There is little new parents obsess over as much as sleep. We go to great lengths to help our babies sleep because when they sleep we finally can, too. For exhausted parents who are warned against bed sharing but want their baby close, in-bed sleepers are intriguing products—a compromise between the convenience of co-sleeping and the separation of a crib or bassinet.
They make parents feel safer when bed sharing, but are in-bed sleepers safe?
This week, Consumer Reports published an investigation into in-bed sleepers which linked the product category to 12 infant deaths between 2012 and 2018. This investigation was published the same day as a new study in the journal Pediatrics which found less than a third of American babies are only put to sleep in the products the American Academy of Pediatrics (AAP) recommends: firm and flat cribs, bassinets, or Pack N' Plays which meet the safety standards of the Consumer Product Safety Commission.
Dr. Ben Hoffman is a pediatrician and the Chair of the AAP's Council on Injury, Violence, and Poison Prevention Executive Committee. He tells Motherly he feels a lot of compassion for parents who choose not to follow the AAP's safe sleep recommendations in the hope of getting more sleep, but he's also gravely worried for them. "I'm afraid that what's going to happen is exactly what we saw with the Rock 'n Play," he says.
A baby registry staple, the Rock 'n Play was an inclined sleeper, the design of which went against the AAP's recommendation that babies sleep on a flat surface. Earlier this year, a Consumer Reports investigation into infant deaths linked to inclined sleepers prompted a recall of the Rock 'n Play and similar products. Many fans of the Rock n' Play criticized the recall efforts, suggesting supervision, not the design, was a factor in the deaths of 59 babies in inclined sleepers.
The CPSC eventually hired a third party expert (a specialist in infant biomechanics at the University of Arkansas for Medical Sciences to conduct a study. According to the CPSC, that study "examined how 10 infants move and use their muscles on flat, inclined surfaces, and in selected inclined sleep products, and whether such product designs directly impact safety or present a risk factor that could contribute to the suffocation of an infant."
The study concluded that the inclined sleep products that were tested were not safe for sleep, and the expert behind the study says the kind of testing she did (after millions of inclined sleepers were sold) should be done before products go to market.
Dr. Hoffman agrees and worries that because there are currently no federal safety standards for in-bed sleepers and boxes "it's sort of the Wild West" for manufacturers. He worries parents are being taken advantage of by companies and compares sleep products that are hailed as miracles to snake oil.
"Every parent struggles with sleep and they are desperate for something…they sell hope to a family," he explains.
The 'Consumer Reports' investigation
Consumer Reports examined data from the Consumer Product Safety Commission (CPSC) and names three in-bed sleeping products in its investigation: The popular DockATot, the Baby Delight Snuggle Nest Infant Sleeper and the SwaddleMe By Your Side Sleeper.
Rachel Rabkin Peachman, an investigative reporter with Consumer Reports, notes that the CPSC "inadvertently disclosed information about the specific products involved in the incidents."
Motherly has reached out to all of these brands for comment on the Consumer Reports investigation. As of this writing DockATot has not responded.
SUMR Brands, the parent company of Summer Infant, maker of the SwaddleMe By Your Side Sleeper has responded with the same statement it provided to Consumer Reports.
The company states, in part: "The Summer Infant By Your Side Sleeper is not responsible for any deaths. Independent medical examiner reports of two incidents where a Summer in-bed sleeper was present in 2014 and 2015 concluded the in-bed sleeper was not a contributing factor to a child's death."
A spokesperson for Baby Delight stated in an email to Motherly that the "Consumer Reports article is a bit misleading since it equates our Snuggle Nest products with inclined sleepers." The Snuggle Nest is not an inclined sleeper and that's not what Consumer Reports or Dr. Hoffman are suggesting. Both, however, suggest parents stop using the product.
Consumer Reports states it identified two deaths that involved the SwaddleMe By Your Side Sleeper, two deaths involving the DockATot as well as three deaths that involved the Baby Delight Snuggle Nest Infant Sleeper.
