Taking a page from Finland’s baby care book, New Jersey will soon begin offering “baby boxes” to parents of all newborns in the state.
These cardboard boxes are large enough — and come with a tight-fitting sheet and hard mattress — to provide a safe sleep space for the baby’s first couple of months.
The boxes are also filled with essential items for newborns — a onesie, diapers, baby wipes, and nipple cream and breast pads for breast-feeding mothers.
The program is a partnership between the state's Child Fatality and Near Fatality Review Board and manufacturer The Baby Box Company. They expect to hand out about 105,000 baby boxes this year.
Funding is provided by a grant from the Centers for Disease Control and Prevention (CDC).
This is the first statewide baby box program in the United States. But similar efforts have been undertaken in other cities, including one started last year at Temple University Hospital in Philadelphia.
These programs attempt to reduce the risk of accidental suffocation and strangulation — which account for 25 percent of the approximately 3,500 cases of Sudden Unexpected Infant Death (SUID) in the United States each year.
Sudden Infant Death Syndrome (SIDS) accounts for 44 percent of the SUID cases. The rest have unknown causes.
Risk factors for SIDS include infant sex and age, secondhand smoke, and premature birth.
SIDS, though, is not related to unsafe sleep.
“SIDS deaths are deaths where we have no explanation for why this previously healthy baby died,” Dr. Elizabeth Murray, a pediatrician at University of Rochester Medical Center’s Golisano Children’s Hospital, told Healthline. “But unsafe sleep deaths are 100 percent preventable.”
Creating a safe sleep space
These “preventable deaths” occur in communities across the country.
“I work in a pediatric intensive care unit and unfortunately we still see this happen,” Dr. Shoba Srikantan, a pediatrician and critical care specialist for Arnold Palmer Hospital for Children in Florida, told Healthline. “We have a few cases every year of a child who died while sleeping in a bed with a parent. A child, whose parent put them to sleep on a pillow, who suffocated on the pillow. A child who fell asleep breast-feeding on their mom and suffocated that way.”
If parents and doctors keep in mind the dangers of unsafe sleeping conditions, said Murray, it “will help to make it very real for the families that are learning this information.”
With baby boxes and other sleep devices, parents also need to keep in mind other safety tips, like “making sure that there’s nothing in the crib — that there are no baby bumpers, that there are no blankets — that the baby is on their back,” said Murray, “and no co-sleeping in an adult bed.”
Toys, pillows, and pets should also be kept out of the baby’s sleep area.
And if parents are using gadgets to keep track of their baby, they shouldn’t get lulled into a false sense of safety.
“If you still don’t have a safe sleep environment, and you put your baby on a pillow — even with a baby monitor … I’ve seen children suffocate and die that way,” said Srikantan. “I can’t emphasize how it’s so important that safety is paramount.”
In countries like Finland, which has been handing out baby boxes to parents since the 1930s, “it’s considered a rite of passage and a very proud thing that the parents engage in,” said Murray.
But this is not the only safe sleep option.
“Other communities have other projects to get Pack 'n Plays or actual cribs to families in need if they don’t have it,” said Murray.
These resources, though, can only do so much for the safety of infants.
“The one thing we’ve definitely seen in our community is that it’s not a lack of access to a safe sleep device,” said Murray. “It’s a choice to not use it. So you have to overcome that barrier.”
Which is why the New Jersey program also tries to educate parents about newborn care through an online curriculum and quiz.
These messages are especially important for new parents, who may feel overwhelmed.
“Parents are focused on so many things when they have a baby,” said Srikantan. “How’s my baby going to feed, how do I give a bath, how much is too much? There’s so much that you’re trying to absorb at once.”
The baby box program is part of a larger conversation about newborn health, one that parents can start long before their baby arrives.
Srikantan suggests that expectant parents “find a pediatrician that you can really partner with,” and remember that “no question is a silly question to ask your pediatrician.”