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Best Crib Mattress in 2021

Best crib mattress in 2021

What is the best crib mattress in 2021?

Your baby will spend over 70% of their first year sleeping in their crib.  Therefore, finding the best crib mattress in 2021 is an important decision. 

Additionally, baby’s good health starts with good sleep.  Thus, creating an ideal sleep setting starts with choosing the best crib mattress in 2021.

In this article we explore the following:

SafeSleep® is our pick for best crib mattress in 2021 

SafeSleep® was designed by a pediatrician to create

  • the healthiest, safest, & most comfortable sleep for your baby. 
  • Air flows freely up & down through the surface for maximum breathability & ideal temperature control. 
  • Scientifically tested showing 100% oxygen-rich air while breathing through the SafeSleep® Crib Mattress.

The SafeSleep® Breathe-Thru Crib Mattress is rated safer than breathable crib mattresses by leading AAP physicians and safe sleep policy makers.

Learn More

Federal Regulations Mattresses Must Meet

Flammability Testing:

Crib mattress makers must conform to two basic regulations.  The first is Federal Standard 16 CFR 1633.   This law is also known as, “Flammability” or  “Open Flame” test.  All mattress sets must pass this test, including crib mattresses.  As an act of Congress, with the control of the Consumer Products Safety Commission (CPSC), this law has been in effect since July 1, 2007. 

Federal Standard 16 CFR 1633 requires mattress manufacturers to put their mattress design through a 30-minute flammability test. This test, which follows a very strict plan, is conducted over an open flame. Hence, the name “Open Flame” test.  If the mattress design passes the test, then it has approval for selling.  However, if it fails the test, then the manufacturer cannot legally create the mattress before making changes that allow it to pass the test.

Testing of Flame Retardant Chemicals/Methods:

Currently, there are no required tests to tell if the flame retardants manufacturers use contain harmful chemicals.  Consequently, a crib mattress that does not use flame retardants is the best crib mattress in 2021.

Proper Size Requirements:

The other regulation crib mattresses must meet is proper sizing.   For example, a mattress for use in a standard-size crib must be at least 27 1/4 inches wide x 51 1/4 inches long.  Further, the crib mattress height cannot be more than six inches in height.  Length and width limits are set for preventing wedging and suffocation between the mattress and crib sides.  The height limit prevents an infant from falling out of the crib while standing.

Other suggested requirements, such as proper labeling of fiber content, are voluntary.

CPSC and FDA Guidelines

The American Academy of Pediatrics (AAP), Consumer Products Safety Commission (CPSC) and the Food and Drug Administration (FDA) regularly update guidelines and recommendations to promote infant safe sleep.  In particular, these guidelines and recommendations are useful in helping parents make safe product choices. 

Retrospective Studies:

Recommendations and guidelines given by safety organizations are based on retrospective analysis of infants who have been injured or died while sleeping. By definition, a retrospective study is an observational study that looks at death and injury cases that already happened before the study begins.  In other words, retrospective studies look backwards and study causes of suspected risk or safety conditions with similarities to a result that is set at the start of the study.

CPSC Crib Sheet Recommendations:

The CPSC was the first to suggest all crib mattresses requiring sheets, use sheets that are “tight fitting.”  In 2001, the CPCS issued a warning to parents to avoid using loose-fitting crib mattress sheets.  This recommendation is based on retrospective studies showing 17 babies, most under 12 months old, who suffocated or strangled.  These infants became entangled in sheets in their cribs.  Most notably, two of these deaths were the result of tight-fitting sheets coming off a crib mattress and strangling the infants.  

Based on these warnings, a crib mattress that does not use a sheet is the best crib mattress for your baby in 2021.

FDA Sleep Positioner Warning:

The FDA makes similar recommendations to parents which includes avoiding the use of sleep positioners and bumper pads.  And most recently, they warn against using an inclined sleeper or putting an infant in an inclined sleep position.

Using AAP Guidelines to Choose the Best Crib Mattress in 2021

AAP crib mattress recommendations focus on eliminating the following:

After a careful study of peer-reviewed published data used by the AAP to create their safe sleep guidelines, we list the top ten things to consider when choosing the best crib mattress in 2021 for your sleeping baby.

Peer-reviewed published studies require looking for the following when choosing the safest and best crib mattress in 2021:

 1.  Firmness is a big consideration in choosing the best crib mattress: 

Most crib mattress makers want parents to believe a firm crib mattress is recommended to support an infant’s growing bones.  This is not accurate (“The Truth About Firm Crib Mattresses”).  In fact, there is a large increase in plagiocephaly  (flat head syndrome) and hip dysplasia in young infants.   Known as an unintended consequence of the back-to-sleep campaign, flat head syndrome was virtually unknown until the popularity of the back-to-sleep campaign which includes back sleeping on firm mattresses.

The reality is, the AAP states, “Soft bedding can increase the risk of suffocation.”  The fact is, a soft mattress allows a baby’s face to compress into the mattress surface and block the infant’s nose and mouth.  In contrast, firm mattresses don’t allow face compression.  The nose and mouth will not be blocked.

Consequently, the best crib mattress in 2021 is firm,

2.  Tight fit in crib is also a must to be considered the best crib mattress: 

The mattress should fit tight against the sides of the crib and the crib mattress.  To test for a tight fit, place two fingers down the side of the mattress close to the inside walls of the crib.  Make sure no extra space exists. Additionally, the same rule applies for all infant mattresses and pads. A tight fit helps avoid entrapment of the baby’s head and tiny arms and legs.

In conclusion, the best crib mattress in 2021 fits tight in the crib.

3.  The best crib mattress has no vinyl, padded, or quilted covering/surface:

Vinyl covers, and padded or quilted surfaces can trap heat.  If heat is trapped, it causes an infant’s core body temperature to rise.  According to the AAP, it is important to avoid overheating with infant’s.  Moreover, the AAP warns against use of padded surfaces.  The fact is, padded surfaces are known to trap harmful carbon dioxide.

Additionally, the materials used in vinyl crib mattress covers off-gas phthalates.  Phthalates are considered harmful chemicals.  

Therefore, the best crib mattress in 2021 has no vinyl, padded or quilted covering/surface.

4.  Air Permeability in a new consideration when choosing the best crib mattress in 2021: 

Science proves infants thrive both physically and emotionally in an oxygen rich environment. In 2011, the AAP recommends air permeable sides in play yards and bassinets.  This recommendation is based on infants  found unresponsive with their face wedged against the side of the bassinet or play yard. In 2016, the AAP recognizes air-permeable mattresses as being safer than air-impermeable mattresses for infants who roll.  

Based on these recommendations, the best crib mattress in 2021 is air permeable.

5.  Carbon Dioxide Retention is hugely important when considering the best crib mattress:  

While there are no scientific studies to demonstrate a direct prevention of SIDS or suffocation, the AAP Safe Sleep Task Force relies on the hypothesis of rebreathing of carbon dioxide as a likely reason for unexpected infant deaths.  A basic pathophysiological principle is the hypothesis that rebreathing carbon dioxide is associated with SIDS and asphyxia.  Crib mattresses that contain fiberfill, loose cores, quilted surfaces, and even crib sheets have all been shown to trap harmful carbon dioxide.  

Therefore, the best crib mattress in 2021 eliminates carbon dioxide retention.

6.  We consider the best crib mattress to be one that does not use  Waterproofing Chemicals:

A crib mattress containing any type of fiberfill, needs waterproofing chemicals.  The fact is, fiberfill crib mattresses become contaminated by a baby’s excretion if there is no waterproof barrier.  Consequently, crib mattresses with fiberfill, have a waterproof coating. Many times, the waterproofing coating contains harmful chemicals.  Common chemicals include silica, monomers, or other toxins. 

Consequently, the best crib mattress in 2021 uses no waterproofing chemicals.

