency said.
Safety advocates said they know cases aren't always clear-cut but they say they worry that obvious dangers are being ignored.
"It's not that I'm denying there were other products involved," Cowles said. "But it was the bumper that the baby had their face up against."
Preston and Aiden's deaths included other products.
The night before he died last April, Preston was placed on a sleep positioner, a product that was supposed to keep babies from rolling onto their stomach. Positioners often have foam bolsters on the sides to keep a baby in place. Preston somehow rolled out of his positioner and landed with his face between the bumper pad and mattress.
In September, the safety commission and the U.S. Food and Drug Administration issued a warning about sleep positioners and urged parents to stop using them, retailers to stop selling them and manufacturers to stop making them.
Preston's death was one of 12 deaths in the past 13 years involving a positioner, according to the safety commission. The commission wouldn't say why it took action against sleep positioners but not bumpers.
When Aiden was found dead, his crib contained stuffed toys, blankets, a small pillow, two towels and the bumpers. Safety experts say a baby's crib should be clear of clutter, but his grandmother said those products were at the opposite end of the crib.
Laura and Kyle Maxwell no longer live in the house where Preston died. Laura never slept there another night. She couldn't bear to walk by his room. The couple, both 27 at the time, sold the four-bedroom home in Alaska and in August moved to an apartment in Fayetteville, Ark.
Their nearly 3-year-old daughter, Emma, prays for Preston every night when she goes to sleep. Laura says she struggles when asked, "How many children do you have?"
Kyle said he knows that when people hear his family's story, they'll think what he would have thought: "That'll never happen to me."
Tribune reporter Patricia Callahan contributed to this report.Copyright © 2014, The Baltimore Sun