Is a Breathable Crib Mattress Worth it?

Is a breathble crib mattress worth it

Is a Breathable Crib Mattress Worth it?

These hybrid mattresses range in price from $249 up to $1,200.  We are hearing a lot more about the benefits of “Breathable.” 

But is a breathable crib mattress worth the added cost?   

It’s important to note that not all breathable crib mattresses are designed the same.  We will explain those differences in this article.  But first we begin with the history.

Breathable crib mattresses hit the consumer market in early 2000.  Prior to breathable, baby mattresses were innerspring mattresses or core material with a fabric overlay.  Popular core materials include polyurethane foam, memory foam, cotton, wool batting or other plant based fibers. Also, they have a vinyl or waterproof cover to prevent the “fill” from becoming contaminated.

Mattresses and Flame Retardants

In 1975, all mattress manufacturers are subject to stringent flammability requirements enforced by the Consumer Product Safety Commission (CPSC).  Flammability standards are required after foam mattresses become engulfed in flames during house fires. 

Consequently, new regulations force mattress manufacturers to use flame retardants such as boric acid and other harmful chemicals. 

The Popularity of Organic Baby Mattresses

In the mid 80’s, organic mattresses are gaining popularity.  This is based of their eco-friendly and natural fiber content.  Moreover, organic mattresses eliminate the need for flame retardants.  However, certified organic cotton and wool mattresses still need chemical coatings to protect the fill from contamination.  Popular coatings include, sprayed on nano-coatings or silicas. 

Nano-coatings are not toxic, but the monomers binding the coating are.  Monomers are a known carcinogenic.  Still, parents are willing to spend more on these mattresses for two basic reasons.  The first reason is preventing their infants from exposure to flame retardant chemicals.  The second reason is to avoiding off gassing caused by heat buildup on vinyl covers.

Scientist Begin Studying the Connection Between Crib Mattresses and SIDS

The early 90’s, scientists are noticing the effects of infant bedding, including crib mattresses, in Sudden Infant Death Syndrome (SIDS) cases.  Should these findings alone answer the question, is a breathable crib mattress worth it? 

Carbon dioxide risk discovered

During the late 70’s, Dr. James Kemp and Dr. Brad Thatch are the first scientists studying the effects of various types of infant sleep surfaces and mattresses.  They discover surfaces retaining high levels of carbon dioxide (or low CO2 rates) prove to be significantly more dangerous than surfaces that do not allow CO2 to accumulate. 

Additionally, one such study concludes the dangers of infants sleeping on sheep skin.  Sheep skin was a popular infant sleep surface used in many Scandinavian Countries. 

Known high-risk hazards

Kemp and Tatch label sheep skin as a high-risk hazard in an infant’s sleep space.  It is a hazard because of the high levels of CO2 it retains.  The scientists use similar methods to point out the dangers of crib mattresses with porous interiors. 

Kemp states, “Mattress filled with tea tree bark made in Australia in the 1980s and ’90s and marketed as breathable turned out to increase the risk of SIDS.  It  turns out, these mattresses caused rebreathing to occur.

Additional Studies helping to answer the question, “Is a breathable crib mattress worth it?” include:

The Year of the Breathable Crib Mattress

Breathable crib mattress designers are awarded patents dating back to 1950.  However, it  is not until 2000 the first breathable crib mattresses are readily available for consumer purchase in the U.S. 

One of the more notable breathable mattresses is the Halo® Active Airflow by Halo® Innovations. 

About the Halo® mattress

The Halo® mattress is a solid plastic frame with a hollow core.  What makes it unique, is it has a fan in it to get rid of carbon dioxide.  Unfortunately, the Company discontinues sales of the product in 2011. 

Notably, the design is bulky making it difficult for consumers to change the bedding.  Additionally, it requires constant replacement of the fan’s filters.  The product has a lot of merit on the safety front.  However, it  falls short on ease-of-use. 

