Day Cares Used Dangerous Infant Sleeper After Recall

Fisher-Price’s Rock ‘n Play inclined sleeper was recalled in 2019, but not everyone got the message.

Credit...Marvin Joseph/The Washington Post via Getty Images

This story was originally published on Aug. 7, 2019 in NYT Parenting.

On an early afternoon in June, Adam Garber checked his phone and saw that his infant son’s day care had called three times; he immediately stepped out of a meeting to return the calls.

“Whenever you see the day care calls three times, you immediately think something’s wrong,” Garber said.

His son was fine. The child care center wanted to reassure Garber that it had removed inclined sleepers, such as the recalled Fisher-Price Rock ‘n Play, from its facility. The day before, Sara Landis, Garber’s wife, had noticed several sleepers sitting around when she picked up their son in the evening. In mid-April, Fisher-Price had voluntarily recalled the Rock ‘n Play sleeper after a Consumer Reports investigation linked the popular products to more than 32 infant deaths since 2009. Garber and Landis — who had purchased one of the 4.7 million Rock ‘n Plays sold in the past decade — had discarded their own sleeper as soon as they heard of the recall and assumed their son’s day care had done the same.

It hadn’t.

Garber, a consumer watchdog at the U.S. Public Interest Research Group in Philadelphia, wanted to know how many other day cares might still be using the recalled Rock ‘n Play or similar unsafe inclined sleepers. Pairing with Kids in Danger, a nonprofit dedicated to improving the safety of children’s products, PIRG surveyed 376 licensed child care facilities in three states to ask whether the items were still in use. One in 10 of the facilities surveyed that have children under 1-year-old said they still used the sleepers, and many claimed they were unaware of the recall or any safety issues, PIRG said in a report released Wednesday.

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Dr. Ben Hoffman, M.D., a pediatrician at the Oregon Health and Science University, who was not involved with the survey, said that the post-recall persistence of these sleepers is a “nightmare scenario.” “It’s just a matter of time until another baby dies. There’s no way that these things can be used safely,” Dr. Hoffman said. “It’s going to take decades before these things are all gone.”

For many parents, one of the biggest challenges of having a new baby is sleep — or the lack thereof. Adding to the exhausted haze of caring for a tiny infant are pressures to return to work, even in families that do have parental leave. The combination of desperation and fatigue can make products that promise to help a child snooze an easy sell. That’s exactly what Fisher-Price and Mattel (its parent company) found when it began developing the Rock ‘n Play.

Infant bassinets and cribs, unlike inclined sleepers, have very strict safety standards, thanks to decades of research and advocacy by pediatricians demonstrating the importance of a safe sleep environment for the prevention of sudden unexplained infant death. A baby needs to sleep alone, on its back, on a firm, flat surface that’s clear of any obstacles including pillows, blankets and stuffed animals, explained Brittany Kaiser, a public health educator at St. Louis Children’s Hospital.

“Your baby should be the cutest thing in the crib,” she said.

The Rock ‘n Play managed to violate three of these rules: it’s neither a flat, firm surface, nor free of soft items that can obstruct a baby’s airway.

The United States Consumer Product Safety Commission began drafting new safety standards for cribs in 2010, which threatened to derail the Rock ‘n Play’s success. Revised guidelines released in 2013, requiring that cribs have a firm bottom surface and an incline of less than 10 degrees, would have barred the marketing of the Rock ‘n Play. But in 2015, A.S.T.M. International, an international standards organization, developed a separate category of voluntary safety standards for inclined infant sleepers, which revived the product, Dr. Hoffman said.

The existence of the A.S.T.M. standards provided false reassurance to parents that the product was safe to use for all-night infant sleep, just as the box said it was, according to Robert Hurley, Ph.D., a professor of leading people and organizations at Fordham University in New York. “It put parents in a position of being able to buy a product that appeared to be safe but instead had significant risks,” he said.

Millions of new parents took Fisher-Price at its word, and inclined sleepers became the newest must-have at baby showers. Parents swore by the product, saying it helped their babies (and subsequently themselves) get a little extra sleep. But when Dr. Hoffman first spotted a Rock ‘n Play at a neighbor’s house several years ago, he gasped in horror.

“I could not believe that something so flagrantly dangerous was being sold,” he said. After Dr. Hoffman shared his concerns, he helped his neighbors dismantle and destroy the sleeper before dumping it in the trash so that no one else could use it.

Other consumer groups and pediatricians expressed concerns over the product’s safety not long after the sleepers came on the market, but their whispers of alarm were deafened by the roar of the sales juggernaut. Additionally, the C.P.S.C. didn’t have the power to alert consumers that babies were dying even when using the sleepers as instructed. (The C.P.S.C. is barred from releasing identifying information about manufacturers of products of concern, Dr. Hurley said.) However, on April 5, the safety commission said — in a joint safety warning with Fisher-Price — that it was aware of 10 deaths of children age 3 months or older that had been linked to the sleeper since 2015.

A lengthy Consumer Reports investigation was published on April 8, detailing more infant deaths. The next day, the American Academy of Pediatrics called the sleeper “deadly” and demanded an immediate recall. When Fisher-Price issued a voluntary recall on April 12, the news made international headlines, with the safety commission recommending that parents stop using the sleeper and seek a refund or voucher from Fisher-Price. In a statement supplied to The New York Times, a C.P.S.C. spokeswoman said that both the commission and the manufacturers have multiple avenues to contact consumers about recalled infant products, including email alerts and product registration postcards. But Landis’s sighting of a Rock ‘n Play at her son’s day care two months after the recall showed that not everyone got the message.

To understand just how widespread the problem was, Garber quickly assembled a team at PIRG to phone and email more than 600 registered day cares in Wisconsin, Texas and Georgia to ask whether they still used inclined sleepers like the Rock ‘n Play. Between June 20 and July 10, the team received responses to survey questions from nearly 400 day cares in those states and found that 10 percent still used the Rock ‘n Play. Both Wisconsin and Texas have laws banning the use of recalled products in child care centers, but day cares in those states still reported using the inclined sleepers.

“The law is only effective if people know products have been recalled,” Garber said. “The recall system is good at stopping sales, not at stopping use.”

Despite the recall of the Rock ‘n Play and three other brands of inclined sleepers (the Kids II Rocking Sleeper and sleepers made by Disney and Eddie Bauer), Dr. Hoffman said that a recent trip to a consignment store revealed shelves full of sleepers that were being sold at a steep discount. Other products identical to the sleepers that are marketed as “soothers” remain on the market, as do a host of other products that make for an unsafe sleep environment, such as crib bolsters and wedge pillows to create an incline in a bassinet.

“If there are any kinds of buckles for your baby, they shouldn’t be sleeping in that,” Kaiser said.

On Facebook and internet message boards, many parents expressed concerns that, without the Rock ‘n Play, they had no idea if their babies would sleep. Kaiser empathized and expressed reassurance.

“Kids are very adaptable. They can make the switch” to a safe crib for sleeping relatively quickly, she said, even if the process feels like forever.

Carrie Arnold is an independent health and environmental reporter in Virginia.