This article is part of “Death by Delay,” a series on how consumer product hazards have cost lives.
The Consumer Product Safety Commission has advanced a proposal to create the first federal requirements for nursing pillows after dozens of infant deaths in recent years.
The agency’s four commissioners — three Democrats and one Republican — voted unanimously on Friday to support making nursing pillows safer through design changes and warning labels intended to discourage caregivers from placing babies down to sleep on the popular U-shaped product.
The changes are “designed to preserve the useful function of nursing pillows — allowing caregivers to comfortably feed babies — while eliminating their hazardous use for sleep,” Richard Trumka Jr., one of the CPSC’s Democratic commissioners, said in a statement Monday, describing the proposal as “the next step in the march towards eliminating preventable infant sleep deaths.”
Under the proposed changes — based on recommendations made last month by CPSC staff — nursing pillows will be required to be “sufficiently firm” to reduce the likelihood of conforming to infants’ faces, which can cause suffocation. The proposal also requires that the curve of the pillows be wide enough to avoid restricting infants’ head movements, which can cut off airflow.
Most nursing pillows already have tags that warn against using them for sleep or leaving infants unsupervised, but the proposed regulations will require that the warnings be more visible and harder to remove.
Nursing pillows will also be prohibited from having straps to secure babies, which can mislead parents into thinking they can safely step away from their infants, the proposal said.
The proposal will be open for public comment for 60 days after it is published in the Federal Register, which is expected to happen this week. Under federal law, the CPSC will review and respond to the comments before finalizing the rule — a lengthy process that can take months or years to complete.
The nursing pillow industry mobilized to oppose CPSC regulation long before the proposed changes were unveiled. Last year, major manufacturers helped create the Breastfeeding Infant Development Support Alliance to lead an advocacy and lobbying campaign in Washington. The group has accused the CPSC of harming breastfeeding women by trying to “impose the will of government over the needs of mothers.”
The alliance — along with members The Boppy Company, Snuggle Me Organic and Leachco — did not immediately respond to a request for comment on Monday.
The proposed regulations come a month after an NBC News investigation found that at least 162 babies have died in incidents involving nursing pillows since 2007. Most of the infants died after they were placed to sleep on or with the pillows.
In the proposal, the CPSC cited 154 deaths involving nursing pillows from 2010 to 2022, including those caused by suffocation, asphyxia and sudden infant death syndrome.
Nursing pillows are a staple of baby registries, with an estimated 1.34 million sold each year in the U.S. The horseshoe-shaped pillows can help position breastfed infants so they get the correct latch — and can help reduce parents’ neck and shoulder strain as they nurse or bottle-feed their babies.
The CPSC has long recognized the danger nursing pillows can pose to infants, but it was not until 2020 that it warned consumers that nursing pillows and other similar cushions “are not designed for sleep and are not safe for sleep.”
“Although I certainly would have preferred to see action much earlier, I welcome the fact that we are now considering regulatory options to help reduce the number of fatalities and injuries associated with these products,” Mary Boyle, a Democratic CPSC commissioner, said in a statement Monday.
The American Academy of Pediatrics’ safe sleep guidelines recommend that babies sleep alone and on their backs on a flat surface without any loose bedding.
Nancy Cowles, executive director of Kids In Danger, an advocacy group, praised the CPSC’s proposal.
“It will definitely reduce the risk and reduce the likelihood of deaths on nursing pillows,” said Cowles, who singled out the requirement for firmer pillows as especially important.
NBC News’ analysis of the 162 infant deaths was based on law enforcement and medical examiners’ reports, federal data obtained through a Freedom of Information Act request and reports by consumers and local officials that had been reviewed by federal authorities.
