Finish Baby Boxes Could Save Infant Lives In Texas

Neonatologist Dr. Sanjuanita Garza-Cox sometimes feels like she’s banging her head against the wall. Since 2009, the number of infants who die from sleeping in unsafe conditions has been increasing. While hospitals try to educate new parents, it just doesn’t seem like it’s working.

“It is very frustrating,” said Garza-Cox, chief of staff of Children’s Hospital of San Antonio. “We are trying to figure out how to help the community.”

IMAGE: John Chance with baby box Courtesy John Chance

John Chance poses with one of baby boxes that the North Central Rotary Club donated to the pilot program in San Antonio.

In 2009, 11 babies died because of unsafe sleeping conditions — perhaps they rolled over onto a teddy bear and suffocated, or slept in a bed with a sibling who rolled over and accidentally smothered them. The final numbers aren’t in for 2015, but a group in San Antonio’s Bexar County, the Unexpected Infant Death Coalition, has already tallied at least 18 deaths last year due to sleep conditions.

Garza-Cox discovered a simple solution is being used in Finland: A baby box. Since 1949, the Finnish government offers every new mother a box including a mattress, fitted sheet, blanket, sleeping sack, snowsuit, mittens, booties, hooded suits, overalls, socks, knitted hat, balaclava face mask, rompers, leggings, onesies, bath towels, nail scissors, hairbrush, toothbrush, cloth diapers, picture books, bra pads, and even condoms.

But the best part — the box itself serves as an infant bed until the baby reaches eight or nine months old, when the risk of unexpected death lessens. The Finnish baby box helped the nation drastically reduce its infant mortality rate from 65 per 1,000 when the program started to 3.36 per 1,000 today.

IMAGE: Adrian Delgado in a baby box Children’s Hospital of San Antonio

Baby Adrian Delgado, who was born at 32 weeks gestation and is now two weeks old, tries out the baby box. He is one of triplets.

“The reason the box works really well (is) you are getting a good air flow,” Garza-Cox said. The firm mattress also helps, offering exactly the texture needed to prevent suffocation.

While Garza-Cox knew the boxes could help reduce deaths from unsafe sleeping conditions, the Bexar County Unexpected Infant Death Coalition struggled to find funding for the boxes.

At the same time, John Chance, past president of the area’s North Central Rotary Club, found an article about the Finnish baby boxes. Himself a new grandfather, Chance thought local moms might appreciate the box. But after learning of the extent of baby deaths in the area, he was really sold.

“I saw the statistics from Finland and saw how [the boxes] reduced the infant mortality rates,” he said. “We can be giving them a welcome to motherhood package, [which] is in the safe sleep baby box.”

IMAGE: Nurse Kelli Brimagner with a baby box Children’s Hospital of San Antonio

Nurse Kelli Brimagner, an educator at the neonatal intensive care unit, displays a baby box.

Chance convinced the club to purchase 100 baby boxes to start a pilot program at the University Health System. The boxes include almost everything that the Finnish boxes do, minus the snow gear — this is Texas, after all. If the pilot goes well, he hopes the club and other organizations will donate enough boxes for the entire city.

“We are trying to save lives. You can’t imagine the tragedy of the newborn baby who turns up dead because they are suffocated,” Chance said.

Garza-Cox thinks the pilot program will help, but believes a city-wide program would have the most impact. She hopes that San Antonio might serve as an example for other cities struggling to prevent the same, very preventable deaths.

“Safe sleep is actually quite simple. That’s what is so freaking frustrating,” she said. “I think it only takes one [success] for other people to follow, especially if we have the ability to document the change.”

Unsure how to make baby’s sleep as safe as possible? Garza-Cox provides these tips:

  • Each baby should sleep in its own environment, whether that’s a crib, bassinet, playpen or box
  • Baby— should sleep on a firm mattress with a fitted sheet
  • Use only one blanket, wrapped tightly under the shoulders, or a baby sack
  • Make sure the sleep area is free of soft items, including stuffed animals, bumper pads, or pillows
  • Babies should be put to sleep on their backs
  • Babies need to sleep in a smoke-free environment
  • Breastfeeding reduces risk of sudden unexpected infant death
  • After a month, pacifier use reduces baby’s risk

Meghan Holohan

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