Banning crib bumpers

Of all the deaths that occur among infants, those caused by so-called crib bumpers — the padded, often brightly colored cushions that line the inside of babies' cribs — may be the easiest to prevent. Crib bumpers serve no real purpose other than the cosmetic, while in some case they can cause serious harm, even death. That's why Maryland health secretary Dr. Joshua M. Sharfstein was right to accept an expert panel's recommendation on Tuesday to ban their sale in Maryland.

Studies have shown that the pads, which are often marketed as a safety feature, have a negligible effect on reducing injuries caused by infants hitting their heads against the hard surfaces of their crib. It's questionable whether infants even have the strength to hurt themselves in this way, but that's how bumper manufacturers tout their products to anxious parents.

On the other hand, the liners themselves pose a small but potentially deadly risk of asphyxiation for sleeping babies. Cases have been documented of infants rolling into the bumpers and getting their faces stuck, or becoming entangled in the fasteners that secure the bumpers to the crib, causing them to suffocate. The available evidence suggests that these risks far outweigh any possible benefit the pads may offer.

Nationally, 27 infant deaths have been definitively attributed to crib bumpers over the last two decades, including one in Maryland. Moreover, researchers suspect that crib bumpers may have played a role in many other cases of Sudden Infant Death Syndrome (SIDS) across the country, in which the cause of death could not be definitively established. Since crib bumpers appear to be one of the significant risk factors for SIDS, eliminating them is one of the easiest ways to lower infant mortality rates.

Health experts recommend that parents of newborns adopt the "ABCs" of safe sleep — babies should sleep alone, on their backs and in a crib with no blankets or stuffed toys that might interfere with their breathing. Crib bumpers, which are often decorated with colorful patterns, make a baby's bed appear more comfortable and inviting but are not part of the ABC regime, and parents should avoid them.

Prohibiting the sale of crib bumpers would make Maryland the first state in the nation to adopt such a regulation, although parents would still be able to buy the pads in other states and use them here. Weaning parents away from such practices will still require a long-term statewide public information and education initiative, such as the successful Safe Sleep campaign that Dr. Sharfstein developed to lower infant mortality rates when he was health commissioner in Baltimore City.

Even so, the proposed ban, which would go into effect in 2013, sends a powerful signal of Maryland's commitment to protecting its most vulnerable citizens and improving overall birth outcomes. That's a smart public health policy that's also likely to save lives.

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