Baby Delight tells Motherly that "based on the information from the CPSC Investigations, each incident was apparently a result of caregiver behavior contrary to safe sleep practices and warning labels present on product and in instruction manual." The AAP points out that the very existence of the Snuggle Nest Infant Sleeper is contrary to safe sleep practices.
The backstory on in-bed sleepers
⚠️ CR urges parents to stop using inclined sleepers or any sleep products—including in-bed sleepers—that do not meet federal safety requirements related to infant sleep. Learn more about #SafeSleep guidelines: https://t.co/ZUHplKQN0I— Consumer Reports Advocacy (@CRAdvocacy) October 22, 2019
Two of the products named in the Consumer Reports investigation, the Baby Delight Snuggle Nest and the SwaddleMe By Your Side Sleeper are comprised of a mattress with low, mesh walls. (Baby Delight describes its product as having "breathable mesh walls along with solid plastic inserts for stability.")
The third product, the DockATot, is softer, a product in a category sometimes known as baby nests or baby pods.
That's the language the FDA, the UK's Lullaby Trust (with support from Public Health England) and Health Canada have used when warning parents not to put babies to sleep in products that have soft bolsters on sides, like the DockATot does. Such bolsters pose a suffocation risk, the FDA notes.
On its website DockATot states the company "recognizes that many people believe strongly that infants and young children should never sleep with adults in their bed, while others believe that such co-sleeping provides benefits. Many who choose to co-sleep with a DockATot dock find that the sides help establish a separate space for the baby that is close by to the parent(s)."
DockATot also states its product should never be used in a crib or playpen.
Safe sleep recommendations
But a quick Instagram scroll through #dockatot proves that many parents are using the DockATot in cribs, and that is not the only way in which parents are ignoring safety recommendations from the makers of sleep products and from pediatricians.
A study released this week in the journal Pediatrics found that while most new parents put their babies to sleep on their backs, only 42% follow the American Academy of Pediatrics' recommendation against soft bedding, and just 32% were using a separate, approved sleep surface.
This follows research published in 2018 which found the number of American babies dying by suffocation has been on the rise in recent years. The majority of these suffocation deaths happened while these babies were in bed. In an email interview with Reuters last year, one of the study's co-authors suggested that the rise in suffocation deaths could be because parents are ignoring safe sleep recommendations, but suggested "It may also be that we have dangerous items on the market and in our homes, and they need to be removed."The recent CPSC study found that was the case with the Rock 'n Play, but even though the product was the subject of a widely publicized recall, some caregivers and parents and still choosing to use the inclined sleeper.
Calls for change
A parent himself, Dr. Hoffman does not want to minimize how much parents struggle with sleep in the early weeks and months of parenthood, calling it "one of the hardest things many people will go through in life."
It really is that hard, he says. But he also says in-bed sleepers are not the solution exhausted parents are looking for. "I've testified a couple of times before the Consumer Product Safety Commission about them, and I feel about them, honestly, the way that I felt about the inclined sleepers—that there's really not a safe way that they can be used," he tells Motherly.
And as much as Dr. Hoffman feels for parents going through sleep deprivation in early parenthood, he knows that losing a child to SIDS is so much harder and he wants lawmakers, manufacturers and the end consumers to think about that when considering infant sleep products.
"Parents are desperate for something because their child is unhappy and it makes them unhappy and everybody's miserable. But the fact of the matter is...it's just not worth the risk."
Hoffman is calling for regulatory change, but he says parents can keep their babies safer by sticking with products that meet the CPSC's standards and by always putting babies to sleep on a flat, firm sleep surface with no soft bedding, bumpers, bears or blankets. "Buy a crib or bassinet that conforms to the Consumer Product Safety Commission crib and bassinet standard. Absolutely. Anything that does not is not a safe place for a baby to sleep unattended."
[Correction: October 23, 2019: A previous version of this post stated the expert behind the new Rock 'n Play study is a specialist in infant biomechanics at the University of Arkansas. She is with the University of Arkansas for Medical Sciences.]
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