Study Highlights Dangers of Letting Babies Sleep in Car Seats, Baby Swings

The findings of a new study suggest that parents may want to think twice before allowing an infant to sleep in a car seat, stroller, swing or bouncer, indicating it may place the child at an increased risk of injury or even death from asphyxiation.  

In the latest issue of the The Journal of Pediatrics, researchers reviewed information on nearly 50 infant deaths that occurred in car seats or carrying devices, indicating that all but one involved asphyxia due either to the baby’s position or by strangulation.

Erich K. Batra, M.D. led researchers from Penn State Milton S. Hershey Medical Center, the U.S. Consumer Product Safety Commission (CPSC), and the Children’s National Medical Center in the study, which focused on improper use of car seats, bouncers, strollers, infants swings and slings. Researchers warn that using these items for infant sleep can put the child in danger of serious injury or death.

Researchers reviewed deaths reported to the CPSC for children under two years old that occurred while they were placed in one of these devices between April 2004 and December 2008. Data was taken from information written on death certificates, reports from medical examiners and coroners and interviews with family members and witnesses. The study included newborns as well as toddlers.

“Many parents use sitting or carrying devices, not realizing that there are hazards when they do this,” said Batra. “Infants and young children should not be left unsupervised when using a sitting or carrying device due to the risk of suffocation and death.”

Of the 47 deaths associated with car seats and other carrying and sitting devices, all but one was attributed to asphyxia, which included positional asphyxiation or strangulation.

Two-thirds of the cases involved car seats. Of the car seat deaths, 52% resulted from strangulation by the straps of the car seat. Overall, 31 deaths occurred in car seats, five in slings, four in swings and bouncers and three in strollers.

An infant that is properly positioned in a car seat with attached straps has little risk of suffering injury, suffocation or death, according to the researchers.

The time that elapsed from when the infants were last seen alive until they were discovered dead ranged from as little as four minutes up to 11 hours.

The average time before an infant was found dead in a sling was 26 minutes, 32 minutes for strollers, 140 minutes in car seats, 150 minutes in bouncers and 300 minutes in swings.

Infant Sleep-Related Deaths

Sleep-related deaths are the most common cause of death in infants ages one to 12 months of age. The American Academy of Pediatrics recommends infants sleep on their back on a firm mattress without loose bedding.

Batra noted that contrary to popular belief, restraints and the design of infant sitting or carrying devices are not intended for unsupervised sleeping.

Researchers advise parents to never leave an infant unsupervised, asleep or awake, in a car seat or other sitting or carrying device. They warn to never leave an infant in a car seat with an unbuckled or partially buckled straps.

They also recommend against placing car seats on a soft or unstable surface, not to place more than one infant together in a swing meant for one infant and to ensure infants cannot twist their head into soft bedding or slump forward in a seat. Restraints should also be used according to manufacturer’s instructions.

They warn slings are hazardous because the design and ease with which an infant’s airway can be collapsed, their face should be “visible and kissable,” at all times.

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. Make sure an infant’s chin is not compressed to their chest to avoid potential suffocation, experts advise.