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In September 2021, federal officials grew so alarmed by the number of babies who had suffocated after being laid down on a popular infant lounger that they issued an urgent notice to parents: Stop using it immediately.

The padded, pillowy Boppy Newborn Lounger — sold to exhausted caregivers who relied on it as a safe place to put their infants — was linked to the deaths of eight babies, the Consumer Product Safety Commission warned. The federal agency announced a recall of more than 3 million of the loungers, which had been a mainstay of baby registries for years.

CPSC staff members then wanted to go a step further. It wasn’t just one manufacturer’s infant lounger that posed a potentially lethal threat; the agency next planned to consider sweeping regulation of other cushioned infant loungers, which some experts and officials believed were just as unsafe as the Boppy lounger. The move could have forced manufacturers to redesign their loungers or stop selling them, according to interviews with current and former CPSC employees, industry representatives and safety advocates.

But one day after the Boppy recall was announced, the CPSC’s two Republican commissioners — who at the time held a majority — scrapped that more comprehensive action, approving an annual operating plan that removed a proposal for regulating infant pillows, according to interviews and a review of the documents.

Since then, babies have continued to die.

NBC News has found that at least four babies have died in incidents linked to infant loungers since late September 2021, based on CPSC records and reports made to the agency. Four days after the CPSC’s vote and less than a week after the Boppy recall, a 3-month-old boy from Texas died while sleeping in the company’s lounger; his father had fallen asleep and woke up to find his child lying facedown, according to a report that local officials submitted to the CPSC.

The following spring, according to another report, a 4-month-old died from asphyxiation on a lounger produced in China that was advertised on Amazon as “perfect for co-sleeping.”

In addition to those four deaths, NBC News determined that at least 21 other babies died in infant loungers from December 2015 through September 2021, more than twice as many deaths as the CPSC cited in public warnings about specific brands of loungers. This count is based on an examination of government data, court documents, public reports reviewed by the CPSC, medical examiners’ reports, and records obtained through a Freedom of Information Act request. (See the full methodology below.)

Many of the incident reports cited suffocation, asphyxiation or a loss of oxygen as the cause of death, and seven lawsuits accused the loungers of causing the babies’ deaths. In some of the reports to the CPSC, the loungers were listed as one of multiple factors contributing to an unsafe sleep environment, while in others, no cause of death was listed. In one instance, after an 11-day-old baby died of Covid in a lounger, a local government agency identified “unsafe sleep” as a potential factor in the death. All of the babies were under a year old; the youngest was 4 days old.

“It is infuriating, and it’s senseless,” said Megan Parker, of Alton, Illinois, whose 2-month-old daughter, Layla, died in a Boppy lounger in 2019. “I don’t understand why they wouldn’t push that information out there, knowing that there are more deaths that are not reported. It could save lives.”

The 25 deaths tallied by NBC News are almost certainly an undercount, according to product safety experts, as autopsies do not always mention specific consumer products.

“The death certificate is not clear, and if it doesn’t list the product, then you don’t know,” said NJ Scheers, a statistician and former CPSC staff member who reviewed NBC News’ methodology.

Before it was recalled, the Boppy Newborn Lounger was beloved by many parents who discovered that even the fussiest of newborns tended to relax in the round, slightly recessed cushion. Other loungers are rectangular or oval-shaped, with a raised perimeter surrounding a cushioned pad.

While the CPSC closely oversees infant sleep products, loungers have largely escaped regulation because they are described as a place for babies to lay while they’re awake. That means that most loungers are not subject to a new federal rule that bans inclined surfaces and other potential hazards in infant sleep products.

Yet newborns can quickly fall asleep at any time. Some companies explicitly advise customers to “transition” their babies to a crib or bassinet if they fall asleep on a lounger, but that does not always happen. And for years, photos of infants peacefully snoozing in loungers have proliferated on social media, muddying the message that the product should not be used for sleep.