The first breathable crib mattress doesn’t meet expectations

Because of the difficulty in using the product, consumers do not believe the Halo® breathable mattress is worth it?  However, the product does bring about an interest by future manufacturers of breathable mattresses to have their products scientifically tested

Testing of breathable mattresses

Similar testing methods used by the Halo® brand mattress are used by other breathable mattress makers.  Ultimately, these studies scientifically prove a breathable crib mattresses is significantly safer than a traditional or organic baby mattress.

Scientific Studies on Crib Mattresses Marketed to be Breathable

  • Dr. Kemp and Colleagues – 2000

  • Ephraim Bar-Yishay and Colleagues – 2011

  • Dr. William W. Fox and Dr. Thomas H. Shaffer- 2012

2000 Dr. Kemp and Colleagues

Test procedure

In 2000, the Halo® Active Airflow Mattress is one of five products marketed to prevent rebreathing of CO2.  Dr. Kemp and colleagues study all five products along with a standard firm mattress.  

An infant mannequin with its nostrils connected via tubing to an 100-mL reservoir filled with 5% CO(2) is used. The mannequin is positioned face-down and near-face-down. Each sleep surface is studied with the crib sheet tight, crib sheet wrinkled, and with the mannequin arm positioned up, near the face.

Products tested

 According to Kemp, “We measured the fall in percentage end-tidal CO2 as the reservoir was ventilated with the piston pump. The half-time for CO2)dispersal (t(1/2)) is an index of the ability to cause or prevent rebreathing. Compared with the face-to-side control, 5 of 6 surfaces allowed a significant increase in t(1/2) in all 3 prone scenarios.

The firm baby mattress and 4 of the 5 surfaces designed to prevent rebreathing consistently allow t(1/2) above thresholds for the onset of CO2 retention and lethal rebreathing in an animal model (J Appl Physiol. 1995;78:740).” 

This means, 4 of the 5 products tested along with the standard crib mattress pose a hazard for an infant placed or rolling to the stomach position. 

Test results

Kemp states, “With very few exceptions, infants should be placed on their back for sleep. For infants placed on their stomach or rolling to their stomach, significant rebreathing of exhaled air is likely on 4 of the 5 surfaces studied.  The Halo® Active Airflow Mattress was the only one where rebreathing is no likely.  

The four other products tested; Bumpa Bed, Breathe Easy, Kid Safe/Baby Air, and Sleep Guardian never achieve commercial success.

2011 Dr. Ephraim Bar-Yishay and Colleagues

2nd test study

In 2011, Dr. Ephraim Bar-Yishay and colleagues provided the second study on CO2 accumulation and rebreathing on six infant sleep surfaces—a breathe-through crib mattress marketed in Israel, two conventional firm baby mattresses and three mattresses with an additional layer or topper (mattress pad) designed to improve air flow (Bar-Yishay 2011).

Test results 

The breathe-through mattress has no fill or core material.  I is proven to have a significantly faster rate of CO2 elimination.  Moreover, mattress with no fill or core material is able to prevent CO2 accumulation,  The CO2 levels are significantly lower than that of the other baby mattresses. 

In conclusion, the breathe-through mattress exhibits significantly better aeration properties compared to the other five mattresses.  

2012 Dr. William W. Fox and Dr. Thomas H. Shaffer

3rd test study

SafeSleep®, a U.S. manufacturer of a breathe-through crib mattress, chooses to use a CPSC accredited lab to conduct similar tests on aeration properties on their product.  The test methods are designed by Dr. William W. Fox and Dr. Thomas H. Shaffer.  Notable, the testing uses a similar mechanical model and methods as designed by Dr. Kemp.

Products tested

The lab compares CO2 elimination on four different surfaces—the SafeSleep® air permeable mattress, a firm baby mattress with tight fitting sheet, sheepskin, and a bean bag chair.

Sheepskin and bean bag chairs are known high-risk hazards for rebreathing (kemp 1991, Kemp 1993).  They have been implicated in a significant number of SIDS fatalities.

Test results

Just as in the studies by Kemp and Bar-Yishay, the SafeSleep® breathable mattress shows significantly less CO2 retention than the firm baby mattress and the high hazard comparators. The lab concludes the SafeSleep® breathe-through crib mattress is a much lower risk hazard for rebreathing than the firm mattress.

