Experts raise safety concerns about cardboard baby boxes

October 17, 2018

Cardboard baby boxes are being promoted for infant sleep as a safe alternative to more traditional cots, bassinets, or Moses baskets, without any evidence in place, warn experts in The BMJ today.

In a letter to the journal, Professor Peter Blair at the University of Bristol and colleagues argue that, without supporting evidence, "the cardboard baby box should not be promoted as a safe sleeping space, but as only a temporary substitute if nothing else is available."

They call for high quality studies "to better understand how families use the cardboard baby box and its safety implications."

In Finland, cardboard baby boxes have routinely been given to every expectant mother since the 1930s. They come with a mattress that fits into the bottom of the box, and are said by some to have helped cut cot deaths (SIDS).

Boxes are now being given out free to new mothers in some parts of the UK.

But Blair and colleagues argue that there is no evidence that these boxes reduce cot deaths (SIDS rates are equally low in neighbouring countries, such as Sweden and Denmark, where boxes are not provided), and they question whether they meet safety standard regulations.

They point out that cots (with their bars and raised surface) and bassinets or Moses baskets (with low sides) allow infants to be easily seen by parents and may also facilitate air flow, whereas the cardboard box (with its higher opaque sides) does not - carers can see the infant only if they are looking from directly over the box to make sure their child is safe.

The cardboard baby box has other potential problems, they say. For example, some of the boxes come with lids, are potentially flammable (especially if not laminated), and if placed on a floor are susceptible to low level draughts, domestic pets, and young siblings.

If placed at a height, the box may fall, and no data exist on the durability of the box (especially if it becomes wet or dirty), they add.

Furthermore, they are too small to be used for most babies older than 3 months old, and are not designed to be brought into their parents' bed at night, so offer no better alternative to bed sharing than the cot, bassinet, or Moses basket.

"We support any initiative that raises awareness of SIDS, including appropriate SIDS risk reduction advice distributed with cardboard baby boxes," write the authors. "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, because the potential to cause inadvertent and unintended harm is much greater than for those that target a selected population," they conclude.
-end-
Externally peer-reviewed? Yes
Type of evidence: Opinion
Subjects: Babies

BMJ

Related Sids Articles from Brightsurf:

Combined prenatal smoking and drinking greatly increases SIDS risk
Children born to mothers who both drank and smoked beyond the first trimester of pregnancy have a 12-fold increased risk for Sudden Infant Death Syndrome (SIDS) compared to those unexposed or only exposed in the first trimester of pregnancy, according to a new study supported by the National Institutes of Health.

New genetic link found for some forms of SIDS
Some forms of sudden infant death syndrome stem from a genetic mutation that keeps infants from processing lipids in milk, a new study has discovered.

Researchers point to a common cause in sudden death syndromes
Sudden Infant Death Syndrome (SIDS) and Sudden Unexpected Death in Epilepsy (SUDEP) are syndromes that share many medical similarities but whose physiological causes are poorly understood.

Serotonin neurons contribute to fail-safe mechanism that ensures recovery from interrupted breathing
Research in mice adds to evidence that dips in the activity of serotonin neurons may increase SIDS risk.

Experts raise safety concerns about cardboard baby boxes
Cardboard baby boxes are being promoted for infant sleep as a safe alternative to more traditional cots, bassinets, or Moses baskets, without any evidence in place, warn experts in The BMJ today.

New link between sleep arousals and body temperature may also be connected to SIDS
What is the origin of these arousals? Scientists from Bar-Ilan University in Israel, together with colleagues from Boston University, have discovered that brief arousals are probably triggered by the intrinsic electrical noise from wake-promoting neurons (WPN) in the brain.

Genetic heart diseases cause fewer SIDS deaths than previously thought, study finds
Genetic mutations linked to heart disease have been considered a leading cause of sudden infant death syndrome, but a new study by Mayo Clinic, British and Danish researchers finds they are to blame for far fewer SIDS deaths than previously thought.

Breastfeeding for two months halves risk of SIDS, study finds
Breastfeeding for at least two months cuts a baby's risk of Sudden Infant Death Syndrome almost in half, a sweeping new international study has found.

Now we know why babies shouldn't sleep face down
A developmental abnormality in babies -- especially in premature babies and in boys -- has for the first time been directly linked to cases of sudden infant death syndrome (SIDS).

SIDS research confirms changes in babies' brain chemistry
University of Adelaide researchers have confirmed that abnormalities in a common brain chemical are linked to sudden infant death syndrome (SIDS).

Read More: Sids News and Sids Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.