Cot death charity raises concerns over baby box safety

Fears have been raised about the safety of cardboard boxes given to new parents for their babies to sleep in.

Leading Sudden Infant Death (SIDs) charity the Lullaby Trust has withdrawn its leaflets from being given to new parents with the boxes. It said it had concerns the boxes were being marketed as a product that reduces SIDs.

The charity said there was no evidence the boxes would reduce infant mortality and went on to question the safety standards of the boxes. It advises parents not to use the box for overnight sleep and instead use a Moses basket or cot.

The NHS in Scotland and some other NHS trusts give the cardboard boxes, including a mattress and other newborn products, to new parents.

There are also several companies that sell the boxes with clothes and other baby goods as gifts for new mums.

The NHS scheme was inspired by a similar project in Finland, which has one of the lowest infant mortality rates in the world.

Francine Bates, chief executive of The Lullaby Trust, said: “We support all efforts to promote safer sleep for babies, however we do have concerns about the baby boxes being marketed as products which will reduce infant mortality and SIDS.

“We are not aware of any evidence, including in Finland, to support this claim.

“If parents choose to use the box to sleep their baby, we urge them to read and follow our advice, approved by our scientific and paediatric advisers.”

The Trust said it is not possible for the baby boxes to fully comply with safety standards because British and EU safety standards for nursery furniture only exist for traditional cots cribs and bassinets and there is currently no specific standard for the use of a cardboard box as a sleeping place for an infant.

The charity added: “We acknowledge that for some parents, who do not have an enclosed space for their baby to sleep such as a cot or Moses basket, a box may be a better alternative than co-sleeping with a baby in hazardous circumstances, such as on a sofa. However, based on the evidence currently available, we do not not believe it is factually correct to directly link the use of a baby box with a reduction in infant mortality or SIDS.”

The charity also raised concerns about the safety of the mattresses given with the boxes.

Parents who have been given a baby box by a professional have been urged to “ensure that boxes and mattresses supplied to parents comply as fully as possible with British and European Standards and our UK fire regulations”.

There were 212 unexplained infant deaths  in England and Wales in 2014, a rate of 0.30 deaths per 1,000 live births. This follows the decreasing trend that has generally been seen over the last decade from 0.5 in 2005.

In guidance to parents who have a baby box, the Lullaby Trust said:

  • Be aware that there is no direct evidence that the use of a baby box will reduce SIDS or lower infant mortality (despite use in some countries like Finland)
  • Be aware that some boxes may be of a higher quality than others
    Be aware that there is no safety standard in existence anywhere in the world that specifically applies to a baby box as a sleeping place for a baby
  • Be aware that some manufacturers state that their boxes meet European Union 1130 standard for cots, cribs and bassinets. While some elements of a cardboard box may comply with this standard, for example, wood material, structure and smooth edges, remember that EU 1130 is a furniture standard  for traditional cots, cribs and bassinets.
  • Ensure that the mattress and mattress filling meets the British Standard 7177 and the 1988 UK fire regulations as amended. The mattress should also meet the British Standard 1877 and this should be clearly and permanently labelled on the mattress.
  • Remember that, according to current research and available evidence, we still recommend that a cot or Moses basket is the safest place to sleep a baby.
  • 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
  • Always keep the box clear as a sleeping space
  • 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
  • Ensure that any pets stay away from the box
  • 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

For more information on safer sleep guidance visit the Lullaby Trust.

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