One infant was 22 days old, his body cold and still when his mother found him. Another, a fussy 2-month-old, was discovered unresponsive by his exhausted parents hours after they had brought him into bed late at night. A third suffocated while lying next to his twin brother in the bassinet they shared.

Before they died, all of the babies had been placed to sleep on nursing pillows — and their deaths were neither isolated nor unavoidable, an NBC News investigation found.

At least 162 babies under a year old have died in incidents involving nursing pillows since 2007, according to a first-of-its-kind analysis based on hundreds of public records as well as internal federal data. Some of the babies slumped down on the pillows or arched backward off of them, constricting their airways. Others turned their faces into the plush surface, suffocating as their parents slept feet away.

In some cases, the cause of death wasn’t clear, but the babies were found on or with nursing pillows, sometimes while co-sleeping with parents or alongside soft bedding that also poses a suffocation risk. At least three incidents involved mothers who fell asleep while feeding their baby with a nursing pillow and awoke to find they couldn’t rouse their child.

“You think, ‘Well, we wouldn’t be able to buy things that are potentially unsafe for our babies.’ But yet, we can,” said Dr. Elizabeth Murray of Golisano Children’s Hospital in Rochester, New York, who sees babies nearly every year who have died after they were placed to sleep on nursing pillows.

Nursing pillows have become a must-have item for many new parents, with 1.34 million sold per year in the U.S., according to industry estimates. The horseshoe-shaped cushions, which come in a variety of colorful prints, are marketed as essential for the early months of life, when babies need to be fed frequently. Manufacturers say they’re safe if used as intended: to help caregivers cradle their babies while breastfeeding or bottle-feeding them.

But infants left unsupervised on the cushions or allowed to sleep with them — against the products’ warning labels — can stop breathing within minutes.

NBC News’ count of deaths is based on a range of records, including reports by consumers and local officials reviewed by federal authorities; law enforcement and medical examiners’ reports; and federal data obtained through a Freedom of Information Act request.

The count includes deaths caused by suffocation or restricted airways in incidents involving nursing pillows. In some cases, other causes were listed, such as pneumonia, or the cause of death was undetermined, unexplained or not listed, but a nursing pillow was mentioned as a potential factor. In most cases, the brand of nursing pillow was not specified. (For the full methodology, see below.)

The vast majority of the babies were less than 4 months old; the youngest was just 3 days old.

NBC News’ list is almost certainly an undercount, as autopsy reports do not always include details about specific products and often are not made public. Separately, state officials in Oklahoma and Indiana told NBC News they have tallied dozens of deaths in which nursing pillows were found in infants’ sleep areas, most of which were not included in NBC News’ count because there were not enough details.

Federal regulators have been aware of the hazard for decades. But it was not until 2020 that the Consumer Product Safety Commission warned consumers that nursing pillows and other similar products “are not designed for sleep and are not safe for sleep.” The agency added that it was investigating fatal incidents but did not say how many.

After years of delays, the CPSC is now preparing to take the first steps toward rules to make nursing pillows safer, with a proposal expected in the coming weeks. Alex Hoehn-Saric, the agency’s chair, recently said at a conference that the CPSC has identified more than 130 deaths associated with nursing pillows over a 10-year period, a figure that does not include some of the deaths on NBC News’ list.

“I’m very concerned, given the large number of deaths,” Hoehn-Saric, who was nominated by President Joe Biden, said in a recent interview. “We need to move forward as quickly as possible.”

But several leading manufacturers of baby products are pushing back against the prospect of new regulation.

The Breastfeeding Infant Development Support Alliance (BFIDSA), which formed last year, is leading a lobbying and PR push whose funders include The Boppy Company and Snuggle Me Organic, two nursing pillow manufacturers. The coalition, which has enlisted support from nonprofit groups, health professionals and small businesses catering to new parents, is framing its effort as a feminist cause.

“Women’s rights are being gutted — and the ability for women and parents to choose how they feed their baby is next on the chopping block,” the alliance says on its website. It warned that federal regulators, who have not yet unveiled their proposal, want to “impose the will of government over the needs of mothers,” requiring such drastic design changes that products would have to be pulled from the market.

