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New study finds 9,500 ED visits related to cribs, playpens and bassinets each year in US

Parents and caregivers have traditionally relied on cribs, playpens and bassinets to protect children while they sleep. The massive crib recalls followed by the announcement in December 2010 by the United States Consumer Product Safety Commission (CPSC) to ban drop-side cribs have caused many families to question the safety of these products. A new study conducted by researchers at the Center for Injury Research and Policy of The Research Institute at Nationwide Children's Hospital examined injuries associated with cribs, playpens and bassinets among children younger than 2 years of age from 1990 through 2008. During the 19-year study period, an average of 9,500 injuries and more than 100 deaths related to these products were seen in U.S. emergency departments each year.

According to the study, being released online February 21 and appearing in the March 2011 print issue of Pediatrics, the majority of the injuries involved cribs (83 percent) and the most common injury diagnosis was soft-tissue injury (34 percent), followed by concussion or head injury (21 percent). The head or neck was the most frequently injured body region (40 percent), followed by the face (28 percent). Two-thirds of the injuries were the result of a fall, and the percentage of injuries attributed to falls increased with age.

"Despite the attention given to crib safety over the past two decades, the number of injuries and deaths associated with these products remains unacceptably high," said Gary Smith, MD, senior author of the study and director of the Center for Injury Research and Policy. "Unlike other child products that require adult supervision for their safe use, cribs, playpens and bassinets must be held to a higher standard because we expect parents to leave their child unattended in them and walk away with peace of mind."

"Educating caregivers about the proper use and potential dangers of these products is an important part of making cribs safer for children, but education alone is not enough," said Dr. Smith, also a Professor of Pediatrics at The Ohio State University College of Medicine. "Innovations in product design and manufacture can provide automatic protection that does not rely on actions of caregivers to keep children safe."

In recent years, organizations such as the CPSC and the American Academy of Pediatrics have amplified their efforts to increase crib safety. The CPSC has issued recalls of more than 11 million cribs and has prohibited the manufacture, sale or lease of drop-side cribs starting in June 2011. Continued strengthening and enforcement of crib safety standards will protect more young children from harm.

Despite the potential risks, cribs are still considered to be the safest location where parents can place infants to sleep. There are several steps parents and caregivers should take when selecting a crib for their child:

  • Pay close attention to the crib you select.
    • Select a crib that meets all current safety standards, does not have a drop side and is not old, broken or modified.
    • Avoid cribs with cutouts or decorative corner posts or knobs that stick up more than 1/16th of an inch
    • Measure the slats to make sure they are not more than 2 and 3/8 inches apart
    • Visit to make sure the crib has not been recalled
    • Make sure the mattress fits tightly into the crib. If you can fit more than two fingers between the mattress and the crib, you need a bigger mattress
    • Frequently examine the crib to make sure it is in good repair and that there are no loose parts
    • Carefully read and follow all assembly instructions

  • When putting your child in a crib to sleep, consider the following:
    • Always place your baby on his or her back to sleep
    • Remember that a bare crib is best. Do not add pillows, blankets, sleep positioners, stuffed animals or bumpers to the crib
    • Crib tents and mesh canopies are not safe to use over cribs. Children can become trapped or strangle in them if they try to get out
    • Avoid placing the crib near a window to prevent falls and possible strangulation from cords from window blinds or shades

  • Monitor your child's developmental milestones and make changes to the crib as needed.
    • Once your child can push up on his hands and knees or is 5 months old (whichever occurs first), remove all mobiles and hanging toys
    • When your child can pull herself up or stand, adjust the mattress to the lowest position. Having the crib sides at least 26 inches above the mattress can help prevent falls
    • Check the manufacturer's instructions to know when your child will outgrow the crib. This generally occurs when your child reaches 35 inches in height

  • If using a bassinet or playpen, make sure they have a sturdy, wide base and that your child meets all height and weight limits.

This is the first nationally representative study to examine injuries to young children associated with cribs, playpens and bassinets that were treated in United States emergency departments. Data for this study were collected from the National Electronic Injury Surveillance System, which is operated by the CPSC.


Contact: Erin Pope
Nationwide Children's Hospital

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