Air Mattresses Are Not Appropriate Sleep Spaces for Infants

It seems that every other month, there is a new product that poses a potential threat to infant health. Some of these products are marketed specifically to parents of infants as the “latest and greatest”; others are marketed for general use, but then are used by parents who perceive them as being a better option than what they are currently using. Air mattresses seem to fall in the second category. Air mattresses first became popular as camping accessories or temporary sleep surfaces. However, as described by Doerling and Salm Ward in the current issue of AJPH,¹ air mattresses are often being used as sleep spaces for infants and have been reported as the sleep space in more than 100 sleep-related infant deaths.

Doering and Salm Ward¹ describe potential reasons for the popularity of air mattresses as infant sleep spaces. The desire for infants to be comfortable, inexpensive cost and portability, and the capability of avoiding bedbugs, rodents, and other pests are all compelling reasons to have one’s infant sleep on an air mattress.

HAZARDS

However, air mattresses pose several hazards to infants. To reduce the risk of sudden infant death syndrome and other sleep-related infant deaths, the American Academy of Pediatrics recommends that all infants sleep on a firm surface (one that “maintains its shape and will not indent or conform to the shape of the infant’s head”).² Air mattresses, even when properly inflated, may not be firm enough for an infant.³

Qualitative data suggest that parents and caregivers often may not interpret “firm” in the same way as health care providers and safety advocates. When we asked mothers who participated in focus groups to define or describe “firm,” responses included comfortable, not too soft and not too hard, flat, not lumpy, and cheap. ⁴ Many mothers believed that a firm surface was any surface that had a tight cover.⁴ Thus, a pillow covered tightly with a sheet would be considered a firm surface.⁴

It is also entirely possible that parents may underinflate an air mattress because of concern that the infant will be uncomfortable or will be more likely to fall off a fully inflated mattress. In addition, more recent iterations of air mattresses include inflatable headboards and pillow rests, which present additional suffocation hazards for infants.

ALTERNATIVE INEXPENSIVE SLEEP SPACES

Air mattresses and air mattress technologies seem to be more commonplace recently. Many “traditional” mattresses have adjustable firmness levels, with air mattress technology making this possible. It is clear that health care providers and public health officials should be aware of the prevalence of air mattresses and should counsel parents accordingly.

There are other inexpensive sleep spaces that would be more appropriate for infants and have safety standards. For instance, portable cribs and play yards that meet Consumer Product Safety Commission safety standards are relatively inexpensive and portable. Many jurisdictions will provide cribs or portable cribs at reduced or no cost, and health care providers can refer patients to these programs. Additional analyses of deaths that have occurred on air mattresses may be helpful in identifying risk factors and behaviors associated with air mattress use so that counseling and public health campaigns can be better targeted.