WellSpan doctor helps write new safe sleep recommendations

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, 505-5439/@ritacambest8:33 a.m. EST November 21, 2016

Dr. Michael Goodstein is on a mission to end infant sleeping deaths.

You could say the WellSpan physician is more than passionate when it comes to preventing sudden unexpected infant deaths, specifically sudden infant death syndrome, or SIDS. The Centers for Disease Control and Prevention estimates sleep-related infant deaths kill thousands each year despite recommendations that could save lives.

The neonatologist wouldn’t disagree with you.

Sudden unexpected infant death includes all sleep-related infant deaths, including accidental suffocation, unknown deaths and SIDS, which is the sudden and unexplained death of a baby under the age of one year that remains unexplained after an autopsy, an examination of the scene of death and a review of the baby’s medical history.

Sleep-related infant deaths decreased drastically in the early ’90s after the American Academy of Pediatrics and other partners launched the Safe to Sleep education campaign, recommending babies sleep on their backs instead of their stomachs. However, after a 50 percent initial decrease, the number of babies dying from sleep-related deaths in the past decade has remained steady — around 3,500 a year — and the rates of accidental suffocation and strangulation in bed have increased 30 percent from 2000 to 2010.

“It’s a national tragedy, and we don’t talk about it,” Goodstein said. “That’s a really bad thing, because with education we could fix this.”

Recently, the WellSpan York Hospital doctor helped author new AAP recommendations. Babies must still be on their backs, but to decrease the risk of SIDS it also recommends breastfeeding, routine immunizations, using a pacifier and avoiding exposure to smoke, alcohol and illicit drugs.

“If mothers didn’t smoke when they were pregnant, a third of SIDS cases would disappear,” Goodstein said.

Recommendations for a safe sleep environment include positioning babies on their backs, using a firm sleep surface, room-sharing without bed-sharing and avoiding soft bedding and overheating.

Despite the recommendations, AAP researchers earlier this year found that 10 percent to 21 percent of babies examined were placed on a nonrecommended sleep surface, 14 to 33 percent were placed in nonrecommended positions, and 87 to 93 percent had potentially hazardous items, such as loose blankets or crib bumpers, on their sleep surfaces.

“People say ‘well that looks so sad,’ but all these cute things that make cribs look beautiful are a hazard to a baby’s environment,” Goodstein said.

He said the guidelines have to be updated every few years, whether significantly changed or not. The last update was done in 2011, but new research since then includes the positive effects of skin-to-skin care for newborn infants and the effects of using bedside and in-bed sleepers, sleeping on couches or armchairs and in sitting devices.

Though the sample size is too small to compare York County deaths year to year, Goodstein said 2015 was the worst year in recent memory for SIDS deaths in York with nine deaths recorded, up from a handful in 2014.

York Hospital, he said, is working hard to decrease sleep-related deaths with a hospitalwide campaign focusing on policy, training staff and education for every family that leaves delivery.

The hospital-based safe sleep education program includes viewing the “B’more for Healthy Babies” video, reinforcement of safe sleep information from nurses and a voluntary consent form signed by parents confirming they understand the importance and the receipt of safe-sleep information. Signs and photographs throughout the hospital show babies sleeping safely, alone in their cribs without extraneous blankets, just as the guidelines recommend.

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Talking with Children about Safe Sleep

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w to Talk to Children about Infant Sleep-Related Death

  1. What is infant sleep related death?

Sometimes babies die when they are sleeping. This does not happen to all babies, but it happens to some. They may die because where they were put to sleep was not as safe as it could have been.

  1. What does a safe sleeping environment look like?

It is easy to remember what to do to keep a baby safe while sleeping. Just remember your ABCs.

A is for Alone. Babies should always sleep alone. They should never be in bed with mom and dad, brother or sister, or with the family pet.

B is for Back. Back is best. Doctors have found that babies sleep safest on their back. Remember that babies should be put to sleep on their back at nap time and bed time.

And C is for Crib. A baby should sleep only in their crib, bassinet, or portable crib at naptime and bedtime.  The baby should never be placed in mom or dad’s bed, brother or sister’s bed, on a couch, or on an arm chair. These places are not safe because they are soft. Soft places are not good for a baby when sleeping because they may cover the baby’s face and make it hard for him or her to breathe. Like soft surfaces, a baby’s crib should not have any soft items such as, pillows, blankets, bumper pads, or stuffed animals, because they could cover the baby’s face and make it hard to breathe.

