Safety Box: 90by30 Crafts Baby Boxes to Help Prevent Harm to Infants

19 Jul 2017

This article by Cara Roberts Murez appeared on July 3, 2017, in The Register-Guard. Click here to read the orginal story.


Later this summer in south Lane County when some happy, yet weary new parents lay their little one down for a nap, it won’t be a crib or a bassinet that they place the baby in. It will be a box.


Baby boxes have been considered a safe sleep system in Finland for nearly 40 years. The state of New Jersey began giving away this version of a bassinet in January.


And south Lane County is next.


A local nonprofit organization — 90by30, which works to prevent child abuse and neglect — is helping to distribute the boxes along with other essentials, information about community resources and baby-care advice starting in this one part of Lane County on Aug. 1.


It likely will bring the program to other rural areas in the coming months and possibly to the whole county at some point in the future, said Phyllis Barkhurst, who is director of the 90by30 initiative and co-director for the Center for the Prevention of Abuse and Neglect at the University of Oregon.


“I do think it’s a trend,” Barkhurst said about baby boxes. “I think to make it a movement, it needs to connect up with more of the idea that this is a start. The baby box is a way to start providing access to resources and good interventions to families. Not as an end in itself.”


Community efforts


The nonprofit group’s name comes from the goal of ending 90 percent of child abuse by the year 2030. The plan for reaching that benchmark is to get the community directly involved in reducing abuse cases — shifting the responsibility for prevention to communities, businesses, schools and neighborhoods.

Strategies are focused on primary prevention and the root causes, Barkhurst said.

Among the strategies is to create volunteer-led community teams in seven “regions” within Lane County. Those teams decide which projects to pursue in their communities, after thoroughly assessing needs and assets, Barkhurst said.


Strategies include parent cafes, getting parents together regularly in a facilitator-led support group environment. Three regions so far have chosen that strategy.

Another strategy is working with elementary school-age kids on developing empathy for others. Four regions have chosen to do this.


The baby box is an idea that has so far been chosen by three regions: south Lane County, including Cottage Grove and Creswell; north Lane County, including Junction City and Veneta; and east Lane County, including Oakridge, West Fir, Lowell, Dexter and Pleasant Hill. The four other regions are considering it.

In south Lane County, where the pilot project is happening, about 250 babies are born in an average year. For that area, 90by30 is now taking registrations at about 15 locations, including medical providers and local nonprofit groups, from parents expecting a baby in August or later.


Once a baby is delivered, parents can call the program to schedule an appointment to receive their box.

The boxes contain a variety of items related to baby safety and health. There’s a DVD or flash drive, depending on parent preference, called the Period of PURPLE Crying, which includes information about the dangers of shaking a baby and how easy it is to do permanent damage. There are clothing items, including those that are homemade or organic cotton, as well as hypoallergenic baby products and books.


A “passport” included in the box contains information about local businesses and supportive organizations that parents are encouraged to visit. The box isn’t just meant to provide a safe sleeping space but to connect parents to the community and the resources that are helpful no matter who you are.


The boxes cost about $200, with their contents, but will be given to new parents in south Lane County for free. The program is accepting donations and sponsorships to help provide these.


“In our view of primary prevention, it’s a universal approach,” Barkhurst said. “All of the strategies that we’re embracing, If a region chooses it, it’s for everyone. … Child abuse and neglect cross all lines, and so our strategies are designed to recognize that.”


The expectation is that having a baby box can help prevent sudden infant death syndrome. Some parents may use it for baby’s nap, and some may use it at night, too, Barkhurst said.


Having a child near you — but without the risks of being in bed with you — promotes attachment, considered an abuse prevention strategy. "If all seven (regions) choose it, then our goal will be from this point forward to provide baby boxes and welcome every new baby in a way that supports parents and promotes good parenting and provides safety for infants because that’s the most vulnerable population we have,” Barkhurst said.


About 4,000 children are born in Lane County each year, 3,200 of them to parents who live in this area.


Somber experiences


The 90by30 program is getting its baby boxes through Pip & Grow, a company whose founder lives in Portland.


Amber Kroeker applied for an innovation grant to create a bassinet box several years ago while working as an injury prevention coordinator at a children’s hospital in Michigan. Part of her job was to review infant autopsies and determine how their deaths could have been prevented.

In 2015, there were about 3,700 sudden unexpected infant deaths in the United States, according to the Centers for Disease Control and Prevention. These were deaths occurring among infants younger than 12 months old, with no immediately obvious cause including those categorized as SIDS, unknown cause and accidental suffocation and strangulation in bed.


Some of the babies in the cases Kroeker reviewed had died from causes that were mostly preventable, including in unsafe sleeping situations, she said.

She felt frustrated. She remembers reading about the Finnish baby boxes.


“It just resonated with me,” Kroeker said. “This is small, it’s portable.”


Kroeker collaborated with manufacturers and others, adding two partners to her business last year.


They launched the boxes — called Smitten — in August 2016. Though it is a business, Pip & Grow also sells the boxes to nonprofit programs and hospitals at significantly reduced cost, Kroeker said.


They’ve distributed several hundred in Oregon already and others around the country.


“My heart is so full. It’s so incredible,” Kroeker said. “It’s kind of like watching your kid graduate.”


Safety considerations


A recent New York Times story about baby boxes quoted experts advising caution. The story said that unlike other baby products, including bassinets and cribs, the cardboard boxes aren’t regulated by the Consumer Product Safety Commission and haven’t been independently tested to meet mandatory safety standards required of other infant sleep products. ASTM International, which develops manufacturing and safety standards for a variety of products, has formed a task force to propose safety rules for baby boxes, according to the New York Times story, though the process to adopt standards could take at least a year to complete.


Questions the story raised included: What are the age and weight limits for baby boxes made in the United States? Is it safe to pick up the box with the baby in it? What is the airflow quality inside the box? Is it safe to place the box with baby inside on the floor or on another surface?

In addition to the story’s cautious opinions, there was optimism that by increasing convenience, the boxes would help prevent bed sharing with infants, considered a risk for SIDS.


Smitten’s publicity materials say the boxes were crafted using Consumer Product Safety Commission bassinet safety standards. The website also says, “The Smitten Sleep System is a lightweight, durable bassinet that parents can easily carry with them from room to room. Infants can sleep in Smitten for up to six months, the riskiest period for SIDS and suffocation.”


Kroeker is happy to be providing this sleep option, after all those years she spent sitting at a table reviewing infant deaths.


“I remember the name of every single baby,” Kroeker said. “And just knowing that they didn’t die in vain. I’m hopeful that this will help promote safer sleeping behavior with parents and babies. I think that’s the really cool thing.”