“Back to Sleep,” we were told when our oldest was born in 2005.
The pamphlets and posters were everywhere, instructing bleary-eyed parents to place their infants *only* on their backs for sleep, because research had shown that the position decreased Sudden Infant Death Syndrome.
Your baby, dying in their sleep? What could be more terrifying?
So we Americans do what the posters say. And within seconds, or maybe twenty minutes, our babies wake up. If not well swaddled, the startle reflex kicks in and their eyes bolt open.
We used to joke that babies weren’t dying of SIDS as often because none of them were actually spending any time sleeping in their cribs when all the parents were putting them “back to sleep.” We’re now raising a nation of children who sleep in their carseats, in baby swings, and propped up slightly by foam bumpers, all because desperate parents yearn for some shut-eye but are afraid to put their infants down on their tummies for sleep.
So why is my baby in the photo smashing his little face into the crib mattress?
Because we’ll take what sleep we can get.
While Americans were fighting SIDS and making gains, but certainly not winning the war with over 2,000 babies still dying every year, New Zealanders were trying something different.
They began wrapping mattresses, especially older mattresses, with polyethylene covers. Polyethylene doesn’t allow gases through from the mattress to the baby.
And you know what? While the US was celebrating a 50% reduction in SIDS deaths, not one single baby died on a properly wrapped mattress in New Zealand.
100% success rate.
And for some reason, we continue to ignore it.
We say “the rate of SIDS decreased as babies lying on their backs increased.” But you know what? From what I’m understanding in this NPR report, infant deaths aren’t counted as SIDS if the baby is in an “unsafe sleep environment,” one definition of which is “sleeping face down.”
So if you don’t count the babies sleeping facedown as dying from SIDS, amazingly, SIDS rates are dropping.
Isn’t that a bit of a case of changing the definition, or is it just me?
In 1999 the definition of SIDS was updated. Notice how any gains made against SIDS after that point are offset by accidental suffocations (the green line). Taking the facedown infants out was the only way of making the SIDS rate continue to drop.
New Zealand Does It Differently
Dr. James Sprott, a scientist from New Zealand, completed research in 1996 that confirmed and expanded a study done by a British Dr. Richardson in 1994 (Journal of the Forensic Science Society 1994;34(3):199-204). They both found what they believe is a link between mattresses and SIDS (or “crib death” or “cot death” as it’s referred to down under and by the Brits).
Their “toxic gas” theory is actually alarmingly simple:
When flame retardant chemicals commonly applied to all mattresses (including but not exclusive to crib mattresses) react with common household fungi in the mattress, toxic nerve gasses are produced which hover low above the mattress near the baby’s face.
There’s a very succinct step-by-step explanation of how SIDS occurs according to the toxic gas theory here, including the catalysts of phosphorus, arsenic and/or antimony (by-products of common flame retardant chemicals). We went over the risks of flame retardant chemicals in adult and child mattresses when we launched the How to Get Healthy Sleep series, but this one is by far the most terrifying.
In an unrelated study from Scotland published in the British Medical Journal, 2002, researchers discovered that “Routine use of an infant mattress previously used by another child was significantly associated with an increased risk of sudden infant death syndrome.” Correlation does not equal causation – meaning there is not proof that something in a used or older mattress actually contributes to unexplained infant deaths – but it may lend some credence to Richardson and Sprott’s theories. Older mattresses would likely harbor greater bacterial and fungal growth, increasing the risk of creating the toxic nerve gas.
A number of other studies contribute to the discussion and may support the theory:
SIDS occurs more often in babies further down the birth order in their families (statistics from the United Kingdom, also Risk factors of sudden infant death in Chinese babies, American Journal of Epidemiology 1997;144:1070-73)
Many studies, including those that inspired the entire back-to-sleep campaign, demonstrate that babies sleeping on their back suffer from SIDS less often than tummy sleepers. Connecting that to the toxic gas theory is a short step: The heavy gasses hang low above the mattress, so babies sleeping facedown are exposed to a greater amount of the gas.
In both New Zealand and the UK, covering mattresses to prevent gasses from reaching the baby demonstrated incredible improvement in the rate of SIDS deaths.
A British researcher demonstrated that yes, there often are fungi in babies’ mattresses: Final Report of the Expert Group to Investigate Cot Death Theories: Toxic Gas Hypothesis (Limerick Report), May 1998.
Here’s another (2012) bit of research showing that one of the common flame retardants impedes learning ability and sociability, especially when children are exposed to it. That’s totally not SIDS related, but yet another reason to avoid the flame retardant chemicals on something on which your baby or child will spend 12+ hours a day!