  1. Why is a safe sleeping environment important?

When babies die during naptime or bedtime they are often found in places that they should not be, or they are surrounded by items that should not be there. But if you remember the ABCs of Safe Sleep, you can be sure that your baby brother or sister is sleeping safely.

  1. Feelings about Death

When someone dies, everyone is sad. After someone you love dies you may feel sad, angry, confused, or afraid. It is okay to feel these emotions. There is no wrong way to miss someone.  It is always okay to cry because you miss your family member or friend. Remember, nothing that you have said or done caused him or her to die. You can always talk to your mom, dad, or another adult about your loved one when you feel sad, angry, confused, or afraid.



Why American Infant Mortality Rates Are So High

Explaining the numbers

The first nuance is one of definition. Infant mortality is defined as the death of babies under the age of one year, but some of the differences between countries can be explained by a difference in how we count. Is a baby born weighing less than a pound and after only 21 weeks’ gestation actually “born?” In some countries, the answer is no, and those births would be counted as stillbirths. In the United States, on the other hand, despite these premature babies’ relatively low odds of survival, they would be considered born—thus counting toward the country’s infant mortality rates.

These premature births are the biggest factor in explaining the United States’ high infant mortality rate. Pre-term births can have many different maternal causes, many of which—such as high blood pressure, diabetes, Zika and other infections and age—are not entirely within an expectant mother’s control. Other factors, such as stress level, might be able to be managed, but are not entirely controllable. On the other hand, some controllable risk factors include the use of tobacco, alcohol, cocaine and other drugs. The major issue of the lack of universal access to quality prenatal care should also be considered in any discussion of preterm births and infant mortality. Also, because about 50 percent of pregnancies in the United States are unplanned, some women might not be aware they are pregnant in time to get early prenatal care, and this may be part of the reason for premature births in this country.

Across all categories, larger, heavier babies and those at later gestational ages tend to have better survival rates. “Still, at any given gestational age, American physicians are just as capable—if not more so—as other health care professionals around the world at expertly caring for premature neonates,” said Mark Sicilio, MD, an assistant professor of pediatrics at the Texas A&M College of Medicine.

Infertility treatments, which often lead to twins or triplets (who have poorer survival rates, perhaps primarily because they are likelier to be premature), have also been blamed for infant mortality numbers.

Or perhaps the blame for infant deaths lies in some sort of pollutant, virus or other toxin causing birth defects? Although these may be factors, and a major Zika outbreak causing miscarriages and microcephaly wouldn’t help the United States’ numbers, these are not currently the primary documented causes either.

The widening gap

Generally, especially compared to the worldwide statistics, American babies have good survival rates in their first few weeks of life. It is only after they reach one month of age that differences between the United States and other developed countries start to widen.

Perhaps not surprisingly, babies born to wealthier and better educated parents in the United States tended to fare about as well as infants born in European countries. On the other hand, those babies born to mothers in the United States without these advantages were more likely to die than any other group, even similarly disadvantaged populations in the other countries.

This might be due in large part to the prevalence of unintentional injuries and sudden infant death syndrome (SIDS) among American babies. Many parents are still not following sleep recommendations to prevent SIDS. More than 20 percent of babies in the United States are still not being put on their backs—the safest position—to sleep.

“It is extremely important that parents put their babies to sleep safely, on their backs in a crib with a firm mattress and no blankets, stuffed animals or pillows,” Sicilio said. “Studies have also shown an increased risk of SIDS with bed-sharing, or even allowing the infant to fall asleep on a sofa or chair with an adult. Further, allowing infants to remain asleep in car seats or strollers after arriving at their destinations is also discouraged.”

There are racial and ethnic differences in infant mortality that might help explain the differences between the United States and Europe. For example, African American and American Indian/Alaska Native babies are at higher risk of SIDS than Caucasian, Hispanic or Asian American babies. As most other developed countries have a comparatively small population with African heritage (and very few people of American Indian descent) these statistics might also help explain the numbers. Still, they probably don’t tell the whole story.

