Product Safety

160+ Infants Have Died Due To Breastfeeding Pillows. Here's How To Stay Safe

160 infant deaths have been linked to breastfeeding support pillows. Does that mean you should stop using yours?

Sleeping baby and mother
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On Wednesday, August 23, the Consumer Product Safety Commission recommended the first ever federal requirements for breastfeeding support pillows, NBC News first reported. The recommendations came after the Consumer Product Safety Commission announced a review had found upwards of 130 infant deaths that could be directly attributed to these breastfeeding staples and a separate but recent investigation conducted by NBC News discovered 160 infant deaths that were related to breastfeeding support pillows.

Breastfeeding support pillows, also called nursing pillows or breastfeeding pillows, are designed to wrap around a nursing mother's body to provide support to the infant while nursing. For many nursing parents, they are an indispensable part of their feeding routine.

Though these pillows are not designed for sleep or marketed as sleep aids, many exhausted parents use them as a place for babies to rest, or mistakenly fall asleep while feeding their babies or allow their babies to fall asleep on the pillows. The American Academy of Pediatricians' Safe Sleep guidelines recommend babies be placed to sleep on their backs, on a firm mattress with no soft bedding or other material in the crib.

While nursing pillows aren’t sold for sleep, the investigation points to a problem.

“... we find ourselves in a murky situation, where there are products that aren’t explicitly sold for infant sleep, but which are cozy and conducive to sleep,” Alexander D. Hoehn-Saric, Chair of the CPSC, said recently at the Safe Kids Worldwide’s Childhood Injury Prevention Convention. “Such products can be a wink and nod to tired parents that seduces them to use a product unsafe for sleep and effectively enters them into a game of Russian Roulette.”

When young babies are propped up to sleep, their heads can slump forward, occluding their airways and causing suffocation. Because infants cannot lift their heads back to an upright position, any inclined position poses a risk.

Hoehn-Saric added that though these products contain warnings against using them for sleep, many desperate parents do just that, explaining that focus group testing found that “even though caregivers are aware of the risk of injury or suffocation and consider these to be scary. . . they consider these risks to be rare and the benefits to be frequent and tangible.”

Due to the alarming number of infant deaths associated with pillows, the CPCS has moved forward with a campaign to make them safer for babies. Despite reports to the contrary, there has been no move on the part of the CPSC to impose a ban on the sale of breastfeeding support pillows.

Instead, the Commission will focus on increasing the safety of pillows by regulating fill materials and redesigning them to decrease suffocation risk. Now, those first recommendations on nursing pillows have begun to take shape. The regulations, among others, would require large, visible labels that warn about the products hazard. They recommended the pillows be tested for firmness — the firmer the better — so that the product doesn’t mold to an infant’s face.

The report also recommends that there be no straps in the pillows so that babies can’t be entangled or the product can’t be confused for a safe product for sleep, and that if the pillow is U-shaped, the opening of the pillow is wide enough so that it doesn’t restrict the head movements of infants.

To gain further clarity, Fatherly spoke with Dr. Rachel Moon, Harrison Distinguished Teaching Professor of Pediatrics at the University of Virginia School of Medicine and Chair of the AAP Task Force on SIDS, about the nursing pillow market and how families can best navigate a landscape that sometimes feels littered with potential dangers for their most vulnerable members.

How exactly do nursing pillows contribute to infant mortality?

I think it depends on the situation. But it's generally not when babies are nursing. It's when they're being used improperly. They’re being used to prop babies up either on their bellies, or for tummy time, or on their backs, and then the baby's head and neck can fall forward, or fall to the side, and is stuck there.

You have to remember that your airway is like a straw — it needs to be straight. So if there's anything that could get onto your face, like if you turn over on a product that has padded sides, and the pad is against the face, that's going to be problematic. Also, when your neck gets kinked and your head falls forward, that's going to be problematic as well. So you want to keep the airway straight. And you want to make sure that there's nothing around the baby to cover their face and nose. You want them on their back, and you want them on something firm because anything that is soft can create this problem.

If these products aren’t marketed for sleep, why are they being used for sleep?

[People think] that if something is marketed for one purpose, they can use it for other purposes as well. Parents see these things, and the natural thought is, ‘Oh, the baby would be so comfortable lying on this,’ or they see it on social media and think, ‘you could use this for tummy time,’ or ‘this is a great way to prop your baby up while they're sleeping.’ And it's a problem because they're not safe.

Most parents think that if it's being sold in a store, some agency has vetted it.

We know that breastfeeding is recommended, but in the U.S., breastfeeding rates are low compared to other developed countries. Would restrictions on the sale or use of breastfeeding support pillows negatively affect breastfeeding rates?

Nobody is saying that we need to ban these pillows outright. We're saying that they need to be safe.

I don't know what's going to happen, but I can tell you I've taken care of thousands of babies who have been breastfed — many parents continue to breastfeed, and many parents don't continue to breastfeed. I have never had anybody who told me that they had to stop breastfeeding because they didn't have a breastfeeding pillow, or they weren't going to continue to breastfeed because of this breastfeeding pillow.

The reason people stop breastfeeding is not breastfeeding support pillows. They're because they don't have a place to pump at work. They don't have paid sick or paid maternity leave. That's the reason why people stopped breastfeeding. It seems like if the community wants to really keep people breastfeeding, that's what they need to do. They need to make it possible for people to breastfeed.

Just a few years ago, inclined sleepers like the popular Rock n Play were banned, and 4.7 million units were recalled after being linked to at least 100 infant deaths. As a new parent, it must be stressful to find out that these items you depend on are so dangerous. What do you tell parents who come to you with questions about safe baby products and how to navigate life with an infant without just holding them all the time to ensure their safety?

I reassure them, ‘I think you’re doing a great job. If there are things that you have questions about, please ask. And if you go online or ask other sources, make sure that they're reputable sources.’ I always recommend, which is the American Academy of Pediatrics parenting site.

Having a baby is really, really hard, and you don't have any training for it. And I think that it's also it's even harder because you have a parent who has gone through this major medical procedure and is physically exhausted. Hormones are all out of whack. They may have some postpartum anxiety or depression. These are all normal things.

I tell parents you don't have to be the perfect parent. It is okay to say, ‘I need a nap; can somebody help me?’ It’s okay to ask for help, and it's okay to ask questions and not think that you should know everything on your own.