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Experts aren't convinced cardboard baby boxes are safe

Concerns have been raised about the safety of cardboard baby boxes [Photo: Getty]
Concerns have been raised about the safety of cardboard baby boxes [Photo: Getty]

Cardboard baby boxes should not be promoted as a safe alternative to a cot or Moses basket, leading cot death experts have warned.

Baby boxes first originated in Finland, where pregnant women have traditionally been given a cardboard box full of useful baby items including a mattress which fits inside the bottom of the box so it doubles up as a bed for newborns.

The boxes have often been cited as a contributing factor to the country’s extremely low infant mortality rates (two deaths per 1,000 live births, compared to 32 per 1,000 globally).

And recently the boxes have become increasingly popular in the UK, with many NHS trusts offering the boxes to new parents and private companies also offering the service.

In 2016, Scotland also announced their intention to provide parents with free baby boxes.

But experts have now raised concerns over the “scarcity” of observational evidence that the boxes can be used safely as places for newborns to sleep.

A letter published in medical research journal The BMJ says there is actually very little evidence that the boxes help reduce cot deaths or meet safety regulations

Instead Prof Peter Blair from Bristol University and other experts, including experts from the Lullaby Trust, recommend that the boxes should only be used as a temporary bed if nothing else is available.

The authors also explained that the boxes could potentially be much more dangerous as they can be flammable and easily accessed by pets and siblings.

Plus when compared with cots, bassinets and Moses baskets, it is harder for parents to see their babies easily when they are sleeping in them.

The experts also warned that the boxes are too small for most babies older than three months and there is no evidence on how durable they are, particularly if they become wet or dirty.

The authors also expressed concern over the “lack of safety standard regulation in place” surrounding the boxes and fears that promotion of the items could undermine current messages about sleeping safety for babies.

“Without supporting evidence, the cardboard baby box should not be promoted as a comparable alternative to cots, bassinets, or Moses baskets, but as only a temporary substitute if nothing else is available – if the device meets accepted safety standards,” the letter concluded.

“We encourage rigorous controlled studies to better understand how families use the cardboard baby box and its safety implications.”

This isn’t the first time Dr Peter Blair has raised concerns over the boxes.

Earlier this year, the specialist in medical statistics at Bristol University, revealed his concerns in a detailed memo to the Scottish government in which he claimed there was no evidence that the boxes were safe or reduced cot death, Sudden Infant Death Syndrome (SIDS).

He suggested that the risks to a baby’s health could come from the boxes’ relatively high sides, which meant parents could only see their child if they stood directly over the box.

And last year, a cot death charity also raised doubts about the benefits of the boxes.

Issuing new advice to parents, The Lullaby Trust said there was no evidence baby boxes reduced the rate of SIDS.

The charity is concerned that the boxes are being promoted as a product, which could help reduce the risk of SIDS, of which they said there is no evidence.

Despite their concerns, The Lullaby Trust provided some advice to parents who do plan on using one of the baby boxes.

The advice, which is posted on the charity’s website, includes some of the below:-

  • Use your baby box for daytime naps only and sleep your baby in a cot or a Moses basket next to your bed during the night

  • Do not lift or carry the box around your home if your baby is in it

  • Do not put the lid on the box if your baby is in it

  • Do not place additional bedding on top of the mattress to raise your baby up to a higher level

  • Ensure the box is placed on a solid surface and cannot topple over

  • Do not use the box if it gets wet or soiled

  • Do not put a box on an under heated floor

  • Do not leave the baby in the box unattended or out of view

  • Do not use the box once your baby is able to roll

  • Ensure that you comply with any instructions relating to the maximum age and weight of the infant for which the box can be used.

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