“Much research has been done on other SIDS environmental risk and protective factors,” Sicilio said. “Using a pacifier, for example, seems to decrease the risk of SIDS, perhaps because sucking on it keeps part of the brain stimulated even during sleep.”

Benefits of home nurse visits

Social programs in many European countries that provide free home visits from nurses for new parents might help increase protective factors and decrease risky ones. The nurses can give the baby a checkup, but perhaps more importantly, they can provide advice for preventing SIDS and can inspect the home for possible hazards. Although some of these home-visit programs exist in the United States, they are not nearly as widespread as they are in other countries.

“We have considerable research evidence of the beneficial effects of home nurse visits for new moms, with special emphasis on the health benefits to their children,” said Lisako McKyer, PhD, associate dean for climate and diversity and associate professor at the Texas A&M School of Public Health. “For example, research reveals that infants in homes which experienced regular visits from nurses and similar paraprofessionals had better psychological outcomes for both mother and infant, which means lower health care costs over the course of their lives.”

Part of the answer for different mortality rates may also lie in differing breast-feeding rates. Some European countries, especially those in Central Europe, have higher rates of babies being exclusively breastfed for the first six months of their lives. “As the Academy of Pediatrics says, breast is best,” Sicilio emphasizes.

Home nurse visits may be beneficial here as well, as studies have shown that they are linked to higher breastfeeding rates. Home nurse visits also seem to be very important to the most vulnerable segments of society, including teen mothers and those coping with addiction or other problems. “Visits to the vulnerable were especially valuable,” McKyer said. “They help to ameliorate the effects of other stressors on new moms and their infants and tend to result in safer home environments for children.”

These safer homes translate to less money spent on treating sick and injured infants, which is especially important considering the cost of care for the rest of the baby’s life. “We can invest a few hundred dollars on the front-end during the first year of babies’ lives to save about $1 million over the course of each of their lifetimes,” McKyer added. “Home nurse visits are also linked to reductions in emergency room visits within the first 10 days of a baby’s life from jaundice and/or dehydration, compared to infants who did not receive home nurse visits.”

Moving forward

In the end, more research is needed to determine how these and other factors really do help explain differences in infant deaths between the United States and other developed countries. For example, could the more generous parental leave policies of Europe help save infants’ lives? Research seems to indicate that maternity leave does reduce infant mortality rates, but the exact mechanism is unclear. It is possible that at least part of the reason is a disproportionally high rate of SIDS cases in child care settings.

“Parental leave policies have tremendous influence on health outcomes for both mom and baby, as well as long-term economic impact,” McKyer said. “Studies show that in countries where there is a generous parental leave policy, there are tremendous effects on morbidity and mortality rates of infants and young children. They’re considerably less likely to get sick enough to require hospitalization or to die. Again, it’s investing on the front end so that we’re not paying on the back end.” This work leads to other questions about how we might be able to bring American infant mortality rates more in line with other developed counties.

“We need to close the infant mortality gap in the United States,” Sicilio said. “I believe we are equipped to do just that.”


Original Source: http://newswise.com/articles/why-american-infant-mortality-rates-are-so-high

About Texas A&M Health Science Center
Texas A&M Health Science Center is Transforming Health through innovative research, education and service in dentistry, medicine, nursing, pharmacy, public health and medical sciences. As an independent state agency and academic unit of Texas A&M University, the health science center serves the state through campuses in Bryan-College Station, Dallas, Temple, Houston, Round Rock, Kingsville, Corpus Christi and McAllen. Learn more at http://www.vitalrecord.tamhsc.eduor follow @TAMHSC on Twitter.

Bad advice on bed-sharing

Sept. 22, 2016

To the editor
: The risks of sharing your bed with your infant are not “imaginary,” contrary to the opinion expressed by Robert LeVine and Sarah LeVine.

An adult bed poses very real risks of sudden infant death syndrome (SIDS), unintentional suffocation, strangulation or entrapment to an infant. Sleep-related infant deaths claim more babies between 1 month and 1 year of age than any other cause.

( “It’s more than OK to sleep next to your infant,” Opinion, Sept. 18)

Multiple studies bear this out. That’s why the American Academy of Pediatrics advises against bed-sharing.

