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The baby box could be the key to safe sleeping for infants, according to some health experts. A cardboard box with a flat mattress inside To a mom like Stephanie Goldberg of Needham, the box looks pretty basic.
“I mean, it seems very rudimentary and little archaic, but sometimes the simplest things work the best, and as long as it’s safe, I think its great,” Goldberg said.
Baby boxes originated outside of the United States, according to Dr. Greg Hagan, chief of pediatrics at the Cambridge Health Alliance.
“It was about 50 years ago that [their] introduction in Finland was associated with a decrease in what we call sudden unexplained infant death. That’s a very interesting and compelling story,” Hagan said.
Sudden unexplained infant death syndrome, formerly known as sudden infant death syndrome, is the leading cause of death in babies from one month to one year old, according to the National Institutes of Health. Most deaths occur in the first four months. The known causes vary and include suffocation and being trapped, for example, between a mattress and a wall. Others are unexplained.
Hagan, former president of the Massachusetts Chapter of the American Academy of Pediatrics, believes it takes more than a compelling story to convince him and other skeptics in American medicine that these boxes prevent sudden unexplained infant death.
“There may well have been other things about that experience during that period in Finland that could have contributed to that decrease in sudden unexplained infant death,” Hagan said. “So there is an association between the introduction of the baby boxes and an improvement in that measure, but it’s not at all clear that they’re related causally.”
Hagan stated no studies have been done that prove the boxes' effectiveness.
The lack of hard evidence has not stopped Donna Sherrill, director of maternal child health and surgical services at Winchester Hospital.
“Even without the evidence, I’m a firm believer in offering people different alternatives to help them meet their needs,” Sherrill said.
Sherrill has been handing out the boxes since last summer. The program, she said, came as a response to an uptick in sudden unexplained infant deaths among Winchester Hospital's patients.
Since July 2017, Sherrill has given away 200 baby boxes, which cost about $80 apiece. She has been able to do that with in-kind donations to the hospital.
“I knew that we wanted to give our parents something more, not to replace their sleep environment that they already have,” Sherrill said, “but something that might help when a baby’s taken into a bed because it’s the only room that’s air conditioned. Parents wake up [and] they’ve rolled over on the baby.”
Besides Winchester, Cape Cod Hospital in Hyannis and Falmouth Hospital have also been distributing free baby boxes since last year.
There are state-run baby box programs in Alabama and New Jersey. Massachusetts State Sen. Patrick O’Connor, a Republican from Weymouth, sponsored a bill for a pilot program through the Department of Public Health.
“We introduced a bill for this legislative session that is going to allow for safe sleeping environments for every child born in the Commonwealth of Massachusetts, by providing baby boxes for expecting mothers, expecting parents, expecting guardians,” O’Connor said.
O’Connor said he hopes the program will help gather more information on how parents use the boxes and whether they work. If the bill passes, the boxes would be distributed through hospitals, community health care centers and non-profit organizations. A manufacturer of the boxes, the Baby Box Company in Los Angeles, would cover the cost.
“The infant mortality rate in Mass. is 4.4 for every thousand births,” O’Connor said.
That’s lower than the nationwide average of 5.8 per thousand births, but O’Connor believes the state's rate could be even lower.
“We’ve talked with individuals who question the infant mortality rate, but what we are saying is if we can do something that could lead to that rate going down, shouldn’t we do it?” O’Connor said.
O’Connor is not the only Massachusetts lawmaker sponsoring a baby box bill. State Rep. Diana DiZoglio, a Democrat from Methuen, has proposed the Department of Children and Families create a safe sleep program with online training and boxes.
Both bills have won the approval of a joint committee on families and are headed for a review before the Ways and Means Committee, which evaluates the financial impact of proposed legislation.
Correction: An earlier version of this story incorrectly stated which supplies might be provided with baby boxes if the proposals pending in the Legislature are enacted. The error has been removed.