Crib bumpers are readily available and often included in crib bedding sets.

They’re cute and decorative, and they seem useful. They’re intended to make your baby’s bed softer and cozier. But many experts recommend against their use. What’s the deal with crib bumpers, and why are they unsafe?

Crib bumpers are cotton pads that lie around the edge of a crib. They were originally designed to prevent babies’ heads from falling between crib slats, which used to be farther apart than they are today.

Bumpers were also intended to create a soft cushion surrounding baby, preventing babies from bumping against the hard wooden sides of a crib.

In September 2007, a study published in The Journal of Pediatrics concluded that crib bumpers are unsafe.

The study found 27 infant deaths that were traced to bumper pads, either because the baby’s face was pressed against the bumper, causing suffocation, or because the bumper tie got caught around the baby’s neck.

The study also found that crib bumpers don’t prevent serious injury. The study authors looked at injuries that could have been prevented by a crib bumper and found mostly minor injuries like bruises. Although there were some cases of broken bones caused by a baby’s arm or leg getting caught between crib slats, the study authors stated that a crib bumper wouldn’t necessarily prevent those injuries. They recommended that crib bumpers never be used.

In 2011, the American Academy of Pediatrics (AAP) expanded its safe sleep guidelines to recommend that parents never use crib bumpers. Based on the 2007 study, the AAP stated: “There is no evidence that bumper pads prevent injuries, and there is a potential risk of suffocation, strangulation, or entrapment.”

However, you can still buy bumpers for your baby’s crib. Why are they available if the AAP recommends against using them? The Juvenile Products Manufacturers Association (JPMA) doesn’t agree that crib bumpers are always unsafe. In a 2015 statement, the JPMA said, “At no time has the crib bumper been cited as the sole cause of an infant’s death.”

The statement also expressed concern that “the removal of a bumper from a crib will also remove its benefits,” which includes reducing the risk of bumps and bruises from arms and legs being caught between crib slats. The JPMA concludes that if crib bumpers meet the voluntary standards for infant bedding, then it’s safe to use.

The Consumer Products and Safety Commission (CPSC) has not issued required safety guidelines for crib bumpers, and it has not stated that bumpers are unsafe. However, in its informational pages on safe infant sleep, the CPSC recommends that a bare crib is best, with nothing in it besides a flat crib sheet.

In response to the danger of traditional crib bumpers, some manufacturers have created mesh crib bumpers. These are intended to avoid the danger of suffocation, even if the baby’s mouth gets pressed against the bumper. Because they’re made of a breathable mesh, they seem safer than a bumper that’s thick like a blanket.

But the AAP still recommends against any kind of bumper. Bumpers that were manufactured after awareness rose about their dangers are still dangerous, as evidenced by a 2016 study in The Journal of Pediatrics that showed that deaths related to bumpers are rising. Although the study couldn’t conclude whether this was related to increased reporting or increased deaths, the authors recommended that the CPSC ban all bumpers since the study showed they have no benefits.

So are bumpers ever OK? Although it can be confusing when the JPMA and the AAP have different recommendations, this is a case where it’s best to go with the doctor’s orders.

Unless the CPSC creates mandatory guidelines for crib bumper safety, your best bet as a parent is to follow the AAP guidelines. Put your baby to bed on their back, on a firm mattress with nothing but a fitted sheet. No blankets, no pillows, and definitely no bumpers.