The safest place for an infant to sleep is in a separate crib or bassinet with a tight-fitting sheet and nothing else, preferably in the parents’ bedroom for up to a year.

Benard Dreyer, MD, Elk Grove Village, Ill.
The writer is president of the American Academy of Pediatrics.


To the editor: The opinion piece cites the work of James McKenna, who suggests that bed-sharing is not dangerous, but even beneficial.

This goes against official recommendations of the AAP, which have been comprehensively researched, and which recommend room-sharing, but not bed-sharing.

This article gives dangerous advice, which may increase the number of babies dying of SIDS, suffocation or asphyxiation.

Thomas G. Keens, MD, Los Angeles

The writer is chair of the California SIDS Advisory Council.


To the editor: As a pediatrician and public health professional, I am deeply troubled by this opinion piece.

The AAP and the National Institutes of Health offer expert guidance that bed-sharing is in fact a significant risk factor for accidental suffocation, sudden unexpected infant death (SUID) and SIDS.

I do not think this risk is adequately reflected in the opinion.

Aside from the risk of accidental layover by the parent, bed-sharing also introduces blankets and pillows, which further increases the risk of accidental infant suffocation.

Parents need to understand that this practice is not risk free.

It is also erroneous to equate the infant sleep environment in Japan (typically a firm mat or futon bedding) with the U.S. (fluffy mattresses, pillows and blankets).

David L. Nunez, MD
Seal Beach

The writer is the Maternal Child and Adolescent Health Medical Director, Orange County


To the editor: As a board-certified forensic pathologist and medical examiner practicing in Florida, I am dismayed by the op-ed advocating bed-sharing with infants.

I have performed multiple autopsies on infants who were co-sleeping with their parents or siblings.

Many times, these infants end up face down, wedged into soft bedding or the cushions of a couch, or between the mattress and the wall, just to name a few situations.

Rollovers can also be a cause of asphyxia.

The risks are not to be underestimated.

Kelly Devers, MD, Tampa, Fla.

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Your Favorite Nursing Pillow Could Be Deadly

When you use it wrong, it puts your baby at serious risk.

Many new moms use crescent nursing pillows to help support their baby during feedings. But a coroner from Pennsylvania has take a very public stance against the popular baby registry item, claiming they may be involved in several recent infant deaths.

Three babies, all under six months of age, have been pronounced dead from similar medical causes at Penn State Hershey Medical Center since January, and Graham Hetrick was the coroner on each case, PennLive reports. After autopsies and x-rays, he attributed each of the deaths to cerebral asphyxia, or lack of oxygen to the brain.

In a recent press conference, Hetrick said that parents of all the babies had been using the same type of pillow, similar to adults’ U-shaped neck travel pillows, in their cribs or bassinets, and the children may have been napping in them. Hetrick explained that using the nursing pillows for sleeping — which is completely incorrect — and leaving babies unsupervised is very dangerous.

“It is possible for the baby to move around enough that their shoulders slip down, and the head to be pushed toward the chest,” he said, which can lead to death in minutes. “If [the pillows] are used in the sleeping area, I would caution, when they are not being observed, that this could be a potential.”

Though he can’t say 100% that the deaths resulted from the pillows (and he declined to list any specific products), Hetrick noted, “I’m not a great believer in coincidence.”

The Boppy Company, the manufacturer of the most popular line of these kinds of pillows, promotes safe sleep practices on their website — and both the products and the website have repeated warnings  to “Remove all soft bedding, toys, and pillows from your baby’s sleep area. This includes all Boppy Pillows.”

Even without conclusive evidence, Hetrick is voicing a very important reminder. Your child may look cozy in the pillow, but it is not meant for sleeping.

