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Firm Crib Mattress – The Truth Please

Breathable Crib Mattress to prevent SIDS


How many of you are led to believe that your baby needs a firm crib mattress to “properly” support their bone and skeletal growth?  This may surprise you, but it’s not true!

Infants have soft bones

It’s true that infants have soft, malleable bones.  In fact, their skull is like puzzle pieces that flex so they can get out of the birth canal.  Over time, their skull  fuses together and hardens.  Also, a lot of what will eventually be harder bones and cartilage, start out rather soft in infants.  Take an infant’s nose for example, their nose continues to develop after birth.  Infants are obligate nose breathers, meaning they only breathe through their nose, for the first six months.  Their nose bones and cartilage are softer than an adult which allows it to flatten and still receive oxygen.  Their nose bones and cartilage will become denser as they become adults.

Infant Growth Phases

Let’s take a logical approach to setting the record straight about firm crib mattresses.  A human’s fastest growth phase is from conception to birth – 9 months on average.   If this growth phase were sustained, we would grow two feet a year.  Looking at this rapid growth phase, are these babies on a hard or firm surface?  No, they are in liquid which cradles their developing structures including their bones.  It’s the ideal environment nature intended.

A human’s next fastest growth phase is from birth to 12 months, so why during this second fastest growth phase do you want to have them on a firm surface?  I can assure you, it’s not for proper support of their bones and skeletons! 


Case in point… plagiocephaly, also known as flat head syndrome.  This condition in infants started appearing in the mid 1990’s with the onset of the back-to-sleep campaign.  This condition is attributed to infants sleeping on their back with positional pressure from firm objects on their soft, malleable skulls.  I believe plagiocephaly is convincing enough to realize that a hard, firm crib mattress or sleep surface is not the ideal condition for a baby’s bone and skull development.   

Next, let’s look at infant hip dysplasia.  Did you know hip dysplasia is more common in first born infants?  Why?  Because a mother’s womb is the tightest during her first pregnancy and loosens with each subsequent pregnancy. 

Physicians believe a baby’s womb position can increase pressure on the hips.  The positioning of the baby in the womb can cause more pressure on hip joints, stretching ligaments.  It’s thought that babies in a normal position in the womb have more stress on the left hip than on the right hip.  This explains why the left hip on infants tends to be more affected.

Hip dysplasia in infants is another convincing factor supporting that firm crib mattresses, which cause positional pressure, are not the ideal surfaces for infant’s bone and skeletal health.

Why does the AAP recommend a firm crib mattress?

So why does the American Academy of Pediatrics (AAP) recommend a firm crib mattress?  There is only one reason the AAP recommends a firm crib mattress and that is to keep a sleeping baby safe.  The AAP’s Safe Sleep Task Force Members are aware that a baby’s ideal sleeping condition for their bone and skeletal growth is for them to be gently cradled and also to sleep on their tummy.  However, through much research, the AAP has discovered that the “safest” way for an infant to sleep is on their back, on a firm crib mattress or surface. 

The argument is infants are dying on soft surfaces and while tummy sleeping.  Babies are not dying from Plagiocephaly, hip dysplasia and other bone and skeletal issues.  A firm crib mattress or sleep surface does nothing positive to support your bones and skeletons as they develop and grow as some crib mattress manufacturers would like you to believe.

Problem with soft surfaces

Soft crib mattresses and surfaces are known to trap carbon dioxide, exhaled air, and block infant’s airways.  SIDS experts believe carbon dioxide rebreathing is the common risk factor associated with infant sleep related deaths. SIDS Experts believe some infants do not respond by turning their heads when rebreathing their exhaled air (carbon dioxide).  If an infant rebreathes their carbon dioxide without responding, the carbon dioxide eventually suppresses their need to breathe, making it lethal.

Ideal sleep surface for baby

The ideal sleeping surface for your baby is a crib mattress that does not have any fill to cause positional pressure while still being firm to prevent carbon dioxide accumulation or suffocation when your baby rolls over. 

Your baby will sleep for up to a total of 20 hours per day so making sure your baby has a safe place to sleep is crucial.  The creators of the only completely breathe-through crib mattress found out the hard way what can happen if an infant rolls in the middle of the night even if on a firm crib mattress.  The pair (a product designer and a pediatrician) set out to create a crib mattress that addresses all the issues with fiber fill crib mattress in 2010.  In 2016, their design was recognized by leading physicians as the “Gold Standard for safe infant sleep.”

Author:  Julie Andreae, SIDS and Safe Sleep Content Expert


Is Your Crib Mattress Firm Enough?

Firm Crib Mattress

Is your baby’s crib mattress firm enough?  The American Academy of Pediatrics recommends babies should be put to sleep on their back on a firm mattress.  BUT HOW DO YOU KNOW IF YOUR BABY’S CRIB MATTRESS IS FIRM ENOUGH TO KEEP THEM SAFE?

Australia/New Zealand firmness testing

The SafeSleep air permeable crib mattress is the only crib mattress in the United States that has been tested and passes the Australia/New Zealand standard 8811.1:2013 – Method 1: Sleep surfaces—Test for firmness.  This test is the only standard to formally address the issue of minimum safe firmness for all crib mattresses including bassinets and pack and play sleep surfaces. Don’t you want reassurance your baby’s crib mattress is firm enough?

Issues with safe sleep recommendations

Putting your baby to sleep on their back is not always enough since your baby will begin to roll around four months when SIDS rates are highest.  The SafeSleep Completely Breathe-Through crib mattress allows a baby who is lying face straight down to breathe normally right through their mattress.   Many pediatricians give parents false assurances that once their baby can roll, they “should be fine”   Scientific research tells us differently.  According to a recent study published in the Journal of Pediatrics, infants who are placed on their back and roll to their tummy for the first time have a 20% increased risk of SIDS/asphyxia.  These rates are even higher for babies who are swaddled.  According to published research from The American Academy of Pediatric Safe Sleep experts, death of infants found on their tummy on a fiber filled crib mattress continue to occur because we have no way to prevent these infants from rolling. 

Once these infants roll, do we know if their crib mattress is firm enough to keep them safe?

Air permeable crib mattress testing

Recent testing conducted by both International SIDS/SUID experts and the Consumer Product Safety Commission’s accredited research scientists,  prove air permeable crib mattresses are safer than crib mattresses containing fiber fill and other core materials to prevent CO2 rebreathing  and air way obstruction which is associated with asphyxia, suffocation, and SIDS incidences believed to be caused by “rebreathing.”  

These studies were conducted using a firm crib mattress as a comparison.  Even through the firm crib mattress passed the recommended “crib mattress being firm enough” test, they were shown to retain high levels of carbon dioxide which can be very dangerous to a sleeping baby.  

The test data on the air permeable “breathe-through” crib mattresses by SafeSleep has been reviewed by several neonatologists including Dr William Fox, Medical Director of the Infant Breathing Disorder Center at Children’s Hospital of Philadelphia; pediatric sleep experts including Dr James Kemp, Co-Director of the Sleep Laboratory at St. Louis Children’s Hospital; and physiologist Dr. Thomas H. Shaffer, Director of the Center for Pediatric Lung Research at Alfred I. duPont Hospital for Children and all agree the data is sound and compelling.  The SafeSleep infant mattress significantly reduces the risk of rebreathing of CO2 when the infant rolls prone.  This data supports earlier peer-reviewed publications demonstrating lower CO2 accumulation on air permeable mattresses when compared to fiber filled mattresses that were considered to be crib mattresses that were firm.