Crib Death Tied to Common Bedding

Published: April 8, 1992

LOS ANGELES, April 7—
A study suggests that ordinary bedding materials, not just the beanbag cushions already recalled by the Government, may have suffocated many babies whose deaths were reported as "crib death," scientists said today.

"Perhaps one in four of sudden, unexplained infant deaths may be explained by exhaled carbon dioxide being trapped around the baby's face by bedding such as pillows, comforters and foam beds," said Dr. James Kemp, a pediatrician at Washington University School of Medicine in St. Louis.

Babies whose deaths were ascribed to the mysterious Sudden Infant Death Syndrome, called SIDS or crib death, should be investigated as possible suffocation victims if they were found face down, said Dr. Bradley Thach, a Washington University pediatrician who conducted the study with Dr. Kemp. He presented the findings in Anaheim at the annual meeting of the Federation of American Societies for Experimental Biology.

SIDS kills about 7,000 infants a year in the United States. Many possible causes have been proposed; none have been proved. At least a quarter of victims are found face down.

In their study, Dr. Kemp and Dr. Thach made rabbits breathe through a model of an infant airway pressed against bedding materials on which infants died. That test and a new mechanical test suggested five types of bedding can suffocate infants by trapping exhaled carbon dioxide, allowing children to rebreathe the gas without getting enough oxygen. The types were a synthetic-filled adult pillow, a three-and-a-half-inch-thick foam couch cushion, a three-inch-thick foam pad covered with a comforter, a sheepskin sold as an infant bed and a soft infant bassinet cushion covered by a blanket.

Dr. Henry Krous, a pediatrician-pathologist at the University of California at San Diego, said some of the conclusions were premature, but said the researchers were "highly reputable, capable investigators" whose "interesting and provocative" study suggested that bedding might lead to crib death for babies with an inborn vulnerability.

Last summer The New England Journal of Medicine published a study in which Dr. Kemp and Dr. Thach used rabbits to show infants could suffocate on polystyrene-bead-filled beanbag cushions made for babies. The Consumer Products Safety Commission earlier recalled 950,000 such cushions, implicated in 35 deaths. The commission received reports of more than 250 infants suffocating on adult or youth mattresses or waterbeds from 1985 to 1990. Some got trapped between a mattress and a wall, some suffocated when adults rolled onto them, and some died face down.

The rabbit test was challenged by some experts because "they forced the rabbits to suffocate and didn't allow for natural movement," said Frederick Locker, lawyer for the Juvenile Products Manufacturers Association. Nevertheless, the association said, "infants should never be put to sleep on adult beds, pillows, cushions or rugs." Mr. Kemp also said that parents should put infants to bed "on their side or back unless there is some medical reason not to."