Link to Original Article:  http://www.goodhousekeeping.com/health/a33752/nursing-pillows-linked-to-baby-deaths/

Why? Because There are Better Options than Cardboard Boxes


Graco Pack 'n Play meets CPSC Safety Standards

Graco Pack ‘n Play meets CPSC Safety Standards

At Cribs for Kids® National Infant Safe Sleep Initiative, our commitment to providing safe sleep environments to infants — UP TO ONE YEAR OF AGE — has been our focus since 1998.  For safe sleep, we have chosen to provide our partners and clients a Graco® Pack ‘n Play® portable playyard unit that is designed and manufactured specifically for our program, along with the Safe Sleep Survival Kit, which includes a Halo® SleepSack® wearable blanket, Philips Soothie pacifier, safe sleep educational DVD, Pack ‘n Play® assembly video, Charlie’s Kids Foundation “Sleep Baby Safe And Snug” book, and other educational materials about the ABCs of safe sleep, and room temperature and smoking around babies. We vetted other products and chose to use the Graco® Pack ‘n Play® due to its safety record, longevity of use, and low cost.  We have elected not to use the Baby Box unit for our infant safe sleep initiative based on the following safety concerns and quality comparisons:


Below are product safety warnings offered by a company that is recommending cardboard boxes for babies, followed by Cribs for Kids’ responses concerning potential hazards that could occur if a parent  uses a cardboard box as a temporary sleeping environment.  A primary safety concern is that babies will outgrow the cardboard box between two and four months of age, which is the age range during which a majority of babies are dying from accidental, sleep-related death and sudden unexpected infant death. (See CDC graph-Length-for-age and Weight-for-age percentiles). When the baby outgrows the box, it will most likely end up in bed with the parent(s) or on another unsafe surface. (See #2. Longevity below) )We advise to use the cardboard box unit at your own risk.

Below, in red, are a cardboard box company’s warnings for their unit followed by Cribs for Kids’ responses:

“Always keep the cardboard box on the floor or on a sturdy wide surface such as a coffee table. Setting a cardboard box on a narrow and/or [unsturdy] surface presents a falling hazard.”

C4K Recommends:  A box placed on the floor can be a dangerous place for a baby to sleep. Items can fall into the box, injuring or covering the baby; young siblings and pets could have easy access inside the box; and unintentional injury can occur if an adult would accidentally trip over, or step into the box. Recently, a baby died when the owner’s pet attacked him while in a make-shift bed on the floor, said to be a laundry basket. The baby’s mother was sleeping near him on the couch.  “[A] coroner plans to rule the death of a three-day-old baby boy in Youngstown, Ohio, as accidental. The newborn, identified as Aiden Grim, died after he was bitten on the head by one of his family’s five dogs. According to Dr. Joseph Ohr, the Mahoning County Forensic Pathologist, the dog, a Labrador retriever/shepherd mix, bit the baby, but did not maul, or even shake him.” http://www.examiner.com/article/autopsy-reveals-that-baby-was-not-mauled-rules-infant-s-death-as-accidental

In addition, it is undetermined by the cardboard box company which type of surface is deemed ‘sturdy’ and wide enough to safely hold the unit.  A cardboard box could be knocked off a coffee table, couch, dresser, or other raised surface. The CPSC guidelines regarding the use of a portable crib / play yard / bassinet are that it must have: (1) a sturdy bottom and wide base; (2) smooth surfaces without protruding hardware; (3) legs with locks to prevent folding while in use; and (4) a firm, snugly fitting mattress. Unlike the Pack ‘n Play®, or a full-size crib, a cardboard box has no legs to raise the unit off of the direct surface of the floor.

“Never use the lid while baby is inside.”

C4K Recommends:  It is concerning that many parents would even consider placing the lid back on top of a cardboard box while the baby is in it.  A cardboard box itself does not allow for reasonable airflow for an infant, unlike the Pack ‘n Play® which has air-permeable mesh sides.  Putting the lid on a cardboard box would dangerously decrease the amount of oxygen in the unit and could lead to suffocation.

“Parents should cease using a cardboard box as a primary sleep space once they [babies] can pull themselves up independently. “

C4K Recommends:  A cardboard box should not be used once the baby is crawling, let alone before they can pull themselves up independently risk tipping the box.  Even a baby that is able to roll over could potentially cause a cardboard box to become unbalanced and tip over.  If a cardboard box is placed on a raised surface, this could cause severe head trauma or a life-threatening injury to the baby.  With the Pack ‘n Play® there is no risk of the baby toppling over the Pack ‘n Play® unit, long after they can pull themselves up.

“Never lift a cardboard box with baby inside once he or she exceeds 15 lbs.”