7.   There should be not use of fire retardants when considering the best crib mattress in 2021:

All crib mattresses must pass flammability testing.  If a crib mattress has fiberfill or a cover made from flammable fabrics; foam, cotton, linen, or other cellulose fibers, fireproofing chemicals are used.  Notably, fireproofing chemicals include boric acid, ammonium polyphosphate, silica, or antimony trioxide.  The fact is, these harmful chemicals are considered carcinogens. 

Therefore, the best crib mattress in 2021 has no fireproofing chemicals.

8.  To be considered the best crib mattress in 2021, it should be completely washable:

Scientific studies point to the relation of Staphylococcus aureus (Staph) colonization with stomach sleep position.  It is believed, stomach sleep position increases the risk of ingestion/inhalation of bacteria contaminating the sleeping surface.  According to scientific studies, this bacteria risk could account for the increased risk of SIDS in babies who are tummy sleeping.  Consequently, the AAP warns against using second-hand crib mattresses to avoid the risk of bacteria and pathogens in mattresses. 

A completely washable crib mattress eliminates the buildup of pathogens, mold, and other microorganisms.  Consequently, the best crib mattress choice in 2021 is a completely washable crib mattress.

9.  The best crib mattress should not cause any positional pressure: 

A firm mattress is necessary.  However, choosing a firm crib mattress that does not cause positional pressure on an infant’s delicate skull, is also an important consideration. Positional pressure is caused by too much time on a hard flat surface. Firm mattresses with dense cores and fill create direct pressure on the back of an infant’s head while back sleeping.  Additionally, they can cause the same type of pressure on an infant’s hips if lying on their side.

Therefore, the best crib mattress choice in 2021 eliminates positional pressure.

10.  Liquids should not be able to pool on the surface of the best crib mattress:

Infants often spit up in the middle of the night.  Many fiberfill mattresses have waterproofing barriers that cause liquids to pool on the surface.  These potentially dangerous water barriers are intended  to make spit up and other messes easy to wipe clean.  Additionally, waterproofing barriers are used to make the mattress stain resistant.  However, if an infant is not being supervised, pooled liquids can be dangerous and uncomfortable. 

Finally, the best crib mattress choice in 2021 is one that forces liquids to immediately travel away from the baby.

Types of Crib Mattresses – Pros and Pros and Cons of Each

There are many different types of crib mattresses.  Let’s go through the different types so you can choose the best crib mattress in 2021.  Remember, our choice is based on peer-reviewed published studies used by the American Academy of Pediatrics’ Safe Sleep Task Force to create safe sleep guidelines.

Innerspring Crib Mattress:

A standard crib mattress with steel coils with an over layer of various cushioning materials such as foam, wool, polyester, cotton, or other cellulose fibers.  This type of mattress is encased in a fabric or vinyl overlay.  Innerspring mattresses manufacturers differentiate themselves by describing their coil count and the steel gauge thickness of the coils.  The larger the coil count and the thicker the steel, the denser the mattress is.

Pros: 

Innerspring mattresses are firm and create a tight fit in the crib.

Cons:

Innerspring mattresses have some type of vinyl, padded, or quilted topper.  Notably, innerspring mattresses have low rates of air permeability.  Consequently, they have high carbon dioxide retention levels. 

Innerspring mattresses require waterproofing and fireproofing chemicals.  Moreover, innerspring mattresses cannot be washed or disinfected. In addition, a mattress pad is normally used that can also trap additional harmful carbon dioxide.  In fact, the AAP warns against using mattress pads.  Mattress pads trap carbon dioxide, reduce air permeability, and can cause suffocation if an infant is in the tummy position.

Positional pressure cannot be avoided with innerspring mattresses.  Lastly,  liquids pool on this type of crib mattress.

Best crib mattress 2021

Innerspring mattresses require additional bedding such as mattress pads and sheets.  They range in price from $60 on the low end to $350 dollars on the high end.

Using the AAP’s Safe Sleep Guidelines, here is a summary of the pros and cons of an innerspring mattress:

Rating

Good:

  • Firm
  • Tight Fight

Bad:

  • Vinyl Cover or Quilted Topper
  • Low to No Air Permeability
  • High Rate of Carbon Dioxide Retention
  • Use of Waterproofing Chemicals
  • Use of Fire Retardants
  • Cannot be Completely Washed to Disinfect
  • Can Cause Positional Pressure
  • Allows Liquids to Pool on Surface

Foam Crib Mattress:  

Foam mattresses are typically made from polyurethane, a foam resin. There are different densities of foam and different chemical makeup of the foam.  Consequently, some foam mattresses will pass the firmness test, while others will not.  To be sure a foam mattress is firm enough, press your hand on the mattress and see how far it sinks in. It should not sink in more than a 1/4″.

Pros: 

Mattresses made from foam are often lightweight and inexpensive.  Additionally, they generally have a snug fit.

Cons: 

Foam mattresses have vinyl  or waterproof cover to protect the foam from contamination.  Further, they have very low rates of air permeability – if any at all.  Additionally, they retain carbon dioxide for long periods of time. 

Since foam is a petroleum-based product, foam crib mattresses contain a fire retardant.  Specifically, petroleum-based products are highly flammable.  If a foam mattress does not have a vinyl cover, it will have some type of waterproofing chemical.  The fact is, there has to be a water barrier between the surface material and the foam.  Otherwise, the foam will become contaminated. 

The vinyl surface of a foam mattress is washable.  However, there is no way to wash or sanitize the foam interior. 

Some foam mattresses will cause positional pressure while others will not.  Positional pressure is contingent on the density of the foam.  For example, the denser the foam, the more positional pressure it will cause on an infant’s head. Notably, the vinyl or waterproof coating causes pooling of liquids.

Best breathable crib mattress 2021

Popular Foam Crib Mattresses

Foam mattresses also require extra bedding.  Mattresses made of foam range in price from $39 to $200.

Using the AAP’s Safe Sleep Guidelines, here is a summary of the pros and cons of a foam mattress:

Rating

Good:

  • Firm
  • Tight Fight

Bad:

  • Vinyl Cover or Quilted Topper
  • Low to No Air Permeability
  • High Rate of Carbon Dioxide Retention
  • Use of Waterproofing Chemicals
  • Use of Fire Retardants
  • Cannot be Completely Washed to Disinfect
  • Can Cause Positional Pressure
  • Allows Liquids to Pool on Surface

Latex Crib Mattress: 

Latex mattresses are similar in construction to foam crib mattresses.  Additionally, they also share many of the same features.  There are different densities of latex mattresses.  In spite of popular belief, pure latex will not cause allergic reactions. 

Most latex mattresses pass the firmness test since they are normally denser than foam.  Latex mattresses are much heavier than foam.  As a result, if you have to change sheets, it can be difficult to lift the mattress.

Pros: 

Mattresses made with latex are firm and create a nice snug fit in the crib.  Furthermore, they help keep baby’s core temperature stable by eliminating the buildup of heat, 

Cons: 

Latex mattresses have minimal air permeability.  In addition, carbon dioxide retain rates depend on the density of the latex.  Most latex crib mattresses contain a fire retardant.  Otherwise, they have a wool overlay.  Notably, wool creates a natural fire retardant. 

Moreover, Mattresses made with latex have some type of waterproofing chemical to act as a water barrier. The surface of latex mattresses is usually fabric which cannot be wiped clean.  Further, most latex crib mattresses require a mattress pad.  Additionally, there is no way to wash or sanitize the latex core. 

Because of their density, latex mattresses cause positional pressure .  How much positional pressure is contingent on the density of the latex.  Additionally, liquids will also pool on the surface of a latex crib mattress.

Best breathable crib mattress 2021

Popular Latex Crib Mattresses

Latex mattresses also require extra bedding.  The mattresses range in price from $350 to $800.

