The United States And Infant Mortality Issues
The United States falls far behind the rest of the developed world in terms of its infant mortality rates. Infant mortality rates are, “associated with a variety of factors such as maternal health, quality, and access to medical care, socioeconomic conditions, and public health practices’”. Finland, with one of the lowest infant mortality rates in the world, has a system of maternity packages or “baby boxes” given to expectant mothers. With Finland’s success in this initiative, other countries have implemented similar systems with varying results. However, the United States has struggled with implementing this system, as infant mortality rates continue to grow, and government support gradually declines.
As of 2017, Finland was reported to have an average of 2.5 deaths out of every 1000 infants, the sixth lowest in the modern world. On the other hand, the United States comes in at 55th with an infant mortality rate of 5.8 out of 1000, falling behind most of the world’s developed nations. One of the main causes of infant mortality is Sudden Infant Death Syndrome (SIDS), defined as, “the sudden, unexplained death of a baby younger than 1 year of age that doesn’t have a known cause even after a complete investigation”.
Towards the end of the 1930s, infant mortality rates skyrocketed in Finland, with almost one out every ten infants dying before the age of one. On the heels of the First World War, Kela, the Finnish social security system, launched a program designed to give low-income mothers the resources they needed. The original maternity package was a cardboard box containing sheets, diapers, fabric to make clothes, and a few other items. After the Second World War, the program expanded to include all expectant mothers, with the option of a monetary grant instead of a“baby box”. In addition, Kela instituted the requirement that in order to receive a package, all mothers had to go to a prenatal clinic before the fourth month of pregnancy.
Today, Kela serves around 30,000 mothers, with another 25,000 choosing the grant instead. Modern baby boxes contain over 60 different products, ranging from sheets and clothes to pacifiers and bottles. However, the baby box is not just valued for its contents, but also for the functionality of the box itself. Since 1938, officials have promoted the baby box as a safe sleep space for infants. The main goal of this suggestion was to reduce bed sharing instances, and hopefully, infant deaths as a result of SIDS. Also, the baby box program lessens socioeconomic barriers between children by providing them with an equal start in life.
With the continued success of the Finnish baby box, many countries began to implement their own maternity packages. Chile, underneath their newborn support program (PARN), provides baby boxes to children born in several public hospitals, especially those from low-income backgrounds. The Chilean government provides an average of 160,000 families a year with traditional baby box materials as well as a playpen, education material, backpack, and baby carrier. According to PARN’s latest study, 59% of baby box recipients had a household income of $3,000 or less per year.
Chile is just one of several countries who have followed in Finland’s footsteps. It is accompanied by similar initiatives in Canada, Scotland, England, and several states in the United States. One program was started by the University of Calgary to help expectant mothers in Alberta, Canada. This program, titled, “Welcome to Parenthood” differs from others in that it requires participants to be paired with a mentor during the beginning stages of their parenthood. Professor Karen Benzies, one of the proponents of the program, stated, “The boxes are only part of a larger system of health and social support, the other part is building adult capacity about how to raise that next generation of children.' In Scotland and England, on the other hand, many critics have raised concerns regarding the cost of baby boxes to taxpayers, as well as a lack of solid scientific evidence regarding the effectiveness of baby boxes on reducing SIDS.
Several states have implemented baby boxes, with different methods used by each, including varying levels of government and private organization involvement. Public hospitals and non-profits in New Jersey, Ohio, and Alabama have started giving out baby boxes in an effort to reduce cases of SIDS. The boxes are given away at no cost in an effort to prevent SIDS by reducing the amount of bed-sharing between parents and their newborns. Critics in the US say that baby boxes are not scientifically proven to reduce cases of SIDS. As states such as Ohio, New Jersey, and Alabama have launched baby box programs, government officials have raised concerns. This article describes the warnings of officials in Canton, Ohio against the use of baby boxes, specifically those sold by the Baby Box Co. In addition, the officials recommend partnering with the organization Cribs for Kids instead. In addition, there are no standards in the US for the safety or production of baby boxes, a factor that can lead to unintentionally dangerous baby boxes. Dr. Moon, head of the SIDS Task Force in the United States, has come out against baby boxes, citing lack of scientific evidence and government standards.
The article by the British Medical Journal, describes the drawbacks of the baby box program in Scotland. It tells about the lack of scientific and academic evidence in support of baby boxes as a sleep space. Instead, the BMJ recommends supporting breastfeeding and midwives.
Parents have jumped on board