Dr. Joshua M. Sharfstein, secretary of Maryland’s Department of Health and Mental Hygiene, has a decision to make.

Will he keep advising against the use of crib bumpers, those nursery fashions that are increasingly considered suffocation hazards to babies? Or will he outright ban the sale of them and make Maryland the first state in the country to take a tangible stand on the issue?

“It has been the view from the public health standpoint for some time that crib bumpers don’t belong in babies’ cribs,” Sharfstein told me yesterday.

The Baltimore Sun reported last Friday that a state advisory panel recommended Sharfstein ban the sale of bumpers. But will he? “It’s too soon to tell,” he said.

Sharfstein said he’ll review the recommendation, the transcript of the panel’s meeting and public comments before coming to a decision in a month or two.

The panel, which recommended a ban on sales but would not outlaw their use, had plenty of evidence of its own to consider.

Much of it was anti-bumper. They saw a letter [pdf] from the Office of the Chief Medical Examiner in Maryland noting its recent determination that a case of a child asphyxiated was caused by a crib bumper.

They also read a public comment [pdf] that, to me, shouted louder than the rest. It’s from an Arkansas mother named Laura Maxwell.

“I was an educated mother who loved my son very much. I can’t explain the details of what happened and how my 7-week-old son ended up nostril pressed against the bumper pad or how I didn’t hear any of it on my extremely loud monitor. All I know is that products I thought were protecting my son ultimately killed him.”

The Juvenile Products Manufacturers Association submitted a rebuttal that called the suffocation research inconclusive. The association also attributed problems to parents who install the bumpers incorrectly.

Maryland, like many public health agencies and pediatricians, currently advises parents to keep babies on their backs in a crib without bedding, pillow, stuffed animals or bumpers.

Late last year, The Illinois’ Attorney General Lisa Madigan asked manufacturers to stop making them after a series of critical articles in the Chicago Tribune. Even the manufacturers themselves advise removing bumpers once a baby can pull-up and possibly use the bumper to launch themselves over a crib rail.

But advisories and warnings aren’t always heard over the din of marketers. Walk into the showroom of a big box baby store or flip through a parenting magazine and witness crib bumpers displayed as necessary accoutrements.

The problem, Laura Maxwell told me in a follow-up e-mail exchange, is that “bottom line is you trust the items on the shelves and think that they are being sold to protect you and your child.”