Using the AAP’s Safe Sleep Guidelines, here is a summary of the pros and cons of a latex mattress:

Rating

Good:

  • Firm
  • Tight Fight
  • Some Air Permeability

Bad:

  • Vinyl Cover or Quilted Topper
  • High Rate of Carbon Dioxide Retention
  • Use of Waterproofing Chemicals
  • Use of Fire Retardants
  • Cannot be Completely Washed to Disinfect
  • Can Cause Positional Pressure
  • Allows Liquids to Pool on Surface

Plant Based Fiber Crib Mattress:  

Coconut coir is the most common type of plant-based fiber used in crib mattresses.  Normally, Coconut coir is used in combination with a foam or cotton layer overlay.   Surprisingly, coconut coir is heavier than foam. 

Pros:   

Coconut coir is very firm and dense.  It creates a tight fit in the crib.  Notably, coconut coir is moisture resistant.  However, it does not do well if it gets saturated.  Consequently,  it needs some type of water barrier.  This plant based fiber has a high level of air permeability if not mixed with other materials.  Unfortunately, we could not find a crib mattress of this type that did not contain a mixture of other materials.  

Cons: 

Coconut coir crib mattresses retain high levels of carbon dioxide.  Additionally, they require some type of vinyl covering or waterproofing chemicals.  If there are no waterproofing chemicals, the coir will become contaminated if saturated.  And, fire retardant chemicals must be used for compliance with CPSC regulations. 

Moreover, there is no way to sanitize coconut coir without ruining its structure.  Since the mattress requires either a vinyl cover or waterproofing chemicals, liquids will pool on the surface of a coconut coir filled crib mattress   In addition, coconut coir is dense; therefore,  it does create positional pressure on the baby’s skull.

Best crib mattress 2021

Popular Plant-Based Crib Mattresses

Plant-base crib mattress range in price from $260 to $1,250 dollars.  Some models we identified need extra bedding while some do not.

Using the AAP’s Safe Sleep Guidelines, here is a summary of the pros and cons of a plant-based mattress:

Rating

Good:

  • Firm
  • Tight Fight
  • Some Air Permeability

Bad:

  • Vinyl Cover or Quilted Topper
  • High Rate of Carbon Dioxide Retention
  • Use of Waterproofing Chemicals
  • Use of Fire Retardants
  • Cannot be Completely Washed to Disinfect
  • Can Cause Positional Pressure
  • Allows Liquids to Pool on Surface

 

Types of Breathable Crib Mattresses – Pros and Cons of Each

The idea behind a breathable crib mattress is that air can flow through the surface of the mattress.  However, there are many types of breathable crib mattresses, so we will explore each type:

  • Open Celled Covers and Traditional Foam or Fiberfill

  • Hollow Cut-Outs or “Air Channels”

  • Spongy, Food-Grade Polymer Core

  • No Fill or Core

Breathable Mattresses with Open-Celled Covers and Traditional Foam or Fiberfill: 

Breathable crib mattress of this type is either a foam filled or Innerspring mattress that has an open channel, 3D spacer fabric cover.  The cover is often removable.  However, removing it from the crib is necessary to remove the cover.

Pros: 

Breathable crib mattresses with open-celled covers and traditional fiberfill are firm and provide a tight fit in the crib.  Additionally, the covers are not vinyl or thick.  Instead this mattress type has an air permeable cover. 

Cons: 

Since breathable crib mattresses with open-celled covers and traditional foam or fiberfill use traditional foam or fiberfill, they can trap high levels of carbon dioxide. Even though the cover does not have waterproofing or flame-retardant chemicals, the same cannot be said for the core. 

Additionally, foam and fiberfill mattress can cause positional pressure.  The open-celled cover is washable, but the core is not.  Consequently, the mattress cannot be completely disinfected.  Liquids will still pool below the open-celled cover.

Best crib mattress 2021

Open Celled Covers and Traditional Foam or Fiberfill

 

Breathable crib mattresses with open-celled covers and traditional foam or fiberfill range in price  from $200 to $350.

Using the AAP’s Safe Sleep Guidelines, here is a summary of the pros and cons of a breathable crib mattresses with open-celled covers and traditional foam or fiberfill:

Rating

Good:

  • Firm
  • Tight Fight
  • Some Air Permeability
  • No Vinyl Cover or Quilted Topper

Bad:

  • High Rate of Carbon Dioxide Retention
  • Use of Waterproofing Chemicals
  • Use of Fire Retardants
  • Cannot be Completely Washed to Disinfect
  • Can Cause Positional Pressure
  • Allows Liquids to Pool on Surface Below 3D, Open-Cell Cover

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

This type of breathable crib mattress is a foam crib mattress with large cut-out areas in the interior center of the foam.  In theory,  air pockets form in the center of the mattress.

Pros: 

Breathable crib mattresses with hollow cut-outs or “air channels” are firm and provide a tight fit in the crib.  However, the covers are made from either synthetic or natural fibers.   These covers impede airflow.

Cons:  

Since the air channels are on the interior, breathable crib mattresses with hollow cut-outs or “air channels” offer limited passive airflow on the surface. For this reason, these mattresses can actually trap harmful carbon dioxide.  Most notably, these mattresses offer no advantage in reducing carbon dioxide levels. 

Moreover, breathable crib mattresses with hollow cut-outs or “air channels” use waterproofing chemicals by admission.  Waterproofing chemicals are used to prevent the foam interior from becoming contaminated.  Further, fire retardant chemicals are also used. 

Additionally, the risk of positional pressure exists since the mattress is comprised mostly of foam,   The cover is washable, but the interior core is not washable.  By design, liquids pool on the surface.

Best safest crib mattress 2021

Hollow Cut-Outs or “Air Channels” in the Mattress

 

Breathable crib mattresses with hollow cut-outs or “air channels” range in price from $199 to $299.

Using the AAP’s Safe Sleep Guidelines, here is a summary of the pros and cons of a breathable crib mattresses with hollow cut-outs or air channels:

Rating

Good:

  • Firm
  • Tight Fight

Bad:

  • Vinyl Cover or Quilted Topper
  • Low to No Air Permeability
  • High Rate of Carbon Dioxide Retention
  • Use of Waterproofing Chemicals
  • Use of Fire Retardants
  • Cannot be Completely Washed to Disinfect
  • Can Cause Positional Pressure
  • Allows Liquids to Pool on Surface

Breathable Crib Mattresses with Spongy, Food-Grade Polymer Core: 

This type of hybrid mattress creates a firm surface and a tight fit in the crib.  However, the quilted topper is questionable.  The AAP warns against the use of quilted toppers and pads.  In particular, they trap carbon dioxide.

Pros: 

Firm, tight fit, high air permeability rate, and completely washable.  One of the three mattresses listed uses waterproofing chemicals and the two others do not.  Additionally, liquids will not pool on the surface.  However, one of the products claims to have a “waterproof” cover.  In this instance, waterproofing chemicals are used.

Cons: 

Breathable Crib Mattresses with Spongy, Food-Grade Polymer have a firm core that may cause positional pressure.  The topper is removable for laundering. However, the core is cumbersome to wash or disinfect.  For example, the manufacturers recommend soaking the core in a bathtub or washing it in a shower.  For this reason, the mattress is susceptible to further contamination from bathroom pathogens. 

In reference to fire retardants, Newton® recently switched from using a phosphorus-based flame retardant chemical on their plastic core to a flame-resistant viscose (wood pulp based) barrier fabric that fits over the plastic core.  Viscose is a man-made cellulose fiber which is flame retardant by incorporating “phosphorus” in the viscose matrix. The phosphorus flame retardant is incorporated at the fiber spinning stage. Halo® uses flame retardants.

Liquids will not pool on the surface.  On the contrary, liquids flow into the spongy, polymer core.  Consequently, requiring a cumbersome and risky cleaning process.

Newton Baby Mattress

Spongy, Food-Grade Polymer Core

 

Breathable crib mattresses with spongy, food-grade polymer range in price from $250 to $350.  Some models have a waterproof covers and some do not.

