Baby Boxes: Gifts Intended to Educate New Parents About Safe Sleeping

A Gift for Every New N.J. Parent

When I had my first child in New Jersey more than a decade ago, the hospital sent me home with a bag of product samples, including a few diapers, a package of wipes, two cans of formula, and an assortment of coupons. These items were helpful to varying extents—I was breastfeeding and unlikely to buy the products featured on the coupons, but the wipes and diapers certainly came in handy. So did the little hat a nurse put on my son’s head soon after birth. With its horizontal pink and blue stripes, this soft beanie that actually stayed in place was ever present during his first few weeks. It was the most useful and well-loved relic of our hospital stay.

The parents of infants in New Jersey are now given an even more practical item, one that also has the potential to reduce infant mortality rates: a baby box. This laminated, nontoxic cardboard box is packed with items that are essential during the early days of parenthood—including diapers, wipes, clothing, and breast pads—but it’s also a bed. The box, which includes a mattress and sheet, provides a safe place for infants to sleep during their first year. It’s free to all new and expectant parents in the state who watch a 20-minute educational video and take a quiz online. Upon completion, they receive a certificate that allows them to pick up the box at a local distribution center or order it by mail.

Motive: Educating New Parents About Safe Sleeping Practices

The educational component is at the heart of the program, which was instituted by the state’s Child Fatality and Near Fatality Review Board after its 2016 report revealed that about 93% (57 of 61) of infant deaths in New Jersey attributed to sudden unexpected infant death syndrome (SUIDS) were related to sleep and the sleep environment. By teaching parents safe infant sleep practices—specifically, the importance of putting babies to sleep on their backs, using a firm mattress covered by a fitted sheet, and not allowing co-sleeping or any loose items to surround the child while sleeping—New Jersey officials hope to lower the state’s infant mortality rate, which is already among the lowest in the country.

The program is expected to distribute more than 100,000 baby boxes in the next year and is funded by a grant from the Centers for Disease Control and Prevention. The Baby Box Co., which has partnered with New Jersey on this initiative, makes the boxes and administers the online parent education program and quiz at

Lessons on Reducing Infant Mortality from Finland

The New Jersey program is rooted in a Finnish tradition that dates back to the 1930s, when approximately one in 10 infants died in that country. In Finland, the baby box program began as a way to ensure that that women received care early in pregnancy (a requirement of receiving the box) and all children, no matter their parents’ economic means, had a safe place to sleep. Since then, receiving the baby box has become a beloved tradition, and although the contents of the box have changed over the years—the government “maternity gift” now includes onesies, a sleeping bag or sack, diapers, samples of infant care products, and outdoor clothing—the goal is the same: to provide all Finnish children a safe start. According to a 2015 UN Inter-agency Group for Child Mortality Estimation report, Finland now has one of the world’s lowest infant mortality rates—about two per 1,000 births—whereas the U.S. rate is about three times higher.

The use of baby boxes has been adopted by other countries, and hospitals in the United States, such as University Health System in San Antonio and Temple University Hospital in Philadelphia, have initiated pilot programs in the past year. The maternity nurses and pediatricians at Temple initiated their safe sleep education and baby box program last May. About 3,000 baby boxes have since been given to the mothers of infants born at the hospital, which serves the North Philadelphia area, where infant mortality rates are particularly high. Funded by grants, donations, and the hospital, the program was one of the largest in the country until New Jersey began its universal baby box initiative in January.

I have to admit, I’m a little envious that I missed out on this baby box tradition. Every new parent needs a safe, portable place to put down an infant, either to sleep or just for a moment. Plus, the efficiency is appealing: after the baby outgrows the box, it can be used for younger siblings, or to store all those baby mementos, like little pink-and-blue-striped hats.

2017-07-27T11:45:04+00:00 February 24th, 2017|Nursing, Public health|1 Comment

About the Author:

AJN senior editor.

One Comment

  1. Krizia November 28, 2017 at 11:36 pm

    I have found this topic very intriguing. I did not know that a program like this had been implemented. I share a similar experience when I had my first child and felt as a new mother not much education or resources were provided. Even though the baby box was developed to help reduce the number of sudden unexpected infant death syndrome (SUIDS) cases, I am not sure culturally if the box would be used for that purpose. Some new parents may be reluctant of placing their baby in a box, especially if they are able to purchase a bassinet. But the most important thing is that education and awareness is provided to all expecting mothers and their families. The incentives of watching educational material with a quiz, to receive a free box of baby products and clothes, is a great way to reach out to the community. In addition, I believe the box would be most beneficial to mothers of lower socioeconomic status, new and/ or young mothers. Unfortunately, this program is only offered in a few states and in my state, it is offered only in one county. I hope that in the future the baby box will be available nationwide.

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