The Consumer Product Safety Commission (CPSC) has issued more than 46 recalls of more than 11 million cribs since 2007. Yet crib-related injuries and deaths remain a real problem. In fact, a study published by Pediatrics in March 2011 revealed that the number of children injured yearly by cribs, playpens, and bassinets remains pretty constant: approximately 26 children under 2 are harmed daily in the US by cribs. That translates to 10,000 children a year. Woah.

To get a better understanding of WTF is going on—and how best to deal—we turned to Dr. JJ. Levenstein, founder of MD Moms and fellow of the American Association of Pediatrics.

“The data generated by this investigation parallels that collected by CPSC and underscores the fact that crib-related injuries continue to be an important source of concern,” says Levenstein. But things are slowly moving in the right direction. “In December 2010, the CPSC published new Safety Standards for cribs, mandating that manufacturers, distributors, retailers, and those entities providing cribs to youth (child care centers, family day care centers, hotels, motels) offer cribs with improved safety standards,” she explains. “The deadline for manufacturers, distributors and retailers was June 2011—and for child care centers, hotels and motels, just last month.” What’s included in the new mandate? “Eliminating drop-side cribs, improving the structural integrity of crib slats, increased vertical and horizontal structural stability, elimination of wood screws from key structural elements, reduction of toehold exposure, and marking and labeling improvements. Still, injuries related to entrapment, wedging and suffocation, and jumping out/falls remain possible.”

The bottom line? Even if you purchase a crib that meets the CPSC’s most up-to-date safety recommendations, injuries are still possible. Ugh. “Crib design is very tricky,” explains Levenstein. “The crib itself must provide an adequately ventilated area for sleep (to help prevent SIDS), visual access for parents to see in—and for babies to see out. Slats must be structurally sound, spaced widely enough to allow ventilation, yet not so widely set as to allow falls and entrapment. Side walls must be tall enough to prevent children from vaulting out, but low enough for parents’ access. All this, and it must look good, too.”

What’s inside the crib must be up to snuff, as well. “A firm, rated-for-crib mattress with a tight fit is essential,” says Levenstein. “With the AAP and CPSC essentially outlawing all bumpers (due to potential suffocation risk), and recalling crib tents (due to entrapment and strangulation risks), a baby left to her own devices can potentially trap limbs, fingers or toes in crib slats or cutouts, make an attempted mad dash for the floor, or be so irritated with such an enforced Spartan environment that self injury within the crib is still possible.”

Great. So what’s a parent to do? “Breathable bumpers? No studies have been done to prove they are safe,” warns Levenstein. “Plus, their design must take all ages and stages into consideration: imagine your tot using low versions as a step ladder, or detaching them with nimble fingers. Cribs starting at floor level and ending at 36 inches? Poor aesthetics and parents’ aching backs aside, adequate ventilation at ground level is a concern—not to mention the possibility that family pets could easily claim baby’s space. Soft-sided cribs? Pliant, bowing sides create potential space for entrapment. Crib mattress on the floor, or toddler bed? Fine for older tots, but potentially unsafe for very young babies who could roll, wedge, or fall face first on to the floor.”

Basically, we’re currently in a no-guarantee situation, while designers and manufacturers struggle with the complex and contradictory challenges of crib design. While they’re trying to sort things out, here are Dr. Levenstein’s tips for creating a safe-as-possible sleeping environment for your wee ones:

•    Purchase a crib manufactured after June, 2011, and check the CPSC’s website for recall notices.
•    Assemble the crib precisely, according to manufacturer’s directions
•    Purchase a mattress specifically designed for crib use
•    Use only a fitted sheet on the mattress
•    Avoid populating the crib with stuffed toys, pillows, sleeping wedges, or bumpers
•    Never use a feather mattress or lofty mattress pad
•    Keep baby’s door open to hear sounds of distress, or use a nursery monitor
•    Never place the crib near a window, or near drapery or shade cords; keep all cords (electrical or other) at least 3 feet away from the crib
•    Avoid cribs with finials or knobs—if baby attempts to climb out, clothing can get caught on these and lead to potential strangulation