Can baby boxes reduce cot death?

The box, filled with useful information for new parents and several newborn essentials, is supplied by the Finnish government. All mums-to-be are entitled to receive one.

According to the BBC, Finnish mums can accept a small cash grant of 140EUR instead, but since the value of the box is much higher, most go for the box.

The box itself is designed for babies to sleep in for the first 8 months of their lives. Saying that, we wonder whether from around 6 months, when babies start being able to sit up and even pull themselves up, the box could contain an active baby safely in the way a high-sided cot would do.

Why are we talking about them in the UK?

Baby boxes are being rolled out in Scotland (all new mums-to-be there should be receiving them by the summer of 2017), and also in some other parts of the UK, including areas of Manchester, Birmingham, London and Liverpool.

But it may be some time before they become a UK staple – if they ever do.

So, what’s in a Finnish baby box?

The content of the original Finnish box is reportedly updated every year. As in the photo above, the boxes contain an array of baby clothing, shoes and bibs, a mattress, nappies, toiletries and bath essentials for mum and baby, a sleeping bag, a quilt, a popular children’s book and the bed box.

And what’s in the NHS baby boxes?

The baby boxes being given out in Manchester, Liverpool, Birmingham and Hackney were created by a company called Baby Box Co. Their boxes contain...

Newborn mattress and a waterproof cover
100% cotton sheet
Nappies
Organic wash and burping cloth
Onesie
Baby socks and hats
Organic wooden teether
Axillary thermometer
Baby wipes
Organic baby bodywash and shampoo
Baby Box University membership card – online advice service
Tips for baby brain development

The Scottish baby boxes contain...

Mattress
Fitted cot sheets
Satin-edged cellular blanket
Mattress protector
Pramsuit with hood
All-in-one day suit
Romper and bodysuit set
Scratch mittens
Short-sleeved bodysuit
Long-sleeved bodysuit
Long-sleeved bodysuit with integral scratch mittens
Long-sleeved wraparound bodysuit
Footed leggings
Fleece jacket with hood
Jersey trousers
Baby wrap
Hooded bath towel
Real nappy and liners
Digital ear thermometer and replacement hygiene cover
Natural bath sponge
Bath and room baby thermometer and battery
Dribbler bib
Organic cotton muslin squares
Comforter/soother toy
Playmat
Travel changing mat
Baby book
Nursing pads

How can you get a baby box?

If you're not in the areas where boxes are given out or where there is a trial, you can buy a baby box from companies such a Ekatot or Baby Box Co but they’re not cheap – starting at about £50 There are 5 different boxes, with the most basic starting at £52.07 and the most expensive costing over £250. The more expensive ones tend to contain loads of extra clothes, as well as toys, bibs, and even condoms!

So can baby boxes really reduce the risk of cot death?

No more than any other baby bed such as a crib, cot or Moses basket.

What's with all the claims then? Well, they come from the fact that the infant mortality rate in Finland fell significantly following the introduction of baby boxes in the 1930s.

The Statistics Finland graph below shows a clear decrease in the number of infant deaths from the late 1930s (when the boxes were first introduced) until 2000s.

However, the term ‘infant mortality’ covers many different causes of death – not just cot death – and there are many factors that may play into this statistic.

For a start, Finland was a poor country in the 30s, and the national health insurance system wasn’t fully established until the 60s. The boxes were initially introduced to low-income families in 1938, and became available to all from 1949.

But perhaps more significantly, Finnish babies used to co-sleep with their parents, often for financial reasons.

"Babies used to sleep in the same bed as their parents and it was recommended that they stop," Panu Pulma, professor in Finnish and Nordic History at the University of Helsinki told the BBC back in 2013.

"Including the box as a bed meant people started to let their babies sleep separately from them."

By providing a new place for babies to sleep, the Finnish baby box initiative drastically reduced the number of co-sleeping families.

So could the cot death risk reduction be linked to less co-sleeping?

We know that co-sleeping is considered a major risk when it comes to cot death. So we asked SIDS charity The Lullaby Trust what they thought of the baby boxes and its safety claims.

"We are concerned about claims that these cardboard boxes are being promoted as a product parents can use to help reduce the risk of Sudden Infant Death Syndrome," a spokespersons for the Lullaby Trust said.

"We acknowledge that for some parents, who do not have an enclosed space for their baby to sleep such as a cot or Moses basket, a box may be a better alternative... However, based on the evidence currently available, we do not not believe it is factually correct to directly link the use of a baby box with a reduction in infant mortality or SIDS."

Furthermore, the Lullaby Trust has raised concerns about the safety standards for baby boxes, pointing out that, while many of the boxes are no doubt completely safe, there is no official safety standard all baby boxes must reach.

"It is not possible," the charity says, "for baby boxes to fully comply with safety standards, as current British and EU safety standards for nursery furniture only exist for traditional cots cribs and bassinets and there is currently no specific standard for the use of a cardboard box as a sleeping place for an infant.

Too long, didn’t read? In summary…

Overall, baby boxes are a nice idea. The well-made ones offer a safe sleeping space and come with some lovely and useful items. But don't worry if you aren't offered one: they're no more safe than a traditional crib, cot or Moses basket would be.

Read more:

Elizabeth Atkin

Wait – what’s a baby box?