Breathable Crib Mattress testing

Additionally, the lab also compares the air permeability of the SafeSleep® breathe-through crib mattress to a firm baby mattress.  The used the  ASTM-D737-04 standard test method of air permeability of textiles.  Based on the test data, the SafeSleep® mattress has an air permeability rate over 330 times greater than the firm mattress.

These well-designed, well-conducted case controlled studies strongly support a recommendation for the use of breathe-through mattresses in reducing the risk of SIDS and suffocation.  So is a breathable crib mattress worth it?

Safe Sleep Policy and Carbon Dioxide Rebreathing

Today, SIDS experts and Safe Sleep Advocates believe many SIDS deaths are caused by infants rebreathing their exhaled air – CO2.  In fact, this is noted in the American Academy of Pediatrics (AAP) 2016 safe sleep policy

The AAP Safe Sleep Policy titled,  “Recommendations for a Safe Infant Sleeping Environment” is used by all safe sleep organizations and advocates.

Looking at the following quotes taken from the AAP’s Safe Sleep Policy Statement, do you think a breathable crib mattress is worth it?

  • “The prone or side sleep position can increase the risk of rebreathing CO2, resulting in hypercapnia and hypoxia.”
  •  “Bed-sharing might increase the risk of overheating, rebreathing or airway obstruction, head covering, and exposure to tobacco smoke, which are all risk factors for SIDS.”
  • “There is increased potential for overheating and rebreathing while cobedding, and size discordance might increase the risk of accidental suffocation.”
  • “Soft bedding can increase the potential of suffocation and rebreathing.”
  • “It is not known whether the risk associated with head covering is attributable to overheating, hypoxia, or rebreathing.”

There are no studies that demonstrate a direct prevention of SIDS or suffocation by the avoidance of rebreathing carbon dioxide.  However, this is the hypothesis the AAP Safe Sleep Task Force uses to make the majority of their safe sleep recommendations.  For example, back sleeping and using a firm mattress with a tight-fitting sheet.

So can a breathable crib mattress help your baby avoid SIDS?

Lack of gold standard studies

Some will argue, there is no evidence a breathable mattresses is safer or will make any difference.  If this is the case, the same has to be said about a firm crib mattress, back sleeping, co-sleeping, and the majority of the other safe sleep recommendations. 

The fact is, no gold standard studies exist in reference to SIDS prevention.  Unfortunately, in order to have this type of scientific evidence, unethical testing would have to be done. 

How rebreathing occurs

The risk of rebreathing exists when a baby has an object covering their face, they are positioned face down, or they have their arm or hand near their face when tummy sleeping.  Rebreathing occurs when they repeatedly inhale the CO2 they’re exhaling.  This is depriving them of oxygen and causing CO2 to build up in their body.

“There hasn’t been any definitive evidence that that’s what’s going on, but it seems to make sense,” says Dr. Rachel Moon,  Chair of the AAP’s Safe Sleep Task Force.  

Flow Control Laboratory, Faculty of Mechanical Engineering, in Israel demonstrates how rebreathing occurs on a fiberfill crib mattress

If a breathable mattress eliminates the risk of rebreathing CO2, is a breathable crib mattress worth it?

The Arousal Defect

Most SIDS and Safe Sleep Experts believe some infants do not respond when they are rebreathing their carbon dioxide.  In fact, most infants will respond.  These infants have the same natural instinct as an adult to move their head or roll over if their oxygen becomes compromised. 

However, babies who die from rebreathing are believed to have an “arousal defect.”  The arousal defect prevents them from waking up even when they’re not getting enough oxygen.

Arousal defect and rebreathing

Dr. Umakanth Katwa, Attending Pulmonologist and Director of the Sleep Laboratory at Boston Children’s Hospital and professor at Harvard Medical School states, “Babies with SIDS not only need to suffocate, but they need to have the abnormal arousal response.  Thus, even though they are rebreathing their CO2, what happens is the brain doesn’t wake up.  So that means they cannot lift the head, turn on the side, or roll over.”