Simple Solutions to Fix the Toxic Problem
I want my babies and older children to be sleeping on safe surfaces already, simply because of the carcinogenic and psychological risks of flame retardants and foam that we covered earlier this week. I’ve been working on finding affordable, non-toxic mattresses for the whole family for three years now, and it’s a HUGE process! I’ll close this series in two weeks with all the possibilities for adult and child mattresses, but for today, let’s talk cribs.
My first two babies slept on a hand-me-down mattress that I was so grateful to receive from the family of one of my students. We were just starting off our adult lives, more or less, and we used anything and everything that was given to us for free.
That mattress is on a toddler bed now (free from Freecycle!), and my 3yo is still sleeping on it. We hope to move him to a twin soon, so we don’t want to invest in a new mattress for just a year, since we have another very safe non-toxic crib mattress for baby no. 4, Gabriel. The hand-me-down mattress has clearly seen better days – it’s cracked in a million places (which is making me cringe more and more as I dig into the research for this series!!!!) and is starting to take on more of a horseshoe shape instead of lying flat. We always make sure to cover it with a waterproof pad or two, which I’m hoping does something to reduce the off-gassing, but I know it’s not enough.
NATURAL BABY CARE COURSE
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There are two proven ways to obtain a safe sleeping surface for your infants and toddlers:
Wrap your old mattress with a Babesafe cover
Buy a mattress without flame retardant chemicals or petroleum-based foam
The Babesafe mattress cover is made of food-grade, BPA-free and vinyl-free polyethylene plastic and at least 5 mils thick has been lab-tested to block all gasses from transmitting from the mattress to your baby. It also blocks dustmites and bed bugs that may be in the mattress.
Wrapping mattresses with this material is what parents did in both England and New Zealand when their SIDS rates first started dropping (in England, it was about two years before their “back to sleep” campaign). One study showed that babies sleeping with a vinyl mattress protector also had a greatly reduced rate of SIDS, which lends credence to the toxic gas theory – but you don’t want anything vinyl in the crib, because vinyl is a huge source of offgassing VOCs (ever smelled a brand-new shower curtain? Ugh.).
Babesafe is the brand sold in New Zealand, but there’s also one on Amazon that is vinyl-free, polyethylene and the right thickness to prevent off-gassing: Harlow’s Earth Crib Mattress Cover. UPDATE: Thanks to a reader for sharing the US distributor for Babesafe.
The mattress wraps are plastic, and they’re crunchy/loud, potentially like sleeping on a potato chip bag. Some say if you put another thick or folded blanket in between the fitted crib sheet and the plastic wrapping, it’s really not so bad. But fair warning!
You can get full-sized mattress wraps here, but the shipping could be bad from New Zealand. ? For a bit of a DIY solution for bigger beds, necessary for co-sleeping, I wonder if you could get polyethylene chair covers from Amazon and duct tape them together under a mattress pad and fitted sheet. They are only 2 mils thick though, so you’d need 3 layers to follow protocol. We slept on a plastic sheet (like the ones used for tarping while painting) in the week or so leading up to Gabe’s birth in the fall, and it was slippery and a little weird but not a sleep killer – and it was over, not under, the regular mattress protector, so I think that would make a positive difference.
Safe Baby Non-Toxic Crib Mattresses
There aren’t many out there, sadly, but that does make it easier to choose the one you want.
Here’s what to look for in a non-toxic crib mattress:
No vinyl (PVC).
No chemical flame retardants. The mattress should use cotton or wool to inhibit flames and pass the government’s test. Silica is another mostly natural, non-toxic fire blocker. Boric acid will be in some crib mattresses as a flame retardant, and that one is debatable on safety. When it comes to your baby, why not avoid it if you can? (more on mattress flame retardants)
No petroleum-based foam. Beware of brands that claim they use a soy-based foam – you have to ask questions about whether it’s 100% soy (many mix a small percentage of soy-based foam in with the highly flammable polyurethane foam), as well as whether there are chemicals mixed right into the foam itself. Ask about antimony, arsenic, and boric acid at least.
Organic mattresses are best, especially since cotton is one of the most highly sprayed crops in the U.S.
We got to review a Naturepedic crib mattress a few years ago, and I do believe it’s one of the best crib mattresses out there (if not the best). It’s waterproof without using vinyl, and for me, that was important. I didn’t want to have to rely on an external mattress pad to create the waterproof barrier necessary to keep my expensive mattress safe.
