Carriers, swings and bouncers are no place for infant sleep, doctors say

Posted at 7:49 AM, May 01, 2015
and last updated 2015-05-01 12:22:23-04

Car seats, carriers, slings, swings, bouncers and strollers are no place for an infant to sleep, doctors warn.

Many parents use these devices as an alternative place for the child to sleep. But a study published in the Journal of Pediatrics says this can lead to death, most often by suffocation.

“Many parents use sitting or carrying devices, not realizing that there are hazards when they do this,” said Penn State study author Erich K. Batra in a statement.

Sleep-related deaths are the most common cause of death for infants between 1 and 12 months of age, according to the Centers for Disease Control and Prevention. About 3,500 infants die suddenly each year, most often due to unsafe sleeping conditions.

“The safest place for any infant to sleep is in a crib. I tell my parents often that they need to sleep on their back and the surface that they’re sleeping on needs to be hard -- a hard and flat surface,” said Maggie Duck, a UC Health primary care physician and assistant professor in the University of Cincinnati College of Medicine. “It is recommended for no cushioned padding or extra blankets, especially in the first year of life.”

Using information from the U.S. Consumer Product Safety Commission, death records and interviews with family members and witnesses, researchers reviewed the deaths of children under two in sitting or carrying devices from 2004 to 2007.

Of the 47 infant deaths associated with sitting and carrying devices, all but one were due to asphyxia. Two-thirds of the deaths occurred in car seats, and half of those were due to the child being strangled in improperly secured straps.

The rest of the car seat deaths were due to positional asphyxia — when the child’s orientation makes it difficult for them to breathe. Babies aren’t strong enough to pull objects away from their face or roll into a safe position.

When properly secured and positioned, car seats pose little risk of suffocation injury, the study said. But infant sitting or carrying devices are not approved for unsupervised sleeping.

“When babies are in a carrier or swing, the concern when sleeping is that they could slouch in a certain way that if unsupervised, could obstruct their airway,” Duck said. “I tell parents it’s OK for an infant to fall asleep in swings if they’re supervised only. For nap or bedtime however, we recommend sleeping in a crib always."

For parents who are traveling with their children, Duck suggests using a Porticrib for sleep, which has a hard, flat surface. Be sure to review it is approved from the manufacturer as a safe sleeping place for an infant.

Batra and others provide the following advice to parents:

  • Do not leave children unsupervised (awake or asleep).
  • Never leave children in a car seat with unbuckled or partially buckled straps.
  • Car seats should never be placed on a soft or unstable surfaces.
  • Infants in bouncers, strollers, and swings may be able to maneuver into positions that could compromise their airway; straps on these devices may not prevent infants from getting into hazardous situations.
  • Ensure that infants cannot twist their heads into soft bedding or slump forward in a seat; restraints should be used according to manufacturer's instructions.
  • Slings are particularly hazardous because of their design and the ease with which an infant's airway can be collapsed. If used, the infant's face should be "visible and kissable" at all times.
  • Do not place more than one infant together in a swing meant for one infant.


Gavin Stern is a national digital producer for the Scripps National Desk.