That could “have a negative impact on breastfeeding” or prompt some caregivers to turn to makeshift solutions that could be dangerous, the alliance said in a statement to NBC News. “It is imperative to have safe products on the market that properly assist parents in caring for their babies.”

Instead of mandating changes, the CPSC should “invest in an extensive campaign to educate consumers on safe sleep practices” and defer to voluntary safety standards that are currently under development, the group added.

When asked for comment, Boppy said, “As a member of BFIDSA, we support their position and responses to your questions.” Snuggle Me did not respond.

‘It’s not worth an entire life’
Sterling Gerber was just shy of 7 months old when he was found unresponsive after falling asleep on a nursing pillow on the floor of his Oklahoma day care in July 2018, according to a police report obtained through a public records request.

The little boy, described by his mom as “one of the happiest babies,” was rushed to the hospital, where he was put on life support. But doctors told his parents he had been without oxygen too long to recover, said Sterling’s mother, Allison Blackburn. A medical examiner ruled it a “sudden unexplained infant death,” and the day care, which had been cited for multiple violations, shut down shortly afterward. The law firm that represented the day care declined to comment.

Sterling Gerber with this mother Allison Blackburn.
Allison Blackburn and her son, Sterling Gerber, who died in 2018.Courtesy Allison Blackburn
Blackburn has since warned as many parents as possible not to buy nursing pillows.

“It’s not worth risking putting your baby in a pillow,” said Blackburn, who now lives in Aurora, Colorado. “It’s not worth an entire life.”

A new product, and new concerns
Nursing pillows are a relatively new innovation — and it took time for them to catch on.

Susan Henderson, a Colorado mother, invented the C-shaped Boppy pillow in 1989, after her daughter’s day care asked parents to bring in pillows that could be used to support babies who couldn’t yet sit on their own.

She said she soon realized that the pillow could be even more useful as a nursing support to reduce mothers’ neck and arm strain as they held and fed their babies. The pillows can position babies more comfortably as they latch onto the breast, which helps with milk production — one of many challenges new moms can face.

During the first few years, Henderson’s company struggled to stay afloat, but the Boppy soon took off. A growing number of Americans were embracing breastfeeding, encouraged by public health campaigns and research showing the benefits for both babies and mothers. By 2006, The Boppy Company had reportedly reached $15 million to $25 million in annual sales; the company was sold two years later. Nursing pillows are now a mainstay of baby registry lists, and Boppy competitors have swarmed the market.

While most nursing pillows have labels warning against using them unsupervised or for sleep, some, including Boppy, have also been labeled or marketed as places for infants to practice tummy time on their stomachs, or as a support for sitting or reclining.

“The Boppy pillow is not limited to breastfeeding; it offers a range of versatile uses,” the company says on its website. Leachco similarly describes its nursing pillow as a “multipurpose” product suitable for supervised tummy time or for lounging while awake.

That might lead caregivers to believe it’s safe to leave their baby unattended in those positions, some safety advocates and medical experts said. But that can quickly turn deadly.

The country’s largest association of pediatricians is warning that a product designed to help infants sleep more soundly could be deadly.

The makers of weighted swaddles and sleep sacks liken them to a parent’s hand resting gently on an infant’s chest or to the sensation of “being held and hugged.”

But the American Academy of Pediatrics says placing weight on babies while they’re sleeping poses an alarming and potentially fatal risk — and the group is calling for a closer examination of the potential danger.

Weighted sleep sacks and swaddles could hypothetically increase the risk of sudden infant death syndrome by making it harder for babies to arouse themselves in response to hazards, such as lack of oxygen, the AAP said in a letter Thursday to the Consumer Product Safety Commission and ASTM International, a technical standards development organization.

“Why would anyone put a weight on top of a child’s chest — particularly a newborn?” said Dr. Michael Goodstein, a neonatologist and member of the AAP’s task force on SIDS. Infants’ rib cages are more elastic and flexible, so adding weight could also potentially compress their chests and affect their breathing, he said.

