To identify and assess dangers associated with placing children younger than 2 years to sleep in adult beds. This article focuses on overlying, wedging, and strangulation hazards and the relationship of these hazards to children's sleeping environments. Design: A retrospective review and analysis of data collected by the US Consumer Product Safety Commission on deaths of children younger than 2 years in standard adult beds, daybeds, and waterbeds. The review included incident data from January 1990 through December 1997. Results: The 8-year records showed a total of 515 deaths of children younger than 2 years who were placed to sleep on adult beds. Of these deaths, 121 were reported to be due to overlying of the child by a parent, other adult, or sibling sleeping in bed with the child and 394 were due to entrapment in the bed structure. Most of these deaths seem to have resulted from suffocation or strangulation caused by entrapment of the child's head in various structures of the bed. Conclusions: Placing children younger than 2 years to sleep in adult beds exposes them to potentially fatal hazards that are generally not recognized by the parent or caregiver. These hazards include overlying by a parent, sibling, or other adult sharing the bed; entrapment or wedging of the child between the mattress and another object; head entrapment in bed railings; and suffocation on waterbeds. Parents and caregivers should be alerted to these avoidable hazards.

ABSTRACT. Objectives. To describe the danger of upper airway obstruction associated with semirigid hollow objects in infants and toddlers and to define a minimum frequency with which episodes involving these products have occurred and propose a model defining the potentially hazardous characteristics of these objects.Methods. A retrospective study of incidents reported to the US Consumer Product Safety Commission from January 1983 to March 2000, involving children younger than 5 years, was conducted. The medical literature (Medline) was searched for similar cases. The resulting case series was analyzed.Results. A total of 17 incidents were identified in which a semirigid, hollow hemispherical/ellipsoidal object was described as having "cupped" the face, simultaneously covering the nose and the mouth. Of the 17 incidents, 13 involved toys; the remaining 4 incidents involved 2 different consumer products. All of these incidents involved children aged 4 to 36 months. Eight incidents resulted in death; 9 were nonfatal because of parental intervention. In all cases investigated, the infant was found with the semirigid object strongly adhering to his or her face. In 16 incidents, significant physical effort reportedly was required to remove the objects from the child's face. The fatal incidents involved children aged 4 to 24 months, whereas the age range of the children in nonfatal incidents was 7 to 36 months. In all but 1 of the fatal cases, the victim was found dead in a crib or playpen. The cross-sectional diameter of the products involved in suffocation incidents was in the range of 6.4 to 9.7 cm. The depths of the products ranged from 4.2 to 5.1 cm. The approximate volume of containers ranged between 100 and 170 mL. These dimensions are compatible with the range of anthropometric measurements that allow the product to fit snugly over the mouth and the nose of a young child, resulting in complete airway obstruction.Conclusions. Children between the ages of 4 and 36 months are at risk from suffocation by hollow, semirigid hemispherical/ellipsoidal objects through suction formation and complete airway obstruction. Shallow containers with dimensions ranging from approximately 6.0 to 11.0 cm seem to be especially hazardous. Several recommendations may be proposed to lessen the hazard to young children. These include product design changes that limit the amount of contact with the perimeter and reduce the chance of forming a seal between the container and the face and ventilation holes to prevent a seal from forming. Although design change alone may be very helpful in products that are intended for use by children who are younger than 3 years, products that have similar dimensions and are not intended for infants present additional challenges. Thus, a very important additional prevention strategy is education. Pediatricians and other health care providers should alert parents and caregivers to the dangers of leaving such products in an infant's crib or playpen or allowing infants to play with these objects while unatt...

No abstract

Parents of infants expect their baby will sleep safely in any of a number of products that are intended for overnight sleep (e.g., crib, bassinet, cradle, play yard) as well as products in which infants routinely nap (e.g., infant seat, swing). Yet each year, infants die while napping or sleeping. The Consumer Product Safety Commission (CPSC) is an independent federal agency charged with protecting the public from unreasonable risk of injury associated with consumer products, including infant sleep products. In this panel, technical experts from the CPSC address issues relating to infant sleep safety including physiological factors associated with infant death and findings from incident data. Case studies for two infant products (handheld infant carriers and infant bouncer seats) and focus group research findings with parents of infants shed light on consumer behavior as it relates to perceptions of infant comfort and product use.

No abstract