Crib mattress showing carbon dioxide dispersion rates

Dr. Katwa, points to simulations done by crib mattress companies in an article in  Fatherly   This testing shows some mattresses disperse carbon dioxide more quickly.  

According to Katawa, “Theoretically, this increases the amount of time it takes for carbon dioxide levels to become lethal, giving babies more time to wake up and move… This is what makes the idea of a breathable mattress so appealing and makes sense.”  

In reality, crib mattresses that do not allow CO2 to accumulate faster than the rate of an infant’s breathing, would prevent the baby from rebreathing lethal levels of carbon dioxide even if still asleep. 

Since we have no way to tell which infants will or will not have an abnormal arousal response, is a breathable crib mattress worth it?

Not All Breathable Mattresses are Created or Scientifically Tested Equally

  • Open Celled Covers and Traditional Fiberfill

  • Hollow Cut-Outs or “Air Channels”

  • Spongy, Food-Grade Polymer

  • No Fill or Core

Compare breathable crib mattresses with plastic cores to the SafeSleep® Breathe-Through Crib Mattress with no core or fiber fill.

Breathable Baby Mattresses with Open Celled Covers and Traditional Fiberfill

There are many baby mattress companies using the word “breathable” as loosely as manufacturers use the word “organic” to market their products.  A few examples are Lullaby Earth® , Avocado® Green, Bundle of Dreams®, Serta®, and Naturpedic®.

In reality, most crib mattress claiming to be breathable, are using an open-celled or 3D fabric cover over top of a fiberfill mattress.  In reality, these crib mattresses are shown to trap high levels of CO2. It is no wonder these breathable baby mattress companies don’t reveal any scientific test data on CO2 retention or dispersal rates.

Breathable Crib Mattresses with Hollow Cut-Outs or “Air Channels”

Nook®’s breathable mattress features hollow cut-outs within what they call “air channels.”  The Company fills their Pebble Pure mattress with coconut husk. Dr. James Kemp, notable SIDS researcher, called this “exactly the wrong idea,” in an email to a reporter at Slate Magazine. 

Noting, a porous interior might actually trap carbon dioxide. As noted prior, a study conducted by Kemp on mattresses filled with tea tree bark made in Australia in the 1980s and ’90s turned out to increase the risk of SIDS, and allowed more rebreathing.

Breathable Mattresses with Spongy, Food-Grade Polymer

Another company that makes their breathable crib mattresses out of a spongy, food-grade polymer that they say is “90% air by volume.”  According to the FDA, Food grade is different from environmentally friendly, sustainable, or biodegradable.

Find out more about the different designs of breathable crib mattresses to determine their effectiveness by reading, Breathable Crib Mattress – Medical and Safe Sleep Experts Explain

Suffocation testing

Many crib mattresses calling themselves breathable claim to have low suffocation rates based on independent testing.  One company compared their plastic spongy core filled mattress with two other baby mattresses claiming to be “breathable.”  These two comparator breathable mattresses are designed with open celled covers with traditional fiberfill. 

A third comparator was also used.  This third mattress is a foam filled mattress with a vinyl cover.  Using a simulated six-month-old mannequin, the suffocation-risk test measures the blockage of the infant’s airway when face-down. 

Test results

The mannequin is placed on the mattress being tested.  Pressure is applied to the back of the mannequin’s head. If the mattress is soft, the head compresses into the surface and blocks the infant’s nose.  In contrast, if the mattress is firm, the infant’s nose is not be blocked. 

According to the test data, all the crib mattresses tested passed the suffocation test.  The traditional vinyl encased mattress scored lowest, but still passed.

The reality

In reality, all firm crib mattresses will pass this test–even baby mattresses with vinyl or plastic covers.  The exception is unless the vinyl or plastic cover is loose fitting.  Imagine breathing for any extended period of time when your head is face down on a plastic surface and you understand why this test is not reassuring. 

It’s not measuring the right risk! 

