Experts raise doubts over baby box safety

Baby in box

Finnish-style cardboard baby boxes given to parents in Scotland and some parts of England could be unsafe to sleep in, experts warn.

Concerns have been raised that baby boxes may not be safe to sleep in, despite health professionals claiming them to be a safe alternative to cots, bassinets and Moses baskets. Experts are warning that the boxes should be used as a temporary bed only if nothing else is available, and are calling for more high-quality studies to help us understand the safety implications.

What are baby boxes?

The cardboard boxes, which have been given to every mother-to-be in Finland since 1930s, are currently offered to new mums in Scotland and some parts of England. The Royal College of Midwives (RCM) had endorsed the scheme, saying it increases the chances of babies sleeping safely and calling for it to be rolled out across all regions of the UK. They consider the boxes, which come with a mattress, clothes, blankets and other baby items, to offer a “more equal start to life”.

The RCM says that baby boxes reduce the risks associated with bed-sharing, as research has shown that babies who sleep on soft or unsafe surfaces, or share sleeping surfaces with parents who smoke, drink, or take drugs, are at a greater risk of cot death or sudden infant death syndrome (SIDS). These risks are proven to be higher in more deprived areas, with more incidents of SIDS occurring in disadvantaged communities.

What are the safety concerns surrounding baby boxes?

This endorsement has been criticised by several experts and leading cot death charity, The Lullaby Trust. They have said that although the boxes might be safer than the sofa, they did not conform to British safety standards because none had been drawn up for them.

It has been found that it is harder for parents to see their babies when they are sleeping in a baby box, compared with cots, bassinets and Moses baskets.

Some boxes may also be flammable or leave babies vulnerable to harm from pets or other small children if placed on the floor. They may not very durable – especially if they become wet – and are generally not easy to clean.

The boxes are also too small for the majority of babies over three months old. There is a risk that parents will continue using the box beyond this point, leaving the baby vulnerable to discomfort, injury or cot death.

Responding to the criticism of their support for the baby boxes scheme, the Royal College of Midwives pointed out that its position statement on baby boxes did acknowledge that there was little evidence around them reducing SIDS.

It said that baby boxes need to be safe, of high quality and the box and mattress should meet at least the minimum UK safety standards.

How to reduce the risk of sudden infant death syndrome (SIDS)

  • Place your baby on their back to sleep, in a cot in the same room as you, for the first six months.
  • Don't smoke during pregnancy or breastfeeding, and don't let anyone smoke in the same room as your baby.
  • Don't share a bed with your baby if you have been drinking alcohol, if you take drugs, or you're a smoker.
  • Never sleep with your baby on a sofa or armchair.
  • Don't let your baby get too hot or cold.
  • Keep your baby's head uncovered. Their blanket should be tucked in no higher than their shoulders.
  • Place your baby in the 'feet to foot' position, with their feet at the end of the cot or Moses basket.

Read more on reducing the risk of sudden infant death sydrome.