Using the AAP’s Safe Sleep Guidelines, here is a summary of the pros and cons of a breathable crib mattresses with spongy, food-grade polymer:

Rating

Good:

  • Firm
  • Tight Fight
  • Air Permeability
  • Lower Rates of Carbon Dioxide Retention
  • Can Be Completely Washed and Disinfected

Bad:

  • Quilted Topper that can Trap Carbon Dioxide Close to The Baby’s Face
  • Use of Waterproofing Chemicals 
  • Use of Fire Retardants
  • Can Cause Positional Pressure
  • Allows Liquids to Pool on Surface of Waterproof Models
  • The Core Must be Removed and Washed in a Bathtub or Shower Making it Highly Susceptible to Bathroom Pathogens

Breathe-Through Crib Mattresses with No Fill or Core: 

The two-part crib mattress system consists of an open frame with side openings.  Additionally, there is an open-celled, air permeable top (topper) surface creating passive airflow.  Oxygen rich air circulates in and harmful carbon dioxide circulates out.

Pros: 

Firm, tight fit, very high air permeability rates promoting an oxygen rich environment.  In addition, the mattress is completely washable without the hassle of having a core to bathe or shower.  For example, the mattress topper slides off easily and is machine washable.  Next, wipe the open frame section with a disinfectant to sterilize.  Since there is no fiber fill or core, there is no reason for waterproofing.  No waterproofing; no waterproofing chemicals!  

Similarly, with no fill or core, there is no need for fire retardants.  Additionally, the absence of fill or a core, eliminates the risk of positional pressure on an infant’s delicate skull.

Cons: 

With all the scientific testing on the two-part breathable crib mattresses with no fill or core, we did not find any cons based on our criteria.  In fact, breathable crib mattresses with no fill or core are the only crib mattresses recognized by American Academy of Pediatric Policy Makers as reducing the risks associated with SIDS and other infant sleep related deaths.

Best crib mattress 2021

No Fiberfill or Core

 

Breathable Crib Mattresses with no fill or core range in price from from $300 to $400.

Using the AAP’s Safe Sleep Guidelines, here is a summary of the pros and cons of a breathable crib mattresses with no fill or core:

Rating

Good:

  • Firm
  • Tight Fight
  • No Vinyl or Quilted Topper
  • Significantly High Rate of Air Permeability
  • Significantly Low Rate of Carbon Dioxide Retention
  • No Waterproofing Chemicals 
  • No Use of Fire Retardants
  • Can be Completely Washed and Disinfected
  • No Positional Pressure
  • Liquids do not Pool on Surface

Additionally, the test data on breathable crib mattresses with no fill or core is impressive!

Conclusion:

A good night’s sleep really sets the tone for any day, especially for babies. With the risk of SIDS and other fears while a baby sleeps, you can now rest assured you will make the safest and best crib mattress choice in 2021.

Our Top Pick:

SafeSleep® is our top crib mattress choice in 2021.  The SafeSleep® addresses every safety and comfort concern:

  • Firmness
  • Tight fit
  • No vinyl, padded, or quilted topper
  • Air permeability rate of over 330x of fiberfill mattresses
  • Significantly low carbon dioxide retention to prevent rebreathing
  • No need for waterproofing chemicals since there is no fill to contaminate
  • No need for fireproofing chemicals
  •  Easy to wash and sanitize
  • No positional pressure on infants skull
  • Liquids are wicked away, prevents liquids from pooling on the surface

The SafeSleep® allows an infant who is face down to breathe-normally.  The open sides and open celled topper eliminates the buildup of carbon dioxide.  Carbon dioxide is a known risk factor in infant sleep related deaths. The Company uses natural and organic components. 

The SafeSleep® is a crib mattress you can use for many children.  It is completely and easily washable to prevent mold and bacteria growth.  We love the fact it is non-toxic and even recyclable.  Above all, it is the only crib mattress recognized by leading AAP policy makers as significantly reducing SIDS and other infant sleep related risks.  

The ultimate goal is your baby’s safety and comfort.  Moreover, when your baby sleeps better, you sleep better.  Therefore, sleep comfortably with the piece of mind you have chosen the safest and most comfortable crib mattress for your baby. 

Make sure to follow these additional safe sleep recommendations to keep your sleeping baby safe:

Avoid Second-Hand if Possible:

Because of the dangers associated with mold and bacteria, it’s best to avoid a used mattress, especially if you don’t know the history of the product. Reusing one from another one of your children? Make sure there aren’t any openings in the waterproof cover where mold could’ve taken root. 

However, breathable crib mattresses with no core are reusable since they have no fill or core where mold or bacteria can accumulate.

Keep the Crib Empty:

Although they look lovely, pillows, bumpers, stuffed animals and blankets shouldn’t be in a baby’s crib. That’s because they can wind up covering your baby’s face and be a suffocation or rebreathing hazard. In addition, crib sheets have been associated with infant sleep related deaths, so don’t use them if you don’t need to.

Breathable crib mattresses with no core do not use sheets or other bedding.  The topper is easily removed for washing.

Place Baby on Back:

The safest sleeping position for your baby is on their back.  However, if your baby should roll in the middle of the night, have the peace of mind they can breathe normally if they are on a mattress they can breathe right through.

Now that you know what the best crib mattress is in 2021, please share with other parents so we can keep babies safe while sleeping.   From tragedy to innovation, check out the story behind the safest breathable crib mattress! 

Breathable Crib Mattress

When Can a Baby Sleep on Their Stomach?

When can a baby sleep on their stomach?

When Can a Baby Sleep on Their Stomach?

Are you finding your baby sleeping on his stomach?  A panic feeling that comes over you when you find your baby has rolled in the middle of the night and is now sleeping on his stomach.  The panic feeling is worse when you find them face down. 

So, when can a baby sleep on their stomach so both of you can sleep better?  

We all hear the safe sleep warnings against placing babies on their stomach.  There is an abundance of research supporting placing an infant on his back to reduce the risk of Sudden Infant Death Syndrome (SIDS). 

What isn’t Clear, is When Can a Baby to Sleep on Their Stomach?

Unfortunately, parents are falsely assured from many sources, including pediatricians, that once their baby is strong enough to roll over, it is safe for their baby to sleep on their stomach. 

Using research-based evidence and compelling insight into the following topics, we navigate facts from fiction to determine when it is safe for your baby to sleep on their stomach.

Why Back Sleeping is Best

We know back sleeping is safest, but you may not know why.  According to the AAP Safe Sleep Task Force, “asphyxia is long been considered the primary cause of death in many instances of SIDS.  Frequent autopsy findings of pulmonary edema, often identified with asphyxia, are found with many SIDS deaths.  The practice of back sleep is known to protect against SIDS.   

Rebreathing

Infants sleeping in a prone position or lying on or near a soft blanket or other soft bedding can rebreathe exhaled carbon dioxide.  Rebreathing leads to hypercarbia and hypoxia.  Hence, if the environment of infants does not change or infants are unable to escape the dangerous situation, they will ultimately die of asphyxia. (JAMA Pediatrics February 2017 Volume 171, Number 2)

Asphyxia

Asphyxia occurs when oxygen is insufficient in the human body.  When an infant begins to rebreathe his exhaled air, he slowly deprives himself of oxygen.  Eventually, the constant re-breathing of carbon dioxide suppresses the infant’s breathing needs, leading to hypercarbia.

Hypercarbia

Hypercarbia is a condition of abnormally elevated carbon dioxide levels in the blood. Carbon dioxide is a gaseous product of the body’s metabolism and is usually expelled through the lungs.  Therefore, when carbon dioxide accumulates in the body, it leads to hypoxia.

Hypoxia

Hypoxia is insufficient oxygen in the tissues to maintain physical function.

The belief is infants who;

  • sleep on their stomach,
  • sleep on soft bedding,
  • use a blanket,
  • have stuffed toys in their crib,
  • have bumper pads attached to their crib,
  • sleep with others,
  • have anything close to their face (including their hands and arms),

Are at increased risk of SIDS since these sleeping situations can trap harmful carbon dioxide.

Back sleeping and rebreathing

When infants sleep on their back without a blanket, there is a much lower risk anything can trap carbon dioxide.  Consequently, making it unlikely for an infant to constantly rebreathe his exhaled air.

