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Breastfeeding nursing pillow.

AAP applauds federal agency’s calls for nursing pillow safety standards

August 24, 2023

The Consumer Product Safety Commission (CPSC) is considering new regulations on the design and marketing of infant nursing support pillows. The AAP welcomes the effort to increase the safety of the products that have been linked to over 150 infant deaths.

According to CPSC, no voluntary or mandatory safety standards for nursing pillows exist to address the hazards of infants sleeping on or in these products. Infants who fall asleep in the pillows may roll, move or be placed in positions that obstruct breathing.

To address the risk of death and injury associated with nursing pillows, CPSC staff is requesting a rule to establish mandatory performance and labeling requirements for nursing pillows. The recommendations include requiring nursing pillows be firm enough to prevent conforming to an infant’s face and obstructing the child’s airway. The recommendations are expected to be voted on next month.

CPSC staff identified 154 infant fatalities and 88 nonfatal incidents from Jan. 1, 2010, to Dec. 31, 2022, involving nursing pillows. Of those 154 fatalities, 142 cases involved an infant sleeping in or on the nursing pillow. An NBC News investigation also found 162 deaths associated with these products.

As an organization promoting both breastfeeding and safe sleep, the AAP welcomes this step by the CPSC to bring safety and clarity to this product category. Breastfeeding parents should be able to trust that the nursing support products they purchase are safe for them and their baby to use.

“We 100% support breastfeeding and we want to do everything that we can to be sure that parents can breastfeed successfully,” said Rachel Y. Moon, M.D., FAAP, a lead author of the AAP policy statement on safe sleep. “We also want to do everything that we can to make sure that babies are safe. The problem with many breastfeeding support pillows is that they may look like they would be a comfortable place for babies to sleep, and so many parents use them to prop babies up, even when they are not being breastfed. And babies fall asleep that way. However, just like any other pillow, a breastfeeding support pillow is not safe for babies to sleep on.”

According to Dr. Moon, there are breastfeeding support pillows on the market that do meet proposed safety standards, adding “it seems clear that we can support breastfeeding parents at the same time that we can prevent infant deaths.”

Other recommendations aim to address entrapment hazards posed when the pillows restrict an infant’s head movements and the risks of suffocation and entrapment or fall when an infant is left unattended in the product by requiring labeling and instructional literature to better communicate risks.

CPSC staff also recommend against using infant restraints on the pillows because proper use involves actively attending to the infant during use, and the presence of restraints could suggest to consumers that infants could be left unattended in the product.

Many of these pillows are used as aids during feeding, nursing, sleeping, propping and lounging. Officials say nursing support pillows need new safety standards to make it clear they are only meant to support a parent holding a breastfeeding infant.

“If the baby's head is propped on it, then the airway can become kinked and the baby can asphyxiate,” Dr. Moon said. “If the baby's face is against the pillow, the baby can suffocate. If we can prevent infants deaths by making sure that there are safety standards for breastfeeding support pillows, then I think that is the right thing to do.”

Approximately 3,400 infants die from sleep-related infant deaths each year, including from accidental suffocation, which is a preventable cause of death. Unsafe products are a preventable driver of persistent deaths.

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