Finnish Baby Boxes Come to the US

It turns out that much like cats, babies love boxes — but for different reasons: they could save lives.

Since the 1930s, Finland has issued “baby boxes” to expecting parents, a measure some say helped improve infant death statistics. Now, several US states will join the party. Ohio, New Jersey and Alabama are all exploring state programs that borrow many ideas from Finland.

But before you get too excited, some context is in order — starting with what, exactly, a baby box is. After all, it’s not just a cardboard box.

The box is lined with a mattress, designed to serve as a crib in the first few months of life. It also comes stuffed with new baby supplies like diapers, with the goal of providing parents with the tools they need for success. In Finland, and some state pilot programs, the boxes — or a cash grant — are provided to all new parents, regardless of class. The initiative aims to reduce stigma, so parents don’t feel singled out.

You may have heard that baby boxes reduce infant mortality by providing infants with a safe place to sleep, but the story is more complex than that. In low-income households where parents can’t afford a crib, a safe place to sleep may reduce the risk of sudden infant death syndrome. But the real benefit of the baby box isn’t the box.

In Finland, baby boxes were rolled out alongside universal prenatal care and other measures designed to promote infant and parental wellness. Infant mortality rates began to drop with the advent of boxes, but the change might not have been related to where babies slept.

Instead, the kind of care they received was likely more important. For instance, parents could participate in early intervention programs and access well-baby exams and other resources after giving birth.

In the United States, similar initiatives will accompany baby boxes. Some states require parents to watch a parenting video or take a class to get a box. These programs provide vital information, especially to first-time parents. Advocates hope that the allure of a baby box will encourage parents to take advantage of these educational resources — something that, in turn, could work to reduce infant mortality and give parents more confidence.

Pilot programs show that baby boxes paired with education could make a difference, though they don’t replace prenatal care and support. Many low-income parents still struggle to access important resources that are free or low-cost in countries like Finland, where the government has made a concerted effort to improve outcomes for parents and children.

As for those sleep recommendations that come with every baby box, the American Academy of Pediatrics says that parents can make their babies safer from SIDS in the first few months of life by:

• Putting babies to sleep on their backs
• Using a firm mattress with a close-fitting sheet
• Keeping the crib bare, with no soft bedding, pillows, or toys
• Sleeping in the same room — but not the same bed — as the baby
• Encouraging skin-to-skin contact
• Breastfeeding, if possible