In order for infants to safely sleep on their stomach, we must eliminate the risk of trapping carbon dioxide.  If we eliminate trapped carbon dioxide, infants cannot rebreathe it. 

Unfortunately, most crib mattresses trap carbon dioxide.  Traditional crib mattress designs contain fillers, vinyl coatings, quilted tops or solid coverings to prevent contamination. These fabrics and fillers all trap deadly carbon dioxide.

What is Rebreathing?

Rebreathing is when an infant lies face-down or near-face-down on his stomach, air is trapped around the baby’s nose or mouth. This causes the baby to breathe more CO2 than oxygen. If the baby does not wake up or react appropriately, it can lead to death.

Watch Professor David Greenblatt video for a visual on rebreathing.

After our analysis, we will introduce you to one crib mattress scientifically tested to eliminate the risk of rebreathing carbon dioxide even if  an infant is in a face-down position.  

Why Some Infants Who Sleep on Their Stomach are at Higher Risk

Most of us know the frightening feeling of a heavy blanket or pillow over our faces.  This feeling forces a natural trigger to remove the object blocking oxygen.  In addition, we do not worry about sleeping on our big fluffy pillows, pillow-top mattresses with our down quilts.  Why?  Because we have an innate sense to turn our head, even in deep sleep, when our breathing is compromised by the accumulation of carbon dioxide. 

Like adults, most infants turn their heads or fight to get something off their faces when carbon dioxide begins to cause breathing difficulties.  But unfortunately, some infants do not!  

A crib mattress eliminating the buildup of carbon dioxide saves lives.

Serotonin and rebreathing

In 2010, a group of scientists discovered the first direct correlation between SIDS / SUID deaths and serotonin levels.  This finding was discoverd by studying the brain stems of infants who died suddenly and unexpectedly.   

Serotonin is a brain chemical that conveys messages between cells and plays a crucial role in regulating breathing, heart rate and sleep.  Researchers theorize serotonin abnormalities reduce an infant’s “ability to respond to breathing difficulties, including low oxygen levels or high carbon dioxide levels. The leading scientist suggests SIDS is the result of infants rebreathing carbon dioxide accumulation in thier bedding and on their mattresses while sleeping on thier stomach. 

Dr. Hannah Kinney, “Babies who died of SIDS had abnormalities in serotonin in reigns of the brain stem that control breathing heart rate and blood pressure during sleep.”  When a baby is put face down in a bed, it begins to rebreathe carbon dioxide, which is toxic.

Several studies have followed, linking high serotonin levels in the blood of SIDS infants and deficiencies in serotonin receptors. These studies report a common result: reflex apnea and arousal reactions that lead to an infant’s inability to respond to rebreathing of carbon dioxide. In brief, some infants simply do not respond when they are in danger of rebreathing of their exhaled air!

Although the link between serotonin and SIDS / SIDS / SUID is a major finding in 2010.   More than ten years later, we still have no way of testing live infants to determine their serotonin levels, serotonin abnormalities, reflex apnea or arousal reactions. Consequently, all infants are at risk of rebreathing lethal carbon dioxide if they sleep on their stomach on a mattress that does not allow carbon dioxide to dissipate, or if they are in an unsafe sleep environment.

A crib mattress that eliminates carbon dioxide before an infant takes in their subsequent breath, was created by two individuals who experienced a similar tragedy.  One is a pediatrician.

Hypothalamus and rebreathing

Subsequent studies focus on how deficits in the hypothalamus region of the brain can cause infants insufficient responses to carbon dioxide rebreathing

The brainstem and hypothalamus are two regions in which nuclei play an important role in stress responses and arousal mechanisms.

As deaths attributed to SIDS occur during sleep, failure to arouse in a stressful situation is a component of the proposed death mechanism. The hypothalamus is a small but complex part of the brain with important roles in the homeostasis of energy balance, circadian rhythms and stress responses, as well as growth and reproductive behavior. As a regulatory center for so many functions, it receives input and transmits output to various other brain regions.

Therefore, since the hypothalamus controls many physiological functions and is highly interconnected with other brain regions, it is an excellent candidate for abnormalities that contribute to the pathogenesis of SIDS.

The reduction of carbon dioxide remains a major concern for safe infant sleep, as it leads to:

  • Asphyxia
  • Hypercarbia
  • Hypoxia

Dangerous Advice on When Can a Baby Sleep on Their Stomach

Recommendations from medical professionals and popular pregnancy resources appear to have a common theme: Once your baby can roll over, they are safe to sleep on their stomach.

Community Baby Center, a credible baby forum sponsored by Johnson & Johnson, states, “If your baby is strong enough to roll from back to stomach and stomach to back alone, you don’t have to worry about him rolling and sleeping on his stomach”. In addition, Parents Magazine says, “If your baby can flip himself on his stomach while sleeping, it’s okay to leave him that way.”

Unfortunately, this is dangerous advice!

Current research

New Zealand researchers report: “Parents and caregivers are often concerned about the appropriate strategy for infants who have learned to roll over, which usually takes place at four to six months of age.  As infants mature, they are more likely to roll.  In a study, 6% and 12% of 16 to 23-week-old infants placed on their backs or sides were in the prone position; among infants aged 24 weeks or older, 14% of those placed on their backs and 18% of those placed on their sides in the prone position. 

Repositioning a sleeping infant to the supine (back) position can be disruptive.  Consequently, this could discourage the supine position. 

Data to produce specific recommendations as to when can a baby sleep on their stomach, is lacking.

Infants placed on their back who roll

Further, research shows  more than a quarter of infants who died of SIDS while sleeping on their tummy were last put on their back. These researchers suggest an infant’s ability to escape potentially lethal situations during stomach sleep may be impaired by inexperience in prone sleep.  Dr. Moon later supported their findings (Head of the AAP Safe Sleep Task Force) and colleagues in their review of infant sleep deaths in childcare centers.   

Unintended consequences

Unfortunately, infant inexperience with stomach sleep is now a common, unintended consequence of the successful back-to-sleep campaign.  Babies who roll and are not used to sleeping on their stomach are at greater risk of SIDS. 

According to researchers at Washington University School of Medicine in St. Louis, babies who never sleep on their stomachs do not learn behaviors that can reduce their risk of SIDS.  Consequently, the researchers warn infants should always be put on their backs to sleep.

In 2016, these same researchers recognized the safety benefits of air-permeable crib mattresses that do not allow carbon dioxide to accumulate on the mattress.

Babies who roll

“The first time babies who usually sleep on their backs or sides roll or are placed on their tummy have a 19-fold increase in the risk of sudden death,  We wonder if these babies, who find themselves face down, do not turn their heads to breathe because their reflexes haven’t developed far enough, or because they simply don’t wake up?” says SIDS researcher Bradley T. Thach, MD.

Additionally,  scientific studies indicate an ample head-lifting ability when lying on the stomach may not be sufficient to protect a baby from SIDS. “Many parents think if a baby can lift its head, it is okay to sleep on its tummy, but that is a false assurance,” Thach says. 

It’s starting to make sense why a crib mattress that eliminates the risk of an infant rebreathing their carbon dioxide is protective against SID!

About Dr. Thach

Dr. Brad Thach, now retired, spent most of his career as a SIDS researcher.  His research is still considered relevant.  He and Dr. James Kemp are credited with finding the link between rebreathing carbon dioxide and SIDS.

About Safe Sleep Policy Makers

Who are AAP policy-makers?  The Committee of the American Academy of Pediatrics (AAP) on Fetus and Newborn established the AAP Safe Sleep Task Force in the 1990s and currently monitors their work.  The members of the AAP Safe Sleep Task Force write the AAP Safe Sleep Policies and Guidelines.  The Task Force consists of five physicians who volunteer their time and expertise to make sense of the available data. Unfortunately, these scientists are not without their bias. 

