Finnish-style baby boxes are NOT safer than cots

Finnish-style cardboard baby boxes are NOT safer than cots: Scientists warn there’s no evidence they slash the risk of sudden infant death

  • Experts state baby boxes should not be promoted as safer sleeping spaces
  • They should only be used as a ‘temporary substitute’ when are all that is available
  • Have routinely been given to every expectant mother in Finland since the 1930s
  • Provided to all babies in Scotland; piloted in certain NHS England Trusts 
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Finnish-style baby boxes are being promoted as a safe alternative to cots, bassinets and Moses baskets without any evidence, experts warned today.

Cardboard baby boxes have routinely been given to every expectant mother in the Scandinavian country since the 1930s.

They are provided for all new babies in Scotland and are being piloted in certain NHS trusts in England but not in Wales or Northern Ireland.

But in a letter to the British Medical Journal, researchers have warned they should only be used as a ‘temporary substitute’ if nothing else is available. 


Finnish-style baby boxes are being promoted as a safe alternative to cots, bassinets and Moses baskets without any evidence they actually reduce cot death, experts warned today (stock)

The cardboard boxes come with a mattress that fits into the bottom of the box and are said by some to cut cot deaths.

Professor Peter Blair, from Bristol University, and his colleagues argue there is no evidence these boxes reduce cot death.

Rates of sudden infant death syndrome (SIDS), as it is also known, are low in Finland.

However, rates are similarly low in countries that neighbour Finland, such as Sweden and Denmark, where boxes are not given out. 

Professor Blair also questioned how safe the boxes really are.

They pointed out the bars and raised surfaces of cots means babies can be easily seen by their parents.

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While the low sides of bassinets and Moses baskets facilitate air flow, unlike the cardboard boxes, which have high, opaque sides.

Parents can therefore only see their babies if they look directly over the box, the scientists wrote.

Other potential hazards include the lids that baby boxes come with, as well as them potentially being flammable.

WHAT ARE CARDBOARD BABY BOXES? 

The concept originates from Finland, where new parents are given a cardboard box, which can be used as a bed, filled with baby products and a mattress.

The tradition has been cited as helping reduce the rate of sudden infant death syndrome (SIDS) – known as cot death – because of Finland’s low rates.

In Scotland, parents of all babies born after August 15 this year will be presented with the boxes despite concerns over the cost.

Included in them during the pilot scheme was a changing mat, a digital thermometer, a fleece jacket, several babygrows, a reusable nappy and liners, a baby book and an organic sponge. Cot sheets, a mattress and a blanket were also inside the boxes to give babies ‘the best start in life’.

The scheme is also being piloted in certain NHS trusts in England but not in Wales or Northern Ireland.

If placed on a floor, babies are also susceptible to low-level draughts, pets and young siblings. And if placed at a height, the box may fall.

There is also no data on how durable the boxes are, particularly when wet or old, the scientists add.

They are also often too small for most babies older than three months old, according to Professor Blair and his colleagues.

‘We support any initiative that raises awareness of SIDS, including appropriate SIDS risk reduction advice distributed with cardboard baby boxes,’ the authors wrote. 

‘But this advice can be undermined if the messages given are incorrect or mixed with non-evidence based messages about the intervention itself.’

‘Population-wide initiatives should have to meet high standards of safety and efficacy and should be subject to rigorous evaluation before implementation.’

They said this is ‘because the potential to cause inadvertent and unintended harm is much greater than for those that target a selected population’.

The researchers are calling for high quality studies ‘to better understand how families use the cardboard baby box and its safety implications’. 

It comes after the Royal College of Midwives urged for all new mothers in the UK to be given Finnish-style baby boxes for their newborns to sleep in last August.

The RCM argues giving out Finnish baby boxes would particularly reduce cot death in deprived areas, where it tends to be higher.

This is due to such babies often not having a cot and therefore nodding off on sofas or in their parents’ bed, which raises their risk of suffocation. 

Cot death kills around 300 babies in the UK and 3,500 in the US every year. 

WHAT IS COT DEATH AND HOW CAN IT BE PREVENTED?

Sudden infant death syndrome (SIDS), or cot death, is the sudden, unexpected and unexplained death of an apparently healthy baby.

SIDS kills around 3,500 babies in the US and just under 300 in the UK every year.

It usually occurs within the first six months of an infant’s life and is more common in those born prematurely or of a low birth weight.

The cause of SIDS is unknown, however, it is associated with tobacco smoke, tangled bedding, co-sleeping with parents and breathing obstructions.

Prevent the risk by:

  • Placing sleeping babies on their backs
  • Keeping babies’ heads uncovered
  • Sleeping in the same room as babies for the first six months of their lives
  • Using a firm, flat, waterproof mattress in babies’ cribs
  • Breastfeeding, if possible 

Do not:

  • Smoke during pregnancy or in the same room as a baby
  • Sleep on a bed or chair with an infant
  • Allow babies to get too hot or cold. Temperatures between 16 and 20C should be comfortable 

Source: NHS Choices 

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