Crib Safety is Important, Especially in the Hospital, Says FDA

Crib Safety is Important, Especially in the Hospital, Says FDA
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December 3, 2015

Crib safety is often the last thing on the mind of a parent when their child is in the hospital.

Since these cribs – also called pediatric medical cribs -- are often a bit different than those at home, the Food and Drug Administration (FDA) stresses that it is important for parents to know how they work in order to keep their child safe while they undergo treatment.

In the hospital, pediatric medical cribs provide easier access to sick or special needs babies who are hooked up to medical devices or otherwise need frequent attention or treatment, most often provided by medical staff. Unlike home cribs, hospital or medical cribs have fixed or movable bed end rails, movable and latchable side rail components, and a mattress designed to fit the crib. Hospital nurses and other staff are well trained in operating these cribs safely.

Often when babies need to stay in the hospital overnight or for several nights, the parents stay there, too.

"If your baby has rotavirus, for example, you might be the main caretaker in charge of feeding or constant diaper changing throughout the night," Joan Ferlo Todd, a senior nurse consultant at FDA, said in a statement. "If so, you need to ask the nursing staff to train you in the proper use of pediatric medical cribs."

Todd adds that parents in this situation are often stressed and sleep deprived. The last thing they need is to battle with a crib that they're unfamiliar with. Parents should learn how to latch, lock and open the side rails, raise and lower the mattress, angling the mattress, and locking and unlocking the wheels.

Any other caregivers coming in to help should also be taught how to operate the crib properly.

Some children need pediatric medical cribs at home, but FDA experts say that parents should evaluate the risks and benefits of using them and whether they are medically necessary.

While these cribs are currently available from manufacturers, a new FDA regulation proposes that they will need to be prescribed by a physician for home use.

If your doctor ever prescribes a pediatric medical crib for home use, it's important not to continue to use the crib once your baby is well, or to use it for another child. By the same token, if you find your daycare facility is using a pediatric medical crib for your child who does not have special needs, make sure your child is transferred to a non-pediatric medical crib.

"Healthy kids are ingenious at pushing latches and accidentally lowering side rails," Todd says. "Pediatric medical cribs should be used only with sick children who need easy access from the caregiver."

Just as such equipment as wheelchairs and walkers are considered medical devices and as such regulated by FDA, so too are pediatric medical cribs.

Cribs used for non-medical purposes at home are considered consumer products and are regulated by the Consumer Product Safety Commission (CPSC).

In 2011, CPSC prohibited the making or selling of drop-side rail cribs for non-medical purposes. Children had been suffering frequent injuries, including entrapment and strangulation due to slat and side rail disengagement. CPSC instituted rules to improve slat strength, make hardware stronger, prohibit traditional drop sides, improve mattress support durability, and make safety testing more rigorous.

Since that time, the FDA has been conducting a full-scale review of the best available data on pediatric medical cribs and medical bassinets.

In addition to proposing that pediatric medical cribs be physician-prescribed, FDA's proposed regulation includes special controls for cribs used in hospitals and other medical facilities that align with those proposed by CPSC in 2011. These controls include establishing standards for spacing between crib slats and improving the quality of hardware and crib testing.

"Many hospitals are already using cribs that meet the FDA's proposed standards," said FDA senior advisor Victoria Wagman. "But we need to be sure that every pediatric medical crib is engineered specifically for child safety."