II. Epidemiology

  1. Crib related injury Incidence
    1. U.S. Crib related injuries in 2002: 34,750
    2. U.S. Crib related deaths in 2000: 44
  2. Reference
    1. (2003) CPSC Hazard Screening Report, Nursery Products

III. Crib

  1. Slats should be no more than 2 and 3/8 inches apart
  2. No rough metal edges
  3. Safe locks and latches (secure from accidental release)
  4. Maximal distance between mattress and top of side rail
  5. Crib head and foot boards should NOT be notched
    1. Notches allow a babies head to be entrapped

IV. Mattress

  1. Mattress should fit snugly
    1. Too small if >2 fingers fit between mattress and crib
  2. Set the mattress at the lowest position
    1. Indicated when child can pull to a standing position

V. Bumper pads

  1. Do not use bumper pads to cover up wide slats
    1. Cribs with wide slats should not be used
    2. Bumper pads are not safe alternative to narrow slats
  2. Run around entire crib
  3. Tie or snap into place (should have >= 6 straps)
  4. Trim excess strap length
  5. Use Bumpers until baby pulls self to standing position

VI. Older crib pointers

  1. Check overall condition of crib
    1. Anything missing?
    2. All Bolts and fasteners in place?
    3. Replacement parts available from manufacturer?
    4. Cover sharp or rough edges with heavy tape
  2. If you paint or refinish crib:
    1. Use only high quality household enamel paint
    2. Do not use old paints manufactured before Feb 1978
    3. Confirm that manufacturer approves for use on cribs
  3. Check size of mattress (See two finger rule above)
    1. Replace mattresses that are too small immediately
    2. Temporize until replace: towel rolls at mattress edge
  4. Avoid the use of cribs with wide-slats
    1. Bumper pads are not safe alternative to narrow slats

VII. General Pointers

  1. Do not leave items in crib child could use to climb out
  2. Never hang any stringed object within reach of child
    1. Examples
      1. Toy on a string
      2. Laundry bag
      3. Venetian blind cord or drapery from window
    2. Risk of strangulation
  3. Cut off cords or elastic on toys
  4. Never put a loop of ribbon or cord around baby's neck
  5. Loose clothing can become entangled on top of bedposts
    1. Avoid cribs with corner post (>1/16 inch above panel)
    2. Avoid loose clothing
  6. Replace any damaged Teething rails (may cut mouth)
  7. Do not use crib as a playpen
  8. Never use thin plastic bags as mattress covers
    1. Suffocation risk
    2. Also avoid loosely fitting sheets

VIII. Indications to Discontinue crib use

  1. Side rail is less than 3/4 of child's height
  2. Crib Extenders (extends the side rails) are available
    1. However slats must be narrowly spaced
    2. Should have no easily removed nuts or bolts

IX. Suspended Rocking Cradles associated with Asphyxia

  1. No longer available on market in US (sold second hand)
  2. Only use with locking pin in place (prevents tilting)
  3. As always, infants should be supine for sleeping
  4. Reference
    1. Ackerman (1997) Arch Pediatr Adolesc Med 151:573-5 [PubMed]

X. Resources

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