Ditch The Crib? Cardboard Boxes Promoted As Key To Safe Baby Sleep

Parents across the United States may be starting to rethink the use of traditional cribs — not in favor of expensive strollers and high-tech baby monitors, but of simple cardboard boxes to put baby to safe and sound sleep.

The idea takes after a Finnish program some seven decades earlier, where baby boxes were used to curb infant mortality rates through promoting safe sleep practices.

Baby Box Phenomenon Across The US

Think of baby boxes this way: heavy-duty paper of rectangular shape, encouraging the newborn to remain on his or her back and with limited potential for flipping over. This is seen as a deterrent to sudden infant death syndrome (SIDS), the abrupt death of an infant younger than age 1.

SIDS is typically implicated in sleep-related cases such as suffocation, strangulation, and entrapment. In 2015 alone, the U.S. Centers for Disease Control and Prevention documented around 3,700 infant deaths from SIDS.

Last January, New Jersey became the first U.S. state to launch a universal baby box program, with babies locally born eligible to receive a free cardboard box as well as newborn essentials such as mattress, clothes, and fitted sheets.

Expecting parents, as well as parents of babies younger than 3 months, are also offered a short online education course and advice on how to use the sturdy box as a safe sleeping space for the little ones.

"In taking the online syllabus, we hope parents will learn the importance of safe sleep environments, thus reducing the number of fatalities related to unsafe sleep environments,” said Kathryn McCans of Cooper University Healthcare in New Jersey.

Other states such as Ohio and several hospitals in Philadelphia and San Antonio, Texas, have since jumped onto the baby box trend. NBC reported that Los Angeles-based Baby Box Co. is partnering with more hospitals in the country to give away free boxes to parents after they are quizzed on the educational video.

Addressing Infant Mortality Rates

Baby box proponents believe that this mix of education and free resources will drive down America’s infant death rates, closer to those seen in wealthy Nordic nations.

The government thinks it’s making great progress since it launched the Back to Sleep campaign in 1994, where parents are urged to have babies sleep on their backs instead of their stomachs. A drastic drop in infant mortalities followed, yet some groups — including black infants — are still worse affected by SIDS more than others.

Baby boxes, 105,000 of which are distributed in New Jersey’s statewide initiative, are deemed key in winning the battle. In Finland when the program took off in 1949, the deaths dropped to 3.5 per 1,000 births from 65 per 1,000 births in the 1930s.

For experts, combating infant mortality will entail the creation of policies enhancing post-neonatal care for mothers of low incomes and socioeconomic status.

According to a University of Chicago study, higher infant death rates in the United States compared to some European nations are driven almost completely by infant deaths among lower-earning families once the mother and child step out of the hospital. Related factors include poor maternal education and health insurance coverage.

Guidance from the American Academy of Pediatricians strongly urges sleeping in the same room with the baby but never in the same bed. It recommends that babies sleep in the parents’ bedroom for the first half of the year or until age 1.

The AAP also deems exclusive breast-feeding extremely beneficial in this matter, lowering the chances of an infant’s instant death by about 70 percent.

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