The Company also offers a waterproof topper.  A mattress with a waterproof topper cannot be breathe-through.  Obviously, if liquids cannot pass through it, than air is also impeded.

Breathable Mattresses with No Fill or Core

The SafeSleep® breathe-through crib mattress is the only breathable baby mattress in the U.S. that does not contain any type of fill or core material.  Therefore, there is nothing  interfering with passive air flow. 

Fresh air flows up and down through the open celled topper.  The topper is firmly suspended over a frame with side openings that facilitate constant air flow.

Best Breathable Baby Mattress

From Tragedy to Innovation, the SafeSleep® Breathe-Through Crib Mattress is Designed for Maximum Breathability, Safety, and Comfort.


Recognized by AAP policy makers

the SafeSleep® is a revolutionary two-part system allowing an infant who is face down to breathe normally right through the mattress.  It is the only crib mattresses recognized by AAP policy makers as reducing the risks associated with SIDS and other infant sleep related deaths. 

SafeSleep® is considered the best crib mattress based on safe sleep guidelines, and scientific testing.  It’s the number one pediatrician recommended crib mattress.  In fact, it is the only baby mattress pediatricians and respiratory therapists write pediatricians for infants who must tummy sleep for health reasons.

Scientific testing

Scientific testing reveals carbon dioxide dissipates in less than half a second on the SafeSleep® Breathe-Through mattress.  An infant takes a breath every 1-2 seconds,.  This means the CO2 on the SafeSleep® mattress is gone before a baby takes their next breath– even if face straight down.

It takes, on average, 160 seconds for CO2 to dissipate on most crib mattresses.  For some crib mattresses that claim to be “breathable,” it takes as long as 180 seconds.  This means CO2 is always present for baby to breathe in if they are on their stomach.

Additionally, there is no fill in the SafeSleep® to become contaminated.  Consequently, there is no waterproof cover or coating.  And for the same reason, there are no fire retardants.  By design, the SafeSleep® is the only completely non-toxic crib mattress.  The SafeSleep® is OKEO-TEX® certified ensuring no harmful substances.  

With all its features and benefits, the SafeSleep® Breathe-Through Crib Mattress a logical choice.  But with a $299 price tag, is the SafeSleep® breathable crib mattress worth it?

Compare the Cost

The SafeSleep® mattress uses no sheets or crib mattress pad.  On average, this is a cost savings of  $70.  SafeSleep® has a removable topper.  The topper is both easy to remove and wash in a conventional washing machine.  A damp cloth with liquid soap is used to sanitize the base.  There is need to remove the base from the crib. 

Additionally, there is no cumbersome bathtub or shower cleaning.

Crib mattresses and pathogens

The AAP warns parents against using second-hand mattresses.  This recommendation is based on the fill becoming contaminated with pathogens and micro-organisms.  Since the SafeSleep® mattress has no core or fill that can become contaminated, it can be used for additional children. 

This feature makes the SafeSleep® the same price as a bargain crib mattress if used for two children.  And, a cost savings if used for more. 

Breathable crib mattress for infants and toddlers

The SafeSleep® also transitions for use in a toddler bed with no additional cost.  SafeSleep® hold the weight of an 80 pound child.  There is no need for the mattress to be duel sided, since there is no core.  Instead, it offers the prefect amount of firmness for any age.

Additionally, With no core to wash, it is ideal during potty training and bed-wetting phases. The entire mattress is easy to clean.  No bathtub or shower is needed.

Your baby spends 70% of their first year-of-life in their crib.  Consequently, your baby’s crib mattress is an important decision.   The SafeSleep® breathable crib mattress brand is offering babies scientifically tested, safer, better, longer sleep™.  And, offering parents complete peace of mind since 2010.

So is a breathable crib mattress worth it?  Yes, but be sure to choose a breathe-through crib mattress.  As you can see, it is a lot different than the breathable baby mattresses that are marketed. 

If a mattress has a core or filling material, then it is not completely breathe-through.  In order to be completely breathe-through, air must be able to travel in an out without being trapped.  

Find out the importance of why a breathable crib mattress should also be air permeable.

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