Baby Boxes Cut Infant Mortality in Finland—U.S. Cities Give Them a Try

Five reasons baby boxes are more than cutesy cardboard containers, from offering a safe place to sleep to giving an equal start in life.

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By Marcus Harrison Green for Yes Magazine

In 1938, the Finnish government presented a gift to impoverished expectant mothers: a box. This gift would transform parenting in the Scandinavian nation. Measuring roughly 27.5 inches long, 17 inches wide, and 10.5 inches tall, each box contained a sturdy mattress and essentials for the first few months of infancy: blankets, clothing, pacifiers, and bibs. Today, the boxes are showing up all over the world, representing much more than a collection of baby items.

  1. Boxes provide a safe sleep space

Baby boxes are more than cutesy cardboard containers: They contribute to safe sleep. The Finnish government extended the baby box program to all mothers in 1949. Prior to the box program, 65 out of 1,000 babies died within the first year of birth. Today, Finland’s infant mortality rate is 2.52 deaths per 1,000 births.

Of course, improved medical care accounted for much of that change. But studies suggest that the box has also played a critical role as it provides a safe sleep space for infants, a fact not lost on American doctors. 

U.S. pediatricians and advocacy groups are pushing hospitals to give away the cardboard cribs to help reduce America’s infant death rate: 5.87 deaths per 1,000 births—the highest of any wealthy nation.

According to the National Institute of Child Health and Human Development, the safest sleep environment for babies is sleeping alone on a firm surface without blankets, pillows, or loose bedding. The baby box provides that, and officials in Texas recently decided to pursue using baby boxes to help curb an increase in cases of sudden infant death syndrome. According to data from the Texas Department of Family and Protective Services, in 2015, 159 infants died in circumstances involving sharing a bed with a parent or sibling. University Hospital in San Antonio introduced the boxes in 2015 to address that problem.

Initially, the hospital provided boxes to 100 new mothers. The boxes proved popular, and the hospital ordered 500 more to fulfill the demand of parents-to-be.

Meanwhile, in Seattle, the King County Public Health Department has begun distributing baby boxes to needy families who don’t have a safe place for an infant to sleep. And several South Asian nonprofits have introduced a version of the box called the “Barakat Bundle.” This version contains additional items—including antiseptics, sterile razor blades, and other equipment to ensure a hygienic delivery—to address the fact that many women have limited access to maternity care. More than a third of the 5 million infant deaths worldwide occur in the region.

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