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Free Cardboard Cribs for New Parents? How One State is Fighting SIDS

Blog Free Cardboard Cribs for New Parents? How One State is Fighting SIDS

“There’s nothing ‘magic’ about the box [in terms of reducing] sleep-related infant deaths,” says Emily K. Scott, MD, a pediatrician at Indiana University Health. “They’re not superior to cribs or bassinets for sleep safety, they just take up less space and may be more portable.”


Babies born in New Jersey this year will go home with a sturdy, safe box to sleep in and other newborn essentials -- all for free. The reason: The state’s health officials have adopted a Finnish practice in an effort to improve infant mortality rates.

In the first statewide program of its kind, New Jersey’s Child Fatality and Near Fatality Review Board partnered with The Baby Box Company to outfit new parents with a “baby box” containing essential items such as diapers, a onesie, baby wipes and nipple cream for breastfeeding moms. Importantly, boxes are typically made from sturdy cardboard and are fitted with a firm mattress and tight-fitting sheets babies can sleep safely in.

“There’s nothing ‘magic’ about the box [in terms of reducing] sleep-related infant deaths,” says Emily K. Scott, MD, a pediatrician at Indiana University Health. “They’re not superior to cribs or bassinets for sleep safety, they just take up less space and may be more portable.”

The boxes can be helpful for families unable to afford a safe sleeping space for their babies, and they also easily can be moved from room to room and house to house, she says. Educating parents about why safe sleeping spaces are so important is the crux of the baby box program. This includes warnings about the dangers of co-sleeping, or sleeping in the same bed with a baby, a major cause of sleep-related infant deaths in the United States, Dr. Scott says.

“When parents co-sleep with their babies, especially in the first four months of life, the chance of the baby dying during their sleep rises significantly,” she says. “Babies can die from suffocation, either in bedding or by the parent rolling over onto the baby.”

Babies can also roll off the bed or get wedged between the bed and the wall, and the risk of the baby dying while co-sleeping increases when babies are on a couch, chair or waterbed, she says.

Most cases of Sudden Unexpected Infant Deaths (SUIDs) -- when a baby 12 months or younger dies suddenly and unexpectedly -- are related to co-sleeping, babies being placed on their stomachs to sleep, or being placed to sleep with pillows, stuffed animals or fluffy blankets.

To keep babies safe, Dr. Scott says, remember the “ABC’s.” Babies should sleep:

All by Myself (no co-sleeping, no stuffed animals/pillows/fluffy blankets)

On my Back (no side/stomach sleeping)

In my Crib (or bassinet, baby box with a flat, firm mattress)

Other safety measures include having the baby sleep in the same room as the parent for at least the first six months of life (ideally for the first year), keeping the home tobacco-free, introducing a pacifier after breastfeeding is well established, not overheating the baby or the home and keeping the baby up-to-date on all recommended vaccines, she says. 

“Safe sleep education is key. You can give parents all the boxes or cribs in the world, but if they’re not educated correctly on how to use them, the baby is still at risk for sleep-related death,” Dr. Scott says.

Baby boxes have been a tradition in Finland since the late 1930s and are largely credited with the sharp decline in the country’s infant mortality rate -- now one of the lowest in the world -- over the last several decades. The idea is catching on internationally, with experimental programs in London, Australia, South Africa and South Asia. A few U.S. cities, including Seattle, San Antonio and Fort Worth in Texas and Philadelphia also are experimenting with baby box pilot programs.

New Jersey is expected to give away around 100,000 baby boxes this year with a grant from the United States Centers for Disease Control. Indiana officials are also considering a similar program, Dr. Scott says. “We’re looking into whether the program would be a good fit for our state, especially since Indiana’s infant mortality rate is higher than the national average,” she says. “For now, we have a robust safe sleep program in Indiana.” 

For more helpful tips about swaddling, sacks and more, click here

-- By Virginia Pelley

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