Are cot bumpers, pillows and soft toys safe?
Avoid — Nothing in the cot but a firm flat mattress, fitted sheet and light bedding; no pillows or duvets under 12 months
No. A baby's cot needs a firm flat mattress, a fitted sheet and light bedding, and nothing else. Crib bumpers are banned outright in the United States. They are still sold in the UK, where the NHS and the Lullaby Trust both say to keep the cot clear. No pillows or duvets under 12 months.
The verdict
No, on all of them, and in the United States this is not advice but law.
The NHS instruction is one sentence: keep your baby's cot clear of anything that could cover their face and head, and do not use pillows, duvets, cot bumpers, loose blankets, soft toys or anything to keep your baby in place, like pods or nests.
The Lullaby Trust lists cot bumpers, sleep positioners, soft-sided pods or nests and baby hammocks under products to avoid, says not to use pillows and duvets for babies under 12 months, and describes the target as a clear cot: babies need just two things, a firm, flat, waterproof mattress and lightweight bedding.
Health Canada's safe sleep guidance asks for a firm, flat surface with a tightly fitted sheet, and no loose, soft bedding, bumper pads, pillows or toys, adding a longer list elsewhere: no loose, soft items including blankets, quilts, pillows, bumper pads, mattress toppers, sleep positioners or toys.
The AAP's list of things to keep out of the sleep area is: pillows and pillow-like toys, quilts, comforters, mattress toppers, non-fitted sheets, blankets, toys, bumper pads or related products that attach to crib slats or sides. It adds weighted blankets, sleepers, swaddles and other weighted objects to that list.
Why an empty cot
Two mechanisms, both mechanical rather than mysterious.
Airway obstruction. A baby under a few months old cannot reliably lift or turn their head away from something covering their face. The Lullaby Trust's phrasing is that items such as toys, blankets and bumpers could cover a baby's face and obstruct their breathing. The CPSC puts the same point as: many young babies cannot lift their heads to pull away from soft objects that can pose a suffocation risk, such as bumpers, blankets, pillows, and sleep positioners.
Entrapment and strangulation. The AAP's framing is that soft objects and loose bedding can increase your baby's risk of entrapment, suffocation or strangulation. Bumpers add a specific hazard the others do not: they have ties. A baby who moves in the night can end up wedged between a bumper and the mattress, or caught in a tie.
The stated purpose of a bumper, preventing limbs slipping through the bars and heads bumping the sides, is not a problem worth solving. A leg through a cot bar is uncomfortable and not dangerous. Modern cot bar spacing is regulated precisely so a head cannot pass through.
Rolling changes nothing about the rule
The AAP addresses this directly: some babies will roll onto their stomachs, and you should always place your baby to sleep on their back, but if they're comfortable rolling both ways then you don't need to keep turning them back. Just be sure that there are no blankets, pillows, stuffed toys or bumper pads in your baby's bed, because your baby could roll into any of these items, which could block their airflow.
In other words, once a baby can roll, the case for an empty cot gets stronger, not weaker.
What should be in the cot
A firm, flat, waterproof mattress that fits the frame with no gaps. A tightly fitted sheet. Lightweight bedding, or better, a well-fitting sleeping bag with no hood.
The AAP defines firm usefully: a firm surface means that it shouldn't indent when your baby is lying on it. It also gives the incline rule that governs everything else: any surface that inclines more than 10 degrees isn't safe for your baby to sleep on.
On warmth, the AAP's suggestion is to dress them in layers of clothing or use a wearable blanket, and in general to dress your baby in only one layer more than you're wearing. The NHS sets the room temperature target at between about 16 to 20C, which is 61 to 68F, and says to place your baby on their back in the feet-to-foot position, with their feet at the foot of the cot so they cannot wriggle down under the covers.
Pods, nests and things that keep a baby in place
The NHS explicitly bans these from the cot in the same sentence as bumpers: anything to keep your baby in place, like pods or nests. The Lullaby Trust advises against using pods and nests as sleep spaces because they are soft with raised or cushioned sides, and says it advises against letting babies sleep in anything that keeps them in a seated or inclined position as this can restrict their breathing.
The AAP goes further and names products: don't use products for sleep that aren't specifically marketed for infant sleep, giving nursing pillows and lounger-style products as examples. Its rule for alternative sleep surfaces is that they are only a safe option if they comply with federal safety standards, and its list of products to check includes inclined sleep products, hammocks, baby boxes, in-bed sleepers, baby nests and pods, compact bassinets, travel bassinets and baby tents. If a product doesn't meet federal safety standards, avoid it.
The comforter question
Parents often ask about a small comfort blanket or a favourite soft toy, and the honest answer is that no authority carves out an exception for a small one during sleep. The Lullaby Trust's clear-cot advice is to remove all unnecessary items and loose bedding from your baby's cot, including toys, pillows and cot bumpers.