For example, before the updated policy in 2016, a new doctor was added specializing in breastfeeding.  There is a new heightened awareness of the importance of breastfeeding to reduce the risk of SIDS.  Eventhoug, there are no gold standard scientific studies to support breastfeeding to prevent SIDS / SUID.

The AAP (including the Safe Sleep Task Force) does not endorse, certify or recommend certain products.  In addition, the AAP restricts interactions with manufacturers, making it difficult for manufacturers to ensure that their products are safe for consumers. 

Randomized Case Controlled Studies vs. Retrospective Analysis

AAP safe sleep policies are based on a retrospective analysis of infant deaths.  These investigations may be flawed.  Actual scientific tests are not carried out to prove SIDS theories, as unethical tests would be required.  Dr. James Kemp, who used baby bunnies, carried out the closest test showing rebreathing of carbon dioxide as a probable cause of SUID / SIDS. 

The AAP Safe Sleep Task Force use retrospective analyses to determine safe sleep recommendations.  Meaning, the best data they have is  filtering through thousands of infant death reports.  Next, they attempt to find correlations between infants in a particular age group, gender, weight, etc., to determine why some infants lived and others died.  Take, for example, the “back-to-sleep” recommendation.  These scientists found infants with similar profiles were more likely to die when they slept on their stomach than on their back.

Unfortunately, retrospective analysis data can be flawed and is subject to scientific interpretation.  SIDS death scene investigations are not currently standardized.  There are considerable efforts in this direction, but we are still not there.  It is up to the medical examiner or pathologist to determine the cause of death.  These individuals  take note of the series of events and the scene. 

However, some will be appropriate and complex in their findings and others will not.  Consequently, there is a high probability that one examiner will include data  that the other examiner will not.  Often examiners label a death as SIDS on the single fact the infant was sleeping during the incident.

Limitations of Safe Sleep Policy Makers

The absence of Randomized Case Controlled (Gold Standard) means recommendations are based on retrospective analyses.   For example, it is recommended not to use blankets for infants.  Instead, it is recommended to use wearable blankets.  There is no scientific study to conclude whether a wearable blanket prevents SIDS deaths. 

However, many death scene investigations show infants who died compared to infants in a similar environment who did not have loose blankets in their cribs.  This suggests loose blankets in the crib are an increased SIDS risk. 

The same applies to back sleep.  No gold standard scientific study has been carried out to show whether an infant is at increased risk of dying on his or her stomach. However, retrospective data shows infants who were on their back were much less likely to die during sleep, suggesting back sleep reduces the risk for SIDS.

Retrospective analysis suggests air-permeable sides and surfaces are preferable to air-impermeable sides and surfaces to protect against SIDS.  Science that dictates high air-permeability in crib mattresses is preferable.

SIDS and Crib Mattresses

Most of us know the importance of keeping fresh oxygen flowing to a sleeping baby.  Additionally, we now know the importance of avoiding anything in the crib that can block fresh oxygen or cause carbon dioxide to accumulate.  

Unfortunately, conventional crib mattresses with fiber fill, vinyl covers, quilted toppers, and loose sheets all impede fresh oxygen flow, Further, they cause causing carbon dioxide to accumulate.

According to Dr. James Kemp and Dr. Brad Thach, “These bedding materials prevent the dispersion of exhaled gases (carbon dioxide) and keep the gases near a face down infant’s mouth. With each subsequent breath, the infant takes in an air mixture gradually less appropriate to maintain life. The more conducive an object is to rebreathing (to preserve carbon dioxide), the more dangerous the object would be.”

SIDS experts agree infants sleeping on their  stomach on fiberfill crib mattresses, quilted surfaces, soft surfaces, pillow-like surfaces, vinyl pads, mattresses filled with tea tree bark and other natural fibers, and even surfaces that claim to be breathable, show an increased risk of rebreathing carbon dioxide.  

Imagine a crib mattress with no fill, no quilted topper, no need for sheets. A crib mattress with side opening and an open celled, firm topper that allows continuous air flow.

Safe Infant Sleeping in the Prone (Face-Down) Position

In the 2011 AAP Safe Sleep Policy and Technical Report, it states, “play yards and bassinets with vertical sides of air-permeable material may be preferable to those with air-impermeable sides.” The recommendation to include air-permeable sides in play yards and bassinets is based on retrospective studies by the AAP Chairperson of Task Force Safe Sleep, Dr. Rachel Moon and her colleague Dr. Jody Pike.

According to Moon and Pike, “We have carried out a retrospective review and analysis of deaths in bassinets between June 1990 and November 2004 reported to the CPSC.” Moon and Pike noted several infants who died were discovered with their faces near or pressed against the side of the bassinet or play yard that had no air-permeable sides.

In 2010, a pediatrician and her sister, a SIDS content expert,  began challenging members of the AAP Safe Sleep Task Force to include published studies confirming the safety benefits of air-permeable crib mattresses with no fill materials for infants who end up in a face-down position.  After all, they recommend air-permeable sides in bassinets and play yards.

Finally, in 2016, the AAP Safe Sleep Task Force states, “Crib mattresses were designed with air-permeable materials to reduce the rebreathing of expired gasses (carbon dioxide), in the event that an infant rolls to a prone position.  These crib mattresses may be preferable to those with air-impermeable materials.”

So, When Can A Baby Sleep on Their Stomach? 

After reviewing the following topics:

  • Why back sleeping is the best if your infant is sleeping on a traditional crib mattress with fiber fill or quilted surfaces.
  • We currently have no way to determine which infants who tummy sleep or roll over are at higher risk.
  • If your baby can roll over on their own from back to tummy and tummy to back, they are “safe” to tummy sleep – which is not only poor advice it could prove fatal.
  • Who our safe sleep policymakers are and the scientific limitations they face.
  • The issues with conventional crib mattresses that contribute to unsafe sleep conditions.
  • The safety benefits of air-permeability.

We can safely say there is no clear age or milestone to determine when it is safe for a baby to sleep on their stomach. However, there is an “air-permeable” alternative to conventional crib mattresses, recognized by AAP policymakers as preferable for infants who end up on their stomach while sleeping.

Air-permeable crib mattress

The test results of the SafeSleep® breathe-through crib mattress are included in the scientific studies reviewed by the AAP.  The SafeSleep® crib mattress is made of air-permeable materials and has no fill or core. Specifically, the design of the SafeSleep® air-permeable mattress eliminates the risk of rebreathing of expired gases (carbon dioxide) in the event that an infant is in a prone position during sleep.

SafeSleep ® does not have any fiber fill or core.  Instead, it has a hollow center with side openings and a firm, air-permeable topper to create an oxygen-rich environment.  

Scientific testing shows exhaled carbon dioxide is gone before a baby takes in their next breath, eliminating the risk of carbon dioxide rebreathing.

Best Crib Mattress
best crib mattress

Back sleep is safest, but if your baby insists on sleeping on his stomach, make sure he sleeps on an air-permeable crib mattress. If you want to learn more about the air-permeable crib mattress allowing an infant to breathe normally, even if face down, check out SafeSleep®’s fully breathe-through crib mattress.

We have no clear answer for when can a baby sleep on their stomach, but there is a clear answer for what a baby should sleep on if they are sleeping on their stomach! 

How to Prevent SIDS

Breathable Crib Mattress

How to Prevent SIDS

We want to help parents avoid a tragedy by sharing how to prevent SIDS (Sudden Infant Death Syndrome). Yearly, there are around 3,500 sudden unexpected infant deaths in the U.S. alone.

SIDS is an unfortunate reality that many new parents face. However, there are certain things you can do to reduce the risk of SIDS for your infant.

Read on to find out what sudden infant death syndrome is and what best to do for your baby to prevent SIDS.

What Is Sudden Infant Death Syndrome?

Sudden Infant Death Syndrome (SIDS) is the general term used when a baby suddenly dies for no obvious reason. In order for death to be under SIDS, the infant must be younger than the one-year-old.  If the child is over one year old, it is considered SUDC (Sudden Unexplained Death of a Child).