C4K Recommends:  The baby’s weight can change between doctor visits.  The ability to know when the exact time would be to stop lifting the baby while he/she is still in a cardboard box may not be feasible.  The bassinet feature of the Pack ‘n Play® can be used for a baby weighing up to 15 lbs and unable to push up on hands and knees,  and the second level (bottom level) of the Pack ‘n Play® will hold a baby up to, but not exceeding, 30 lbs or 35 inches tall.  In addition, the Pack ‘n Play® can be moved from place to place because it has wheels which provide for easy mobility.

“Keep a cardboard box away from open flame.”

C4K Recommends:  CPSC is committed to protecting consumers and families from products that pose a fire, electrical, chemical or mechanical hazard. CPSC’s work to help ensure the safety of consumer products – such as toys, cribs, power tools, cigarette lighters and household chemicals  contributed to a decline in the rate of deaths and injuries associated with consumer products over the past 40 years.  A cardboard box unit is a cardboard box and not a crib.  Therefore, it has not, yet, been researched by the CPSC as a product that should be used for sleeping infants.

The foam in the mattress of all Pack n’ Play® is fire retardant and meets the Federal Flammability Standards” years.https://www.instagram.com/p/2boRJDJfhm/?tagged=mybabybox.  The Pack ‘n Play® is not cardboard and will not easily burn when near a flame or heater.

“Do not get the box wet.” 

C4K Recommends:  If the cardboard box company recommends that the cardboard box unit should not get wet, it poses a great concern about the durability of the unit for babies who may vomit, have leaky diapers, or spill water or milk in it. It is also recommended that a cardboard box not be used in areas with higher humidity, as it degrades the sturdiness of the cardboard.  You can completely wash down the Pack ‘n Play® and no part will be damaged.

“Do not transport a cardboard box while the baby is inside if any tripping hazards are present in the room (stairs, toys, rugs, etc…)”

C4K Recommends:  There is no fear of a fall hazard head injury with the Pack ‘n Play®.  Also, since it is likely parents may try to transport a baby in the box, they might be tempted to use the box in a car.  If the baby is asleep and you need to go somewhere, you might decide to just leave the sleeping baby in the box instead of strapping him/her into a car seat.


 “How long will the baby be able to use a cardboard box?

C4K Recommends:  On the website of one cardboard box company, the company recommends that “[M]ost babies are comfortable in their Baby Box until 8 months of age.”

A more accurate estimate is 2-4 months. Some newborns will actually roll onto one side to sleep in their very first days, but most babies seem to lose the ability to roll onto their sides independently within the first month. By 4 months of age, babies can develop sufficient upper body strength to use his/her arms. By 6 months old, most babies have mastered not only the belly-to-back roll but also the reverse back-to-belly maneuver.  A cardboard box may not be able to handle the weight shift caused by a baby rolling over.CDC_GrowthChart

A typical cardboard box unit measures as follows: 26 3/4 X 16 3/4 X 11 1/2 inches.

Average length of baby at 3 months – 23 – 24.7 inches

Average weight at 3 months – 11.8 – 14 lbs

Average length of baby at 6 months – 25.3 – 27.2 inches

Average weight at 6 months – 14.8 – 18.8 lbs

* World Health Organization: http://www.cdc.gov/growthcharts/who_charts.htm
Centers for Disease Control and Prevention:  http://www.cdc.gov/growthcharts/cdc_charts.htm

According to an article published in The Washington Post, November, 2015, “Finnish babies sleep in boxes for the first three to four months.”  This is a remarkable variance from 8 months, as suggested by a cardboard box Co.

Noack, Rick (2010, November 10). Why babies should sleep in cardboard boxes, explained in 2 charts. Retrieved from https://www.washingtonpost.com/news/worldviews/wp/2015/11/10/why-babies-should-sleep-in-cardboard-boxes-explained-in-2-charts/

Most sudden unexpected infant deaths that occur in the first year are attributed to unsafe sleep environments. Babies can safely sleep in the Pack ‘n Play® up to 30 lbs and 35” which is well over one year of age.

