Infant bed

An infant bed, depicted with posts that present a strangulation hazard

An infant bed (commonly referred to as a cot in British English, and in American English a crib or far less commonly a cradle or stock) is a small bed specifically for infants and very young children. The intent of infant beds is to restrict the child to the bed; around two or three years of age children are able to circumvent this and are moved to a toddler bed to prevent an injurious fall while escaping the bed.

Infant beds are commonly seen in countries affected by Westernization, employed by the majority of parents as an alternative to sharing a bed or due to cultural norms.

Design

As an example of improving safety of infant bed designs, the U.S. Consumer Product Safety Commission has set standards for infant beds sold since 1973. Since this time U.S. annual deaths attributed to infant beds reducing from approximately 200 to approximately 50, and injury rates now at approximately 8,000 per year. Many of these injuries are attributed to the 25 million infant beds manufactured prior to the progressively refined safety standards, yet still in use.

Infant beds are designed to restrict the baby to the bed. The sides are too high for a baby to climb and provide no footholds. Technical standards for infant beds include considerations such as the materials used and preventing hand and head entrapment. Standards for infant beds have been specified in Australia and New Zealand, Europe, the United States and internationally. Design standards all identify and address four broad hazards:

Falls 

To prevent injuries such as concussion and bone fractures from falls when trying to climb out, footholds are not permitted. Minimum cot side heights are defined for various mattress positions.

Strangulation 

Infants can become trapped and strangled if their clothing gets caught on parts of a cot that stick out, or if their head becomes trapped between gaps. Neither gaps large enough for a child's head nor protrusions are permitted.

Suffocation 

Babies lack the motor skills or strength to turn their heads should they roll into something that obstructs their breathing. They can become trapped and suffocate if they fall into gaps created by ill-fitting or additional mattresses.

Entrapment 

Infants can suffer injuries to their arms and legs if they become trapped between gaps. Gaps small enough for a limb to become trapped are not permitted.

Infant beds can be stationary or portable (portacots, portacribs or folding infant beds). In their portable form the beds generally don't feature a dropside, and portability factors are emphasised. Portacots are often made from plastics, are often smaller and fold into a compact package. Rather than bars, they will have breathable mesh sides with an aperture too small for any finger to fit into. Standards for folding infant beds exist for Australia and New Zealand, Europe and international (adopted by various organisations including the American National Standards Institute).

Convertible cribs or convertible cots that can be converted into a standard sized bed as the child grows larger have become increasingly popular due to a longer useful life for the furniture. By removing both sides it becomes a toddler bed with unusually high head and foot boards, or removing just one side it becomes a daybed.

Although in the USA there is a standard size for an infant bed (~71cm x ~133cm), 12% of the 2.4 million infant beds sold annually are not of this size; "mini cribs" are an example of this. Larger infant beds are manufactured, generally for hospital use or for those with special needs. They may include a top, generally made of plastic or metal, to prevent a child from climbing out.

Use

An infant bed is typically used after it is no longer safe to leave the baby in a bassinet. They have a lower center of gravity, a broader base of support and can hold a larger baby than a bassinet. Infant beds are more stable than bassinets and as such become desirable when a baby can roll, transferring inertia with their actions; a bassinet may tip, an infant bed won't without concerted effort. Around two or three years of age children are able to defeat their confinement and are moved to a toddler bed to prevent an injurious fall while escaping their bed (falls account for 66% of emergency room admissions due to infant beds in the USA).

A baby lying on an elevated mattress in an infant bed with now-discouraged bumpers

Placing a child into an infant bed can put strain on a caretaker's back. To reduce the strain on those operating an infant bed, many infant beds feature:

• a mattress that can be in a raised position until the child is able to sit upright.
• a drop gate (or drop side), a side which lowers to ease the process of putting the child into the bed, but can be raised again to restore the integrity of the enclosure.

  In the United States, the sale of drop gate infant beds and their use by hotels and childcare centers is prohibited following reports of assembly problems and malfunctioning hardware leading to infant deaths; all infant beds manufactured and sold are required to have fixed sides.

• casters to make it easier to move the bed around.

The American Academy of Pediatrics recommends that infants under 12 months share a room (but not a bed) with their parents, as this has shown to be protective against SIDS.

Accessories

Scientific research has shown that the mattress influences SIDS outcomes; a firm, clean and well-fitting mattress lowers SIDS risk, but neither the mattress materials nor re-use affect SIDS risk. It is common to place a waterproof membrane between the mattress and the bedding to prevent uncontained bed wetting from damaging the mattress. Bed sheets ought to fit the mattress tightly so that the child cannot become entangled and suffocate; a common safety recommendation is to short sheet the bed.

Because of the pronounced risk of suffocation in very young children, and the danger of a fall from the bed for other children, the addition of anything other than sheets (including quilts, pillows and stuffed toys) into an infant bed is not recommended by health authorities. A sleepsack can be used instead to keep the baby warm. Older children can use items such as pillows and toys to construct a platform to facilitate escape, defeating the major design criteria and endangering the child.

An infant bed with raised mattress, mobile and now-discouraged bumpers

Bumpers (cushioning) are marketed to keep children from bumping against the hard sides and hurting themselves; breathable bumpers are intended to prevent suffocation, while providing padding. According to 2011 guidelines released by the American Academy of Pediatrics (AAP), bumper pads should not be used. This recommendation, issued as part of an updated and expanded set of guidelines on safe sleep and SIDS prevention for babies, is the first time the AAP has officially come out against the use of bumpers. According to the AAP, there is no evidence that bumpers protect against injury, but they do carry a potential risk of suffocation, strangulation, or entrapment because infants lack the motor skills or strength to turn their heads should they roll into something that obstructs their breathing.

Toys specifically for an infant bed include mobiles, which are musical toys to soothe the baby to sleep and mirrors to keep the children entertained while awake in the bed.

With decreasing technology prices and increasing house sizes, it has become increasingly common to have a baby monitor nearby so as to alert the caretaker when the child awakens. In some cases an apnea monitor is used to alert the caregiver if the baby stops breathing, regardless of the efficacy of such devices.

See also

• Jenny Lind crib, vertical bars in an infant bed were publicized by the bed Jenny Lind slept in
• Co-sleeping, a practice in which babies and young children sleep with one or both parents
• Bassinet, a common precursor bed for babies
• Toddler bed, a common subsequent bed for toddlers
• Single bed/Twin bed, a less common subsequent bed for toddlers due to bed height (making it hard to get in and out) and a lack of cot sides to stop the child accidentally rolling out while asleep

External links

• United States federal government's Consumer Product Safety Commission. "Full-Size Baby Cribs and Non-Full-Size Baby Cribs: Safety Standards". http://www.cpsc.gov/businfo/frnotices/fr11/cribfinal.pdf. Retrieved 2011-12-16. 
• CPSC crib safety standards