Here are the non-toxic crib mattresses I was able to find for you to choose from (this may not be an exhaustive list, but I’m happy to hear your suggestions in the comments if I missed any!):
- Naturepedic crib mattress on Amazon (many independent retailers like Healthy Child also carry Naturepedic)
- Organic Grace crib mattresses (including organic cotton, wool and latex plus the Savvy Baby brand)
- Cocomat is totally different – made of coconut husks and lambswool, no polyethylene, but not waterproof
- Babyletto is another brand using coconut, and it looks very clean – they do offer waterproof versions
- White Lotus (cotton and wool)
- Natural Sleep Store (Eco Baby and Sueno brands)
- Lullaby Earth crib mattresses (endorsed by Healthy Child, Healthy World)
- As with adults, you can get a doctor’s prescription for a mattress without any flame retardant qualities at all as long as you can find a company to custom-make one.
There are many brands of organic crib sheets on Amazon to complete the picture. This brand is what we use (and we’ve bought at least 2-3 sets plus others as gifts! They hold up incredibly well and are very soft.) To cover the waterproofing issue, we reviewed the many waterproof mattress pads we’ve tried in the past ten years and also have another post just on research into waterproof mattress pad safety.
Although I’m normally a huge proponent of using second-hand products because of both the cost savings and the environmentally friendly aspect, I can’t recommend used mattresses for babies (unless you’re willing to wrap them, which is more like a $40-60 cost instead of a few hundred).
What If “Toxic Gas” Is a Load of You-Know-What?
Some say that the mattress wrapping info is totally bunk.
In a 2009 article from American Academy of Family Physicians, the authors state this about the cause of SIDS:
“Current literature supports a triple-risk model, which suggests that SIDS is the final common pathway of three coinciding factors. This model proposes that an infant must first have an underlying vulnerability and then be stressed by an exogenous source, such as prone sleeping placement. Finally, for SIDS to occur, the stress must occur during a critical developmental period, namely in the first year of life. The last two factors in the triple-risk model have been well researched and defined in the medical literature, but the underlying vulnerability remains to be identified.”
They do not discuss for one moment that the type of mattress or any chemicals could be related to SIDS. Since 2000, mainstream medicine has brushed of the toxic gas theory, largely because of a study done by Limerick in England between 1996-2000. Note that they don’t bring it up and disprove or disagree with it. It’s just completely left off the table. I’ll let you interpret that move how you wish. ???
So what’s with this Limerick report?
An expert group spent 3.5 years studying Richardson’s toxic gas theory, and when they published their results, they debunked all of it (according to media sources). They proved that antimony is in kids’ blood even before birth and called into question that it comes from crib mattresses; they found no correlation between SIDS and antimony; they couldn’t replicate Richardson’s results; and they said not enough crib mattresses were being wrapped from 1993-5 to make any impact on the decrease in crib deaths. (source)
Some argue those results. They say that only one of the three gases was tested for, only PVC (vinyl) covered mattresses were tested, and that some of the results were skewed because of the perspective from which data was analyzed. (Dr. Sprott is the assume original author of that page, although it’s been copied in many other places on the web without attribution.)
Unfortunately, a large percentage of the websites sharing the mattress wrapping information seem to have the same ultimate source, even though they’re all different URLs. That increases my distrust of the whole theory, BUT on the other hand, the research is compelling and makes so much sense to me. There haven’t been any studies that disprove the theory well, depending on how you interpret the Limerick report.
The results of mattress-wrapping in New Zealand is incredibly compelling but also controversial.
235,000 babies slept on properly wrapped mattresses in New Zealand over about a decade. In that time out of that number, the rate of SIDS would be expected to be about 1.1 per 1,000 babies. That means almost 258 babies should have died in their sleep with no explanation – and there were none. ZERO.
The dissenting sources often cite 3 deaths on wrapped mattresses. The counterpoint is typically given that those mattresses may not have been wrapped with thick enough polyethylene. But you know what?
Even if that statistic is true, I bet those 255 parents who didn’t lose a baby would be grateful beyond belief. I’ll bet my forty bucks on being in the 255 instead of the 3 and wrap my mattress. (In the U.S. the rate of SIDS is 0.57 per 1,000 babies, but that would still equate to 136 deaths out of the 235,000.)
In the end, more unbiased research is needed.
But for my family? In the face of the unknown of SIDS plus the known risks of chemical flame retardants, it only makes sense to me to buy the safest non-toxic crib mattress I can find and rejoice in the fact that decreased risk of unexplained death is a likely byproduct of that choice. The only downfall of getting a non-toxic mattress is the cost – which can be a big problem for many families, unfortunately. I fervently hope that costs of non chemically treated mattresses continues to come down!
Click to Read the Whole Healthy Sleep Series:
Disclosure: Links in this post will generate commission for this site, but I worked hard to include many resources beyond my affiliate links as well. I received a Naturepedic mattress for review directly from that company three years ago.