HB4638ham001 97TH GENERAL ASSEMBLY

Rep. Emily McAsey

Filed: 3/26/2012

09700HB4638ham001 LRB097 18907 KMW 68010 a

AMENDMENT TO HOUSE BILL 4638

AMENDMENT NO. ______. Amend House Bill 4638 on page 1, immediately below line 1, by inserting the following:

"Section 1. Purpose. Research concludes that crib and bassinet bumpers are dangerous. From 1985-2005, 27 accidental deaths attributable to bumper pads were reported by medical examiners or coroners. A report, published in a 2007 issue of a prominent pediatric journal, concludes that the data does not suggest any way in which changes in bumper design can reduce the risk of death.

According to an investigative report conducted on the expansion of recommendations for a safe infant sleeping environment, in light of risks associated with sudden infant death syndrome, cribs should meet safety standards of the Consumer Product Safety Commission (CPSC), Juvenile Product Manufacturers Association, and the ASTM International, including those for slat spacing, snugly fitting and firm mattresses, and no drop sides.

One of the most prominent national professional organizations of pediatricians recommends the use of new cribs, because older cribs might no longer meet current safety standards, might have missing parts, or might be incorrectly assembled. If an older crib is to be used, care must be taken to ensure that there have been no recalls on the crib model, that all of the hardware is intact, and that the assembly instructions are available.

For some families, use of a crib might not be possible for financial reasons or space considerations. In addition, parents might be reluctant to place the infant in the crib because of concerns that the crib is too large for the infant or that "crib death" only occurs in cribs. Alternate sleep surfaces, such as portable cribs, play yards, and bassinets might be more acceptable for some families, because they are smaller and more portable. Local organizations throughout the United States can help to provide low-cost or free cribs or play yards. If a portable crib, play yard, or bassinet is to be used, it should meet the following CPSC guidelines: (i) sturdy bottom and wide base; (ii) smooth surfaces without protruding hardware; (iii) legs with locks to prevent folding while in use; and (iv) firm, snugly fitting mattress.

In addition, other guidelines for safe sleep, including supine positioning and avoidance of soft objects and loose bedding, should be followed. Mattresses should be firm and should maintain their shape even when the fitted sheet designated for that model is used, such that there are no gaps between the mattress and the side of the bassinet, playpen, portable crib, or play yard.

Only mattresses designed for the specific product should be used. Pillows or cushions should not be used as substitutes for mattresses or in addition to a mattress. Any fabric on the sides or a canopy should be taut and firmly attached to the frame so as not to create a suffocation risk for the infant. Portable cribs, play yards, and bassinets with vertical sides made of air-permeable material may be preferable to those with air-impermeable sides.

Finally, parents and caregivers should adhere to the manufacturer's guidelines regarding maximum weight of infants using these products. If the product is a combination product, the manual should be consulted when the mode of use is changed.

Bedding is used in infant sleep environments for comfort and safety. Parents and caregivers who perceive that infants are uncomfortable on firm surfaces will often attempt to soften the surface with blankets and pillows. Parents and caregivers will also use pillows and blankets to create barriers to prevent the infant from falling off the sleep surface or to prevent injury if the infant hits the crib side. However, such soft bedding can increase the potential of suffocation and re-breathing. Pillows, quilts, comforters, sheepskins, and other soft surfaces are hazardous when placed under the infant or left loose in the infant's sleep area and can increase SIDS risk up to 5-fold independent of sleep position. Several reports have also described that in many SIDS cases, the heads of the infants, including some infants who slept supine, were covered by loose bedding. It should be noted that the risk of SIDS increases 21-fold when the infant is placed prone with soft bedding. In addition, soft and loose bedding have both been associated with accidental suffocation deaths. The CPSC has reported that the majority of sleep-related infant deaths in its database are attributable to suffocation involving pillows, quilts, and extra bedding. It is therefore recommended that infants sleep on a firm surface without any soft or loose bedding. Pillows, quilts, and comforters should never be in the infant's sleep environment. Specifically, these items should not be placed loose near the infant, between the mattress and the sheet, or under the infant. Infant sleep clothing that is designed to keep the infant warm without the possible hazard of head covering or entrapment can be used in place of blankets; however, care must be taken to select appropriately sized clothing and to avoid overheating. If a blanket is used, it should be thin and tucked under the mattress so as to avoid head or face covering. These practices should also be modeled in hospital settings.

It is the purpose of this legislation to conform to the safety and precautionary standards established by the American Academy of Pediatrics as of December 28, 2011, and it should be interpreted thusly."; and

on page 1, immediately below line 7, by inserting the following:

"(a) Findings. The General Assembly finds and declares that bumper pads are unsafe for use in cribs. Bumper pads increase the risk of sudden infant death syndrome (SIDS), accidental suffocation and strangulation deaths in infants, as well as non-fatal injuries such as contusions. While the use of bumper pads prevents only minor injuries, the significant risks from using bumper pads outweigh the possible benefits provided by crib bumper pads."; and

on page 1, line 8, by replacing "(a)" with "(b)"; and

on page 1, line 16, by replacing "(b)" with "(c)"; and

on page 1, line 19, by replacing "(c)" with "(d)".