The cause of death of a baby is typically defined as SIDS after a thorough investigation and no cause of death can be identified. 

SIDS is considered a diagnosis of exclusion.

Why Does Sudden Infant Death Syndrome Happen?

At the time of writing, scientists are not 100% sure what exactly causes SIDS. However, they speculate it is because infants are unable to effectively detect low oxygen or high carbon dioxide levels. Children and adults can wake up to prevent suffocation, but many babies are unable to do so.

There is a triple risk model that’s proposed by scientists:

  1. An undetectable abnormality prevents the infant from responding to low oxygen/high carbon dioxide levels
  2. There’s a triggering event (i.e. sleeping on the stomach, blanket around the face, hand or arm near the face)
  3. The above 2 points happen in a critical development period believed to be a rapid brain growth phase

Some SIDS deaths are not preventable, but most are preventable.  Infants in unsafe sleep conditions are at high risk of SIDS. 

How to Prevent SIDS

Unfortunately, we cannot fully prevent SIDS. The good news, however, is that there are many steps you can take to drastically reduce the risks of SIDS and the chances of it happening. Read on for our tips on how to prevent SIDS.

Preventing SIDS Starts with Get Your Infant Vaccinated

There is a small minority of people who believe vaccinations cause problems, including SIDS. But that’s not true.

In fact, vaccines help protect against SIDS. The evidence suggests vaccinations reduce the risk of SIDS by 50%. 

So, one sure way on how to prevent SIDS is getting your baby vaccinated.

Have Your Baby Sleep on Their Back Helps Prevent SIDS

If your baby is sleeping on their side or stomach, this can lead to one of two scenarios.  Firstly, when the crib mattress is soft, its nose and mouth are buried in the crib mattress, which cuts off its oxygen supply.  The second, when the crib mattress is firm, exhaled air (carbon dioxide) can be inhaled.  When carbon dioxide is continuously inhaled, it leads to death.

Another way to prevent SIDS is to always put your child down to sleep on their back. Back sleep is the safest place for a baby to sleep and is believed to significantly reduce the risk of SIDS.

Risk of SIDS Increases When Co-Sleeping

Co-sleeping is something some parents choose because parents believe it helps them bond with their babies better.

But the fact is insufficient sleep associated with parenthood can prevent adults from getting clues they have rolled over on their infants. As a result, they can unintentionally suffocate their babies. Babies can also easily become entangled in the sheets and blankets.

For breastfeeding mothers, make sure that your infant is safely put in their crib before falling asleep. 

Your baby should have his own crib, which means he should not co-sleep with anyone. This means they should not sleep with you or their siblings. Co-sleeping is one of the biggest risk of SIDS and other infant sleep related deaths.

Keep the Crib in Your Room to Prevent SIDS

For the first three months of your child’s life, you should keep the crib in your room. This allows you to quickly check them and take lifesaving measures if you notice they are not breathing.  It is best to put the crib as close as possible to the bed.

After three months, your baby should eat enough to sleep through the night.

Keep the Crib as Bare as Possible

If you have a baby, you might want to decorate your crib so it is cute, or you might want them to have soft, comfortable objects with which they can snuggle, like blankets, toys and pillows. However, these items can trap harmful carbon dioxide, which increases the risk of death.  Avoiding rebreathing of carbon dioxide is one of the most important step to prevent SIDS.

Even plain pillows and blankets can significantly increase the risk of SIDS. All you need is a firm mattress, and that’s it. Do not use bumper pads; they have been associated with suffocation, asphyxiation and strangulation deaths of infants.  Some states have even banned selling them.

Make sure you dress your baby warmly and adequately for the weather.  The general rule is to add one more layer than you would have for the bed.  Wearable blankets are best suited to reduce the risk of SIDS.

Get a SafeSleep® Crib Mattress 

If you need a firm mattress, you should get one from SafeSleep ®.

The SafeSleep ® Breathe-Through Crib Mattress has years of research and testing to create a safer, more sanitary sleeping environment for babies. The SafeSleep ® crib mattress is fully and easily washable.  It is also hypoallergenic.

According to leading AAP doctors and policymakers, SafeSleep® breathable crib mattress is a scientific answer to “how to prevent SIDS.”

The SafeSleep ® Breathe-Through Crib Mattress has been scientifically proven to have the lowest risk of suffocation and carbon dioxide rebreathing. So if your baby needs to sleep on their stomach for any reason, you want a SafeSleep ® crib mattress.  It’s the only crib mattress physicians write prescriptions for infants who must tummy sleep for health reasons.

Furthermore, the mattress has a 3D air-permeable topper and no core that leads to position pressure, which can cause skull deformities. Both factors will help keep your infant comfortable throughout the night.

And if the mattress is dirty, you can throw the topper in a washing machine and wipe the base! it’s the only completely washable crib mattress on the market.

Lower the Risk of SIDS

Now you know what sudden infant death syndrome (SIDS) is, why it happens, and how to prevent SIDS, you lower the chances of it happening to your baby.

Thank you for reading our blog on how to prevent SIDS. PLEASE share and pass this along to keep babies safe while sleeping.

Will a Breathable Mattress Help Avoid SIDS?

Breathable Crib Mattress to Prevent SIDS

Will a Breathable Mattress Help Your Baby Avoid SIDS?

Over 3,600 seemingly health babies die each year in the U.S.  Will a “breathable” mattress help your baby avoid SIDS (Sudden Infant Death Syndrome)?

In early 2000, the crib mattress buzz word was organic.  Twenty years later, it is now “breathable.”  With so many crib mattress manufacturers claiming to have breathable mattresses, we thought it was time to address the question, “Will a breathable mattress help your baby avoid SIDS?”

What is SIDS

A baby is determined to have died from SIDS if no cause of death can be identified following a death scene investigation, an autopsy, and a review of the clinical history. SIDS as a cause of death is determined only when all other causes have been excluded.

With infant related sleep deaths, the cause of death can be difficult to determine with certainty. Infants who die from sudden death usually pass away while asleep in their cribs. Victims are often found lying face down. There are no signs of trauma. Usually their deaths are not witnessed by another person, which makes it difficult for investigators to piece together how they died.  There are also no clear biological markers.

Slate Magazine

In an August 2016 article published in Slate Magazine under a similar title, Could a Breathable Mattress Help Your Baby Avoid SIDS?, the author believes breathable crib mattresses manufacturers do nothing more than exploit the fears of parents. 

According to the article’s author,

“There was a lot of research in the 1990’s that showed rebreathing is a hazard when babies sleep on soft bedding, like sheepskin, or with a blanket covering their heads. However, there isn’t evidence that sleeping on firm mattresses with a tight-fitting sheets—as is recommended—causes problematic rebreathing in babies, even if they roll onto their tummies. Plus, rebreathing is just one hypothesis for why tummy sleeping might be riskier.”

The fact is, there is scientific data showing that crib mattresses with fiber or other core materials do cause problematic rebreathing in babies.  This is noted in the same pub med resources as the author uses to debunk firm mattresses with a tight fitting sheet as not being problematic.  Logically, if fiberfill mattresses were not problematic, why not suggest infants can tummy sleep? 

The author’s goes on to state,

“More recent research has found that babies sleeping belly-down also have impaired arousability, altered cardiovascular control, and lower blood pressure and cerebral oxygenation, any of which may be important when it comes to SIDS.”

Without knowing it, the author is describing effects of rebreathing exhaled air (CO2).  Impaired arousability, altered cardiovascular control, low blood pressure, and lack of cerebral oxygenation, are all signs of rebreathing.  When an individual rebreathes their exhaled air (CO2), it suppresses their need to breathe and eventually leads to hypoxia and then death.

Rebreathing

According to a March 2019 article in Health, research by Dr. Gordon Buchanan, a neurologist and epileptologist at the University of Iowa reveals,

“Babies and adults who die from sudden death syndromes may be born with brains that aren’t good at recognizing rising CO2 levels in their blood. In sudden death cases, it’s thought that the individuals’ airways get blocked somehow while sleeping in bed — such as by a pillow, a toy or tangled bedding. But it wasn’t clear why the person doesn’t simply wake up and fix the problem by repositioning themselves or by crying out for help.

