Inclined Sleep Products are Not Recommended – What About a Car Seat?

On October 31, 2019 The U.S. Consumer Product Safety Commission (CPSC) issued a warning to parents and caregivers about the dangers of popular inclined sleep products for infants, citing the findings of a new study. The study is part of a growing body of evidence showing that inclined sleepers with higher angles do not provide a safe sleep environment for infants. 

CPSC received reports of 1,108 incidents, including 73 infant deaths, related to infant inclined sleep products that occurred from January 2005 through June 2019. CPSC hired independent expert Erin Mannen, Ph.D., a mechanical engineer specializing in biomechanics at the University of Arkansas for Medical Sciences, to conduct infant testing to evaluate the design of inclined sleep products. Dr. Mannen measured infants’ muscle movements and oxygen saturation while in various products and positions, such as a flat crib, an inclined crib, and several inclined sleep products. Dr. Mannen found that none of the inclined sleep products her team tested is safe for infant sleep. Dr. Mannen’s report was conclusive that products with inclines 10 degrees or less, with flat and rigid surfaces, are likely safe for infant sleep. Dr. Mannen also found that soft and plush-like sleep surfaces pose dangers to infants.

It is not surprising that Dr. Mannen’s study concludes that infants should be placed to sleep on a firm, flat surface in a crib or bassinet. 

So, what is the American of Pediatrics’ (AAP) take on infant car seats since they put infants in an inclined position?  And we all know infants do fall asleep in the car.

The American Academy of Pediatrics (AAP) advises against letting babies sleep in car seats, strollers and other sitting devices.  According to a recent article in Reuters Health, Dr. Jeffrey D. Colvin of the University of Missouri-Kansas City School of Medicine told Reuters Health. “Car seats are for cars, and they’re not a substitute for cribs or bassinets,” Most infant deaths in car-safety seats happen when the seat is being used as a napping spot, rather than for transportation, according to Colvin’s study.

Ben Hoffman, M.D., chairman of the American Academy of Pediatrics Council on Injury, Violence, and Poison Prevention Executive Committee, agrees. “All the data that we have on car seats indicate that there aren’t risks associated with babies sleeping in the car for short periods of time when they’re properly restrained in a car seat that’s been installed with appropriate positioning.”

Colvin and his colleagues reviewed U.S. data on 11,779 infant sleep-related deaths in 2004-2014, of which three percent took place in a sitting device, such as a car seat, stroller or bouncer. Car safety seats accounted for nearly two-thirds of these deaths, and the sitting devices were being used as directed less than 10 percent of the time.

According to the study, most deaths occurred while a child was at home or at a friend or relative’s home, and while a child was being supervised by a parent or guardian. Deaths in sitting devices were almost three times more likely to occur when a child was being supervised by a child-care provider rather than a parent and were twice as likely when a babysitter was watching the child.

In many cases, infants had not been strapped into the seat properly, Colvin noted. “What we saw a lot as well was that the infants had been placed in that car seat in the house for hours and hours, and the parent who was supposed to be supervising the child went to sleep.”

Because car seats are safety devices, and the safest place for babies to be while in a car, parents and caregivers may mistakenly believe that the seats are safe for sleep too, Colvin said. Low-income families may be forced to let their child sleep in a car seat because they can’t afford a crib or a bassinet at home, he added.

“All parents, me included, have been guilty of taking a sleeping infant in a car seat out of the car and not wanting to risk waking them up,” Colvin said. “The safest thing to do for a sleeping infant outside of a car is to place them in a bassinet or a crib, but at an absolute minimum, that infant should be directly observed and fully strapped in.”

The AAP continues to emphasize that the best place for a baby to sleep is on a firm, flat surface in a crib, bassinet or play yard. Parents and caregivers should never add blankets, pillows or other items to an infant’s sleeping environment. Babies should always be placed to sleep on their backs. 

According to the AAP;s 2016 Safe Sleep Technical report, air permeable surface may be preferable to air impermeable surfaces for infants who roll.  There are many safety features of a completely “breathe-through” crib mattress that the AAP recognizes.

You can check www.cpsc.gov often to see if your nursery products have been recalled.  If your product has been recalled, promptly follow the recall instructions to receive a refund, replacement, or repair. Consumers who register their nursery products with the manufacturer’s registration card (included with nursery items) can be contacted directly by the manufacturer if there is a recall.

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