The practical route most families take is to keep the comforter for cuddles, feeds and cot-side settling while awake, and remove it once the baby is asleep. From around 12 months, when a baby can reliably move an object away from their own face, the risk profile changes, and that is also the age at which the Lullaby Trust stops advising against pillows and duvets.
Where guidance genuinely differs
The United States has banned crib bumpers outright; the UK has not. The Safe Sleep for Babies Act, enacted in 2022, declares crib bumpers to be banned hazardous products under section 8 of the Consumer Product Safety Act at 15 U.S.C. section 2057e. The CPSC states that the law makes it unlawful to sell, offer for sale, manufacture for sale, distribute in commerce, or import these products into the United States, regardless of the date of manufacture. The ban took effect on 12 November 2022 and is codified at 16 CFR part 1309.
The US definition is precise, and one product escapes it. A crib bumper is defined as any material intended to cover the sides of a crib to prevent injury from impacts against the side, or to prevent partial or complete access to openings in the sides to prevent entrapment. It includes a padded crib bumper, a supported and unsupported vinyl bumper guard, and vertical crib slat covers, and it does not include a non-padded mesh crib liner. Mesh liners are outside the ban; that is not the same as being recommended, and no authority recommends them.
In the UK, bumpers are legal to sell and advised against. A British parent can buy a cot bumper in a shop while the NHS page tells them not to use it. That gap between what is on sale and what is advised is real, and it is the main reason these products persist in nurseries.
Canada sits with the UK on law and with everyone on advice. Health Canada's safe sleep guidance excludes bumper pads, pillows and toys from the sleep space and asks for a firm, flat surface with a tightly fitted sheet, without an equivalent statutory ban.
The NHS instructs parents to keep your baby's cot clear of anything that could cover their face and head, and not to use pillows, duvets, cot bumpers, loose blankets, soft toys or anything to keep your baby in place, like pods or nests. It advises always placing a baby on their back in the feet-to-foot position, on a firm flat mattress, in a separate cot or Moses basket in the same room as you for every sleep for at least the first 6 months, with the room kept at a temperature of about 16 to 20C (61 to 68F). The Lullaby Trust lists cot bumpers, sleep positioners, soft-sided pods or nests and baby hammocks among products to avoid, says not to use pillows and duvets for babies under 12 months, and describes the safest cot as a clear cot containing a firm, flat, waterproof mattress and lightweight bedding. Cot bumpers remain legal to sell in the UK.
Showing guidance from NHS / The Lullaby Trust — read the source.
Crib bumpers are banned outright. The Safe Sleep for Babies Act, enacted in 2022, declares crib bumpers to be banned hazardous products under section 8 of the Consumer Product Safety Act, at 15 U.S.C. section 2057e. The CPSC states the law makes it unlawful to sell, offer for sale, manufacture for sale, distribute in commerce, or import these products into the United States, regardless of the date of manufacture; the ban is effective 12 November 2022 and is codified at 16 CFR part 1309. A crib bumper includes a padded crib bumper, a supported and unsupported vinyl bumper guard, and vertical crib slat covers, and does not include a non-padded mesh crib liner. The AAP separately advises keeping pillows and pillow-like toys, quilts, comforters, mattress toppers, non-fitted sheets, blankets, toys and bumper pads out of the sleep area, and adds weighted blankets, sleepers and swaddles to that list.
Showing guidance from CPSC / AAP — read the source.
Health Canada's Safe Sleep for Your Baby guidance asks for a safe sleep space with a firm, flat surface with a tightly fitted sheet and no loose, soft bedding, bumper pads, pillows or toys. Its fuller list of items to keep out is blankets, quilts, pillows, bumper pads, mattress toppers, sleep positioners or toys. It advises always placing a baby on their back for every sleep, room sharing in a crib, cradle or bassinet in the same room as you for the first 6 months, and states that sleep positioners or rolled up blankets should not be used to try to keep your baby on their back, as they increase your baby's risk of suffocation. Canada has no equivalent statutory ban on bumper pads.
Showing guidance from Public Health Agency of Canada — read the source.
Sources
- Reduce the risk of sudden infant death syndrome (SIDS) — NHS, accessed
- Baby sleeping products — The Lullaby Trust, accessed
- Crib Bumpers Business Guidance — U.S. Consumer Product Safety Commission, accessed
- A Parent's Guide to Safe Sleep — American Academy of Pediatrics (HealthyChildren.org), accessed
- Safe Sleep for Your Baby — Public Health Agency of Canada, accessed
- Cribs Safety Education Center — U.S. Consumer Product Safety Commission, accessed