Buchanan thinks that individuals who succumb to sudden death syndromes may have malfunctioning serotonin receptors in their brains. These receptors are part of our brain’s “suffocation alarm system” and help to ensure that blood oxygen and carbon dioxide (CO2) levels are healthy. But Buchanan thinks that a rare neurological difference causes some people’s brains to be bad at detecting when blood CO2 levels get too high — which is a signal to our bodies that we could be suffocating. Instead of waking up like most people would, those with this defect stay asleep and are seemingly powerless against what’s happening to them.

Dr. Hannah Kinney was the first to be credited with discovering the effects of serotonin levels in an infants brain stem and SIDS 

The problem we face, is there is no way to test to find out which babies do, and which babies do not have a compromised “suffocation alarm system,” so all infants remain vulnerable.

Approved Standards

So, can a breathable mattress help your baby avoid SIDS?  In the Slate article previously mentioned, the author correctly states,

One problem with mattresses being marketed as “breathable” is that there aren’t any approved standards for what this should mean.”

She gives one example of the Nook Pebble Pure mattress that uses coconut husk as part of its fill.  According to Dr. James Kemp, a pediatric pulmonologist at St. Louis Children’s Hospital and SIDS expert, called this “exactly the wrong idea,” noting that a porous interior might actually trap carbon dioxide. A 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, and, according to a study by Kemp, allowed more rebreathing.

Some “breathable” crib mattresses with porous interior and cores are actually shown to be more dangerous than a solid fiber fill crib mattress.

Claims of Preventing SIDS

The Slate author states,

 “In designing “breathable” mattresses and claiming that they will inherently keep babies safer, these companies are demonstrating a fundamental lack of understanding of the complexity of SIDS, and, more broadly, of science. “The ‘evidence’ the manufacturers of these crib mattresses provide is not evidence of reduced risk of suffocation or SIDS,” said Dr. Fern Hauck, a member of the AAP’s Task Force on SIDS. “As long as the mattresses meet government safety standards, they can be used, but they should not be marketed as preventing SIDS or suffocation,” she added.”

The reality is none of the “breathable” crib mattress companies mentioned in the article claim to prevent SIDS.  The author uses a very misleading statement.

Since SIDS is a diagnosis of exclusion, there is nothing that can prevent it.  It would be like say you have something that can cure death by natural causes.  The term Sudden Infant Death Syndrome is also misleading, and often confusing, since SIDS is not a syndrome or a diagnosis.  It’s simply a term used if we don’t know what else to classify an infant death as.

Science

No studies exist comparing infants who sleep on various crib mattresses to see which one has fewer SIDS deaths.  This lack of studies includes the recommended firm crib mattress with a tight-fitting sheet. No published studies or valid scientific testing is available that shows if one crib mattress, including the currently recommended firm mattress with a tight-fitting sheet, or sleep surface has a lower/higher SIDS risk.  These gold standard studies do not exist for any of the AAP Task Force recommendations and likely never will; it is not feasible to enroll the number of infants required to get sufficient data.  

We cannot say with scientific certainty if a breathable mattress could help your baby avoid SIDS.  We also cannot say with scientific certainty that a firm crib mattress with a tight-fitting sheet can avoid SIDS.  In fact, we can’t say with scientific certainty that any of the AAP’s safe sleep recommendations will avoid SIDS.  The real question should be, can a breathable crib mattress avoid known SIDS “risks”?  All of the AAP’s safe sleep guidelines focus on risk avoidance.

Risk Avoidance  

Knowing what we now do, the question should be can a breathable crib mattress avoid known SIDS risks? 

Let’s look at the following quotes taken from the AAP’s Safe Sleep Policy Statement ;  

  1. Supine sleep position: “The prone or side sleep position can increase the risk of rebreathing expired gases, resulting in hypercapnia and hypoxia.”
  2. Room-Sharing Without Bed-Sharing Is Recommended: “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.”
  3. It Is Prudent to Provide Separate Sleep Areas and Avoid Cobedding for Twins and Higher-Order Multiples in the Hospital and at Home: “Furthermore, there is increased potential for overheating and rebreathing while cobedding, and size discordance might increase the risk of accidental suffocation.”
  4. Pillows, Quilts, Comforters, Sheepskins, and Other Soft Surfaces Are Hazardous When Placed Under the Infant or Loose in the Sleep Environment: “However, such soft bedding can increase the potential of suffocation and rebreathing.”
  5. Avoid Overheating and Head Covering in Infants: “It is not known whether the risk associated with head covering is attributable to overheating, hypoxia, or rebreathing.”

While the studies do not demonstrate a direct prevention of SIDS or suffocation, they rely on the hypothesis of rebreathing of CO2 as a potential contributor for these unexpected infant deaths.   A basic pathophysiological principle is the hypothesis that rebreathing C02 is associated with ALTE/SIDS/asphyxia.  Indeed, no studies have substantiated this hypothesis; however, this is the same hypothesis used by the AAP Task Force to support the majority of their recommendations.

Further, the Task Force recommends air permeable sides when bassinets are used. This recommendation is based on a retrospective review and analysis of infant deaths occurring in bassinets between June 1990 and November 2004 that were reported to the CPSC (Pike/Moon 2008). The authors identified at least six infants who were found with their “face wedged against the side of the bassinet.” While there is no mention of any bassinets having air permeable sides in the study, the study authors (including R Moon who is on the AAP Task Force) recommends “a bassinet with vertical sides of air-permeable material, such as mesh, may be preferable to one with air-impermeable sides.”  The Task Force makes the recommendation for air permeable sides based on infants with face wedged against side of sleep environment.   Logic would dictate that air permeable mattresses as being preferable to air impermeable mattresses to address infants face-straight- down on firm mattresses.

Breathable vs. Breathe-Through

Not all breathable crib mattresses are air permeable.  An air permeable crib mattress allows an infant who is face straight down to breathe normally right through the crib mattress without rebreathing their exhaled air.

There is only one mattress on the market today that has been scientifically tested and concludes it significantly reduces the risk of carbon dioxide rebreathing and is completely breathe-through.

The Science of “Breathe-Through”

Safe SleepTechnologies is a company that does understand the complexity of SIDS, and, more broadly, of science.  The four founders all lost a loved one to SIDS.  One of the founders is an AAP member and chairs one of the AAP’s committees.

The SafeSleep®Breathe-Through Crib Mattress was designed with the idea that baby’s do not always arouse when rebreathing harmful carbon dioxide.  Ten years ago, SafeSleep® founders challenged an industry standard by creating a crib mattress with no fill and replaced it with free-flowing air. 

These efforts have been recognized by top medical professionals and even prompted the American Academy of Pediatrics to recognize their crib mattresses with no fill and air permeable surfaces as safer for the infant who rolls in their 2016 Safe Sleep Technical Report.  

The SafeSleep® Breathe-Through Crib Mattress is designed to prevent harmful carbon dioxide from accumulating so that if an infant is face straight down and cannot arouse,  they will not rebreathe their exhaled air.

The SafeSleep® Breathe-Through Crib Mattress has been tested for carbon dioxide retention and has a ten-fold decrease in carbon dioxide retention when compared to a fiberfill mattress with a tight-fitting sheet.  It takes 2 minutes for carbon dioxide to dissipate on a firm crib mattress with a tight sheet; it takes less than 1/2 a second for it to dissipate on the SafeSleep® Crib Mattress.  An infant takes a breath every 1-2 seconds, meaning the carbon dioxide (poisonous gasses) on the SafeSleep® Breathe-Through mattress are gone before the infant takes their next breath of air – even if face straight down and does not arouse.

We can say with scientific certainty that the SafeSleep® Breathe-Through Crib Mattress significantly reduces the risk of carbon dioxide rebreathing even if the infant is face down or tummy sleeping.