The Consumer Product Safety Commission has not put out any warnings about infant deaths linked to weighted sleep sacks or swaddles. An agency database lists one infant who died while wearing a weighted sleep sack, though it’s not clear whether the sleep sack played a role in her death.

In September 2011, Sara Thompson found her 15-week-old son Alexander unresponsive in a Fisher-Price Rock ‘n Play, his face pressed against the device’s fabric.

Nearly 12 years later, the inclined infant sleeper is associated with the deaths of about 100 babies, including Alexander. Yet Thompson, who lives in Nazareth, Pennsylvania, routinely sees the Rock ‘n Play for sale on platforms like Facebook Marketplace — despite a 2019 recall of the product. She immediately messages the sellers.

Some quickly take down their posts, saying they had no idea it had been recalled, Thompson said. But others get defensive.

“They say, ‘The product is fine, it’s the parents’ fault — they should have been watching their babies,’” said Thompson, who settled a lawsuit against Fisher-Price last year.

She is among a small group of grieving parents who’ve taken it upon themselves to curtail sales of the potentially lethal product that remains readily available online.

Their challenge reflects the shortcomings of the federal recall system, which keeps products circulating even after they’re deemed hazardous, safety advocates argue. Online platforms prolong the danger by failing to provide easy ways for users to flag recalled items if they are listed for resale, with Facebook Marketplace, in particular, lacking a clear reporting mechanism, the advocates say.

For the Rock ‘n Play, this has proven particularly perilous. At least eight deaths have been linked to the product since it was recalled in April 2019, prompting the federal Consumer Product Safety Commission to re-announce the recall in January.

But four years after all 4.7 million Rock ’n Plays were recalled, less than 10% have been returned to the manufacturer, according to a recent letter from Fisher-Price obtained by NBC News.

Babies can die in the Rock ‘n Play and other inclined sleepers when their head rolls to the fabric-covered sides of the product, or when their chin drops to their chest, restricting the airway, according to medical experts. Infants left in Rock ‘n Plays unrestrained can also roll from their back to their stomach or side, putting them in an unsafe position.

Fisher-Price says that not all deaths reported from the Rock ’n Play have been confirmed to be associated with that brand, specifically.

Under federal law, companies may decline to make recall numbers public, and Fisher-Price only provided them in response to questions from members of Congress who were alarmed about the mounting death toll.

In a letter to members of Congress last month, Fisher-Price said that it had completed more than 465,000 “cumulative corrections.” That number includes both Rock ‘n Plays that consumers returned and those that were expunged from warehouses and retail stores.

Fisher-Price also said in the letter that the company has found about 54,000 Rock ‘n Play listings online, including on Facebook Marketplace and other platforms, and 98% are now inactive after Fisher-Price worked with the websites to get them removed.

The company’s letter added that Fisher-Price had limited information about the babies who died after the recall, but that “the products were purchased by consumers before the initial recall announcement or were acquired second-hand via private sales or as gifts.”

These previously unreported details come a week after the chair of the Consumer Product Safety Commission sent letters to Facebook parent company Meta and Fisher-Price parent company Mattel demanding they do more to stop sales of secondhand Rock ‘n Plays.

From February 2022 to March 2023, CPSC staff issued nearly 4,000 takedown requests for Fisher-Price Rock ‘n Plays on secondary marketplaces, with most submitted to Facebook Marketplace, which responded swiftly to remove items, the agency said.

Nancy Cowles, executive director of consumer advocacy group Kids in Danger, said part of the problem is that sites like Facebook Marketplace don’t offer a clear way to flag recalled goods.

Facebook requires users to choose a specific reason for reporting posts, and there is no option that would fit an item that has been recalled, despite the site’s own policies prohibiting such sales.

Craigslist and eBay, by contrast, allow users to flag listings for broader reasons and also include prominent links with information about recalls.