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Baby boxes and education cut bed-sharing in early infancy

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The introduction of baby boxes and sleep education reduces risky bed-sharing between parents and babies in the first week of infancy, according to US researchers.

They found that face-to-face education about safe infant sleep, combined with the distribution of a free cardboard baby box, reduced the rates of bed-sharing during babies’ first eight days of life.

“It’s inspiring to see the impact that this programme is having”

Jennifer Rodriguez

In Finland, the practice of giving new mothers baby boxes has been credited with reducing infant deaths. The boxes are traditionally used as the baby’s bed for up to the first eight months of life.

It is thought that the size of the box prevents babies from rolling onto their stomach, behaviour linked to sudden infant death syndrome.

This time last year, Queen Charlotte and Chelsea Hospital, part of Imperial College Healthcare NHS Trust, became the first in the UK to trial baby boxes. A number of others have since adopted the idea.

The new research on their impact, by North Philadelphia’s Temple University Hospital, was presented earlier this month at the US Pediatric Academic Societies Meeting in San Francisco.

The hospital is in an area with one of the highest infant mortality rates in the US, with many babies born into poverty and to young mothers who do not have adequate resources to care for them.

As a result, the hospital created the Sleep Awareness Family Education at Temple (SAFE-T) programme in an effort to address common high-risk behaviours associated with infant mortality.

The new study looked at whether the programme was effective, based on a year’s worth of data between 2015 and 2016, and including interviews with 2,763 mothers.

One group, the controls, received standard nursing discharge instructions that included instructions on safe infant sleep.

Meanwhile, the intervention group received education that included safe infant sleep recommendations delivered in person by a select group of registered nurses.

The intervention group also received a baby box, complete with a foam mattress, cotton fitted sheet and baby supplies. In addition, each mother watched a three-minute video on using the baby box.

The research team found that face-to-face sleep education and providing a baby box reduced the rate of bed-sharing by 25% in the first eight days of life.

In particular, they noted that bed-sharing was reduced by 50% among exclusively breastfed infants, a population they said was at increased risk of bed-sharing.

Of the mothers who received the baby box, a majority said they used the box as a sleeping place for their infants, though only 12% said they used the box as the primary or usual sleeping space.

“We are pleased with the results of this first-of-its-kind study”

Megan Heere

Additionally, of mothers who exclusively breastfed and also used the box as a sleeping space, 59% said the box made breastfeeding easier.

Lead study author Dr Megan Heere said: “We are pleased with the results of this first-of-its-kind study.

“Future studies are needed to determine if the effect of this intervention is sustainable through the first six to 12 months of life, and if this intervention can significantly reduce the incidence of sleep-related death in large populations over time,” she said.

Jennifer Rodriguez, director of nursing Services at Temple University Hospital, said: “The SAFE-T programme is a total team effort with a high level of collaboration between nurses and physicians.

“It’s inspiring to see the impact that this programme is having on the well-being of our patients and their families,” she added.

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