3. COST:

A cardboard box unit (just the box $25-$35) will likely cost less than the Pack ‘n Play® ($49.99), but a cardboard box can only be used for approximately three to four months.  The Pack ‘n Play® can be used for babies up to 30 and 35” and more than one year of age.  Regardless of the slight cost difference, babies need a safe sleep environment throughout their first year, not just the first two to four months.  When the baby outgrows the box, another SAFE sleeping environment will need to be provided. Otherwise, the baby will likely be placed in bed with the parents, siblings, or on other unsafe surfaces, such as couches and car seats.

4. RESEARCH: Cardboard box companies have implied that Finland has a low infant mortality rate due to the distribution of boxes to all Finnish mothers. Finland’s low infant mortality rate is due to a combination of accessibility to healthcare (socialized medicine), education, and economic resources to provide for the family after the baby is born. Maternity leave is 105 week days, of which the mother receives 90% of her pay and then over 70% of her pay for the remaining maternity leave. Paternity leave/parental allowance may occur when maternity leave ends, which could potentially result in close to an entire year of parental care for the infant without significant financial hardship to the family.

A literature search was done for research that has actually studied the [cardboard] box to document any independent effect it has had on infant mortality.  There are NO studies available to support the claims being made about the box or even the frequency with which they are actually used as a sleep surface.  The media reports the success of the box in reducing infant mortality rates over a 70 year period, but they don’t offer comparisons from other countries.  Almost all countries have dramatically decreased infant mortality because of better sanitation, housing, health care, vaccinations, medications. improved standards of living, etc.  Here is a comparison of the graph quoted by companies selling cardboard boxes as safe sleeping units vs. infant mortality in the US, where boxes were never used…. the graphs are strikingly similar.FinnishInfantMortalityGraphs


  • Its safety record is UNMATCHED
  • The Pack ‘n Play® is compact, easy to assemble, and easy to transport in its carry case, making it easy to take on the go any time needed.
  • When space is an issue the Pack ‘n Play® serves dual purposes;  it can be used when the baby is sleeping, or as a playpen for the first year of life.
  • Cribs for Kids® can send Pack ‘n Play® to many mid-Atlantic and mid-west states served by Ohio Pitt Express.


Every year in the United States, more than 3,500 infant deaths occur due to accidental suffocation, asphyxia, or undetermined causes during sleep. Since 1998, Cribs for Kids® National Infant Safe Sleep Initiative has been making an impact on the rate of babies dying of sleep-related death in unsafe sleeping environments.  Cribs for Kids® is a 501 (c)(3) organization whose mission is to prevent these deaths by educating parents and caregivers on the importance of practicing safe sleep for their babies and by providing Graco® Pack ‘n Play® portable cribs to families who, otherwise, cannot afford a safe place for their babies to sleep.  All proceeds from it’s national infant safe sleep init

Cribs for Kids® offers parents and caregivers a wealth of infant safe sleep information on its website at www.cribsforkids.org, including an “Ask the Pediatrician” link for parents, educators, and caregivers who require more detailed answers to their questions.

On a national level, Cribs for Kids’® 690+ partners across the country have forged a coalition of organizations that view success for one, as success for all. Cribs for Kids® partners do not exist in a hierarchical structure but as collaborators, whose ideas and materials are shared by all of the partners. Partners agree to adhere to certain infant safe sleep standards and, giving them the right to use Cribs for Kids’® standardized forms, Cribs for Kids® name and logo, and safe-sleep materials at our discounted prices.  Cribs for Kids® offers a free Toolkit to organizations interested in the collaboration which includes safe sleep educational material in English and Spanish, hold harmless agreements, parental guidelines, pre and post tests for evaluation purposes, and grant writing materials.  Safe Sleep Brochures, DVDs of Public Service Announcements, and educational powerpoint presentations with up-to-date statistics will help partners spread the infant safe-sleep message in their communities.  All of these materials save new partners from ‘reinventing the wheel’ and assure that a consistent safe-sleep message is being spread throughout the country. –

Partners can call Cribs for Kids® for assistance on anything from getting started with their program, to raising funds, writing grants, and creating boiler-plate policies and forms that can be modified for their individual programs.  Cribs for Kid is not a “crib giveaway” program; it is a national infant safe sleep education program that provides safe sleeping environments for families who, otherwise, could not afford safe places for their babies to sleep.  We readily share our program and welcome others to join in our mission to Help Every Baby Sleep Safer.

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