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Dr. Joni Bhutra: Safety first when selecting a crib

Posted: March 11, 2011 1:55 a.m.
Updated: March 11, 2011 1:55 a.m.
Several safety factors should be considered when selecting a crib. Several safety factors should be considered when selecting a crib.
Several safety factors should be considered when selecting a crib.

At our practice in the Santa Clarita Valley, it seems every other mother is pregnant with another child.

Congratulations to these families. I know this is not only seen here in the SCV, but globally as the most common birth months are August through October — making this the season of pregnant mothers.

Since I have the largest audience now, I wanted to address the safety of the baby room and crib.

Let’s start with the crib. This is important if you are planning on “inheriting” a crib. Safety standards were first required in 1972 and continue to be updated.

The safest cribs have been made since 2000. Even still, in the years 2002-04, there were 97 crib-
related deaths. Most crib-related deaths are related to three issues:

1. Quilts, pillows or bedding were added to the crib that created a suffocation hazard. 

2. The crib was in old, or poor, condition with loose or missing hardware. 

3. The crib became unsafe after being near other hazards, including windows, window cords or the baby fell out of the crib.

When choosing or accepting your crib, consider the following:
n Look for Juvenile Products Manufacturers Association certification.

n Cribs slats should be no more than about 2.375 inches apart; widely spaced slats can trap the infant’s head, resulting in death.

n All joints and parts should fit tightly, and the wood must be smooth and free of splinters.

n Check for cracked and peeling paint. All surfaces should be covered with lead-free paint safe for nursery furniture.

n The end panels should be solid, without decorative cutouts, as cutout areas on panels can trap an infant’s head.

n Corner posts should be flush with all the panels or else be very, very tall (such as posts on a canopy bed). Clothing and ribbons can catch on tall corner posts and strangle an infant.

n If the crib has a drop side or drop gate, even when lowered, the sides should be at least 9 inches above the mattress within the crib to prevent the infant from falling out. Raised crib sides should be at least 26 inches above the mattress.

n The drop-sides should have a locking, hand-operated latch that will not release unintentionally.

n All hardware, including screws, bolts, nuts, plastic parts, etc., should be present and original equipment. Never substitute original parts with something from a hardware store.

n Do not use the crib if there are any missing, damaged or broken parts.

n The mattress should be the same size as the crib so there are no gaps to trap arms, body or legs. If you can fit more than two fingers between the mattress and the side of the crib, the crib and mattress combination should not be used.

n If your baby has reflux, pick a wedge mattress that has the same measurements as the mattress that came with your crib. Make sure you cannot fit more than two fingers between the wedge mattress and the side of the crib.

n Don’t use pillows, blankets, quilts, sheepskins or pillow-like crib bumpers in your baby’s sleep area, and keep all objects away from your baby’s face.

n Remember the back sleep position is the safest and should be used at every sleep time.

If you choose to start with a bassinet, the following should be your basic criteria:

n Look for a bassinet that has a stable base. If it’s a fold-up model, make sure the legs lock securely when it’s in use.

n Avoid rough or sharp edges, and loose threads or stitching could allow your baby’s tiny fingers to get trapped.

n The mattress pad should be less than 11 1/2” thick, fit snugly against the sides of the bassinet and be firm, not soft (which is a suffocation hazard). Use a tight-fitting sheet made specifically for the bassinet you choose, and buy extras to keep on hand for changes. Don’t use additional padding or fluffy bedding as these can increase the risk of suffocation.

n Keep your bassinet away from curtains, window blinds, blind cords and wall hangings; any of these can be a strangulation hazard.

n Your baby will probably outgrow the bassinet by the time he or she is 3 months old, but always follow the manufacturer’s weight and size specifications.

When it comes to portable cribs and playpens, always remember:

n Never leave the side of a mesh playpen lowered because a baby can become trapped and suffocate.

n When your child is able to sit or get up on all fours (or when he or she reaches 5 months), remove any toys tied across the top of the playpen.

n When your child can pull himself to standing, remove any large toys that could be used as steps.

n Check the top rails for tears and holes that can trap body parts of your baby. Teething children often bite off chunks of the covering.  You can repair holes with duct tape if they are smaller than

quarter-inch, otherwise you should replace the crib.  

n Make sure the mesh is securely attached to the top rail and the floor plate. If staples are used, make sure they are not missing, loose or exposed.

Now to the changing table:

n Try to keep a hand on your child at all times, even when using the safety belt.

n Keep all supplies within arms reach so you never have to leave your baby unattended.

n Make sure drapery and blind cords are out of reach. Loose cords can strangle children. Keep the cords tied up high with no loops. Check the cords in other rooms while you’re at it.

n If you use baby powder, pour it out carefully into your hand and then apply to your baby instead of shaking out large amounts all over your baby. Keep the powder away from your baby’s face. Published reports indicate that talc or cornstarch in baby powder can injure a baby’s lungs.

Finally, in the bedroom:

n Keep night-lights away from drapes or bedding where they could start a fire. Buy only cool night-lights that do not get hot.

n Install smoke alarms outside every bedroom (or any area where someone sleeps), in furnace areas and on every level of your home, including the basement.

Buy alarms with long-life lithium batteries; standard batteries should be changed every year.

Test alarms every month to make sure they are working properly.

Joni Bhutra is a pediatrician at Santa Clarita Pediatrics. She is a native Californian and completed her training in pediatrics at Children’s Hospital Los Angeles. Within pediatrics, Bhutra is especially interested in genetics and learning disorders.


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