Each case was analyzed for hazard patterns. 8 In addition, the CPSC conducts its own investigations into specific cases, which may include interviews with family members and other witnesses.įor all cases, we collected demographic information, position of the infant, type and mechanism of injury or potential injury, cause of death when applicable, and presence of known SIDS risk factors such as smoke exposure, presence of soft bedding, or bed-sharing. Reporting to the CPSC is voluntary, and reports can be submitted by police and fire departments, insurance investigators, medical examiners and health care workers, manufacturers and retailers, and consumers. We used the Freedom of Information Act to access data from 3 CPSC databases, including Death Certificates, Injury and Potential Injury Incidents, and In-Depth Investigations. We conducted a retrospective review of infant deaths, injuries, and potential injuries involving wearable blankets, swaddle wraps, and swaddling that occurred between September of 2004 and July of 2012 as reported to the CPSC. To that end, we reviewed data collected by the Consumer Product Safety Commission (CPSC) pertaining to deaths, injuries, and potential injuries of infants in wearable blankets and swaddle wraps, as well as those swaddled in ordinary blankets, to assess the risks therein, and to suggest strategies for minimizing these risks. 7 However, no subsequent studies have confirmed this, and there are no data about the use of the newer swaddle wraps. The use of wearable blankets has been prevalent in Europe, and one case-control study found that use of a wearable blanket was associated with a decreased incidence of SIDS, possibly because it facilitated supine placement and reduced rolling to the prone position. (personal communication, William Schmid, Halo Technologies). Indeed, more than 1 million swaddle wraps have been sold in the U.S. These include items such as infant sleeping bags (commonly referred to as wearable blankets), and swaddle wraps, which are wearable blankets with bands of fabric that can be wrapped around the infant. Various forms of infant clothing designed to avoid loose blankets, and thus purportedly to decrease the risk of SIDS, have become available in recent years. 1, 2 In addition, swaddling is frequently used as a strategy to calm infants 3, 4 and to encourage supine sleeping. The recommendations on avoiding soft or loose bedding note that infant clothing that is designed to keep the infant warm without posing a risk of entrapment or head covering may be used. These recommendations include supine positioning, breastfeeding, room-sharing without bed-sharing, immunizations, consideration of pacifier use, and avoidance of soft or loose bedding, smoke/alcohol/drug exposure, or overheating.

1, 2 In 2011, the AAP expanded its recommendations for an overall safe sleeping environment for infants, rather than focusing only on SIDS. However, this decline in the rate of death has plateaued, and other causes of sleep-related deaths in infants have increased in frequency. In its 2011 policy statement and technical report, the American Academy of Pediatrics (AAP) noted that the incidence of sudden infant death syndrome (SIDS) has significantly decreased since its 1992 recommendation that infants be placed to sleep in a non-prone position.

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