What are "baby boxes" and do they work?

Research Summary
Alexander Nguyen
Research Assistant

Cardboard boxes have many uses such as storing materials, giving away presents, and surprisingly as beds for infants. These “Baby Boxes” started in Finland, a country with a much lower infant mortality rate than the United States. In an attempt to reduce sleep-related infant deaths in the U.S., some hospitals have begun to give away baby boxes, which include a fitted mattress, sheets, and other baby products.

A study done by researchers at Temple University suggests that baby boxes may reduce the risk of Sudden Infant Death Syndrome (SIDS) and “other unexpected sleep-related deaths” by decreasing high risk behaviors, such as bed sharing between parents and infants. This is not done by the box alone, but rather by the combination of the box and in-person education on safe infant sleep.

According to the New York Times, the excitement surrounding baby boxes has some doctors worried. While the Baby Box Company has independently tested the safety of their product, baby boxes are not regulated by the Consumer Product Safety Commission (CPSC). One skeptic argues that it is not safe to assume that because this program works in Finland, that it will work in a much larger country like the U.S.  Others believe that it is not about the box at all. According to the NYT, a researcher at Kela, a company focusing on maternity packages in Finland, found that only 37% of parents in Finland actually use the boxes as beds for their infants. One doctor suggests the lower infant mortality rate is due to Finland’s health care system that offers free, high quality maternal and child health care services. Another doctor argues that the low mortality rate in Finland is due to lower rates of preterm birth, the most common cause of infant death in the U.S. This implies that the box may have little impact on overall infant mortality rate in the U.S.

While the results of the Temple University baby box study are intriguing, much more research is needed. In the meantime, check out this article from NPR on the American Academy of Pediatrics’ guidelines on safe infant sleep and how these guidelines may not always agree with what parents feel is best.