Infant deaths and injuries associated with wearable blankets, swaddle wraps, and swaddling
Emily McDonnell1, Rachel Y Moon2
1Pediatric Residency Program, Children's National Medical Center, Washington, DC.
Insights
Sudden unexpected infant deaths linked to wearable blankets and swaddling are rare but serious. Reducing risks involves safe sleep practices like supine positioning and avoiding soft bedding.
Area of Science:
- Pediatric Safety
- Consumer Product Safety
- Infant Sleep Practices
Background:
- Wearable blankets, swaddle wraps, and traditional swaddling are common infant sleep aids.
- Concerns exist regarding potential risks associated with these products.
Purpose of the Study:
- To evaluate the safety risks associated with wearable blankets, swaddle wraps, and swaddling.
- To analyze reported incidents to understand the nature and frequency of adverse events.
Main Methods:
- A retrospective review of incident reports submitted to the Consumer Product Safety Commission (CPSC) from 2004 to 2012.
- Analysis of 36 reported incidents involving wearable blankets and swaddle wraps, and an additional 12 incidents involving traditional swaddling.
Main Results:
- 36 incidents with wearable blankets/swaddles included 10 deaths, 2 injuries, and 12 non-injury events. Deaths often involved positional asphyxia and soft bedding.
- Traditional swaddling incidents (12) all resulted in death, with similar risk factors like prone sleeping and soft bedding.
- Injuries included dental issues from zippers; non-injury events raised concerns about strangulation, suffocation, and choking hazards.
Conclusions:
- Sudden unexpected infant deaths in swaddled infants are infrequent.
- Key risk reduction strategies include placing infants supine, stopping swaddling at the first signs of rolling, and eliminating soft bedding.
- Ensuring secure attachment of fasteners on commercial swaddle wraps is crucial for safety.
Objective:
To assess risks involved in using wearable blankets, swaddle wraps, and swaddling.
Study Design:
This was a retrospective review of incidents reported to the Consumer Product Safety Commission between 2004 and 2012.
Results:
A total of 36 incidents involving wearable blankets and swaddle wraps were reviewed, including 10 deaths, 2 injuries, and 12 incidents without injury. The median age at death was 3.5 months; 80% of the deaths were attributed to positional asphyxia related to prone sleeping, and 70% involved additional risk factors, usually soft bedding. Two injuries involved tooth extraction from the zipper. The 12 incidents without injury reported concern for strangulation/suffocation when the swaddle wrap became wrapped around the face/neck, and a potential choking hazard when the zipper detached. All 12 incidents involving swaddling in ordinary blankets resulted in death. The median age at death was 2 months; 58% of deaths were attributed to positional asphyxia related to prone sleeping, and 92% involved additional risk factors, most commonly soft bedding.
Conclusion:
Reports of sudden unexpected death in swaddled infants are rare. Risks can be reduced by placing infants supine and discontinuing swaddling as soon as an infant's earliest attempts to roll are observed. Risks can be further reduced by removing soft bedding and bumper pads from the sleep environment. When using commercial swaddle wraps, fasteners must be securely attached.
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