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Are parents ensuring crib safety to prevent falls and head injuries?

By Aimee Keenan-Greene

A new study in the Journal Pediatrics utilizing a nationally representative sample to examine injuries associated with cribs, playpens, and bassinets says there is a consistently high number of observed injuries and greater efforts are needed to ensure safety in the design and manufacture of these products, ensure proper use in the home, and increase awareness of their potential dangers to children.

The research is a retrospective analysis done using data from the National Electronic Injury Surveillance System for children younger than 2 years of age treated in emergency departments in the United States from 1990 through 2008 for an injury associated with cribs, playpens, and bassinets. 

Scientists found an estimated 181,654 (95 percent confidence interval: 148 548–214 761) children younger than 2 years of age were treated in emergency departments in the United States for injuries related to cribs, playpens, and bassinets during the 19-year study period.

There was an average of 9561 cases per year or an average of 12.1 injuries per 10 000 children younger than 2 years old per year. 

Injuries occurred most often in association with:

cribs - 83.2%

playpens - 12.6% 

bassinets -  4.2% 

The most common mechanism of injury was a fall from a crib, playpen, or bassinet, representing 66.2 percent of injuries.

Soft-tissue injuries comprised 34.1 percent, the most common diagnosis.

The most frequently injured body region was the head or neck, 40.3 percent.

Patients with fractures were admitted 14 percent of the time, making them 5.45 (95 percent confidence interval: 3.80–7.80) times more likely to be hospitalized than patients with other types of injury.

Children younger than 6 months were 2.97 (95 percent confidence interval: 2.07–4.24) times more likely to be hospitalized than older children.

The Consumer Product Safety Commission  unanimously approved new standards to take all drop-side cribs off the market by June of this year.

The CPSC is also mandating stronger mattress supports, more durable crib hardware, and more rigorous safety testing.

More than 59,000 childcare facilities nationwide will now have to conform to performance standards. An additional 53,000 hotels and motels will need to follow the new regulation.

The CPSC estimates these types of public establishments alone have 935,000 cribs that need replacing, at a total cost of $467 million. CPSC Commissioner Anne Northrup said almost every large daycare center who spoke to them had asked for 5 years to comply. They have until June 2012.

The CPSC has recalled more than 11 million dangerous cribs since 2007. Detaching drop-side rails were associated with at least 32 infant suffocation and strangulation deaths since 2000. Additional deaths occurred due to defective hardware.

The CPSC Safe Sleep Campaign says to further reduce the risk of child sleep injuries, always lay a baby on their back, remove all loose pillows and bedding, and use only a fitted bottom sheet designed for the mattress, to reduce the risk of Sudden Infant Death Syndrome.

The CPSC has a toll-free hotline for consumers  - 800-638-CPSC.

Additional Information: 

Researchers writing in the Journal Pediatrics

Elaine S. Yeh, BSa,b, Lynne M. Rochette, PhDa, Lara B. McKenzie, PhD, MAa,c, Gary A. Smith, MD, DrPHa,c

aCenter for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio; and cDepartment of Pediatrics, bThe Ohio State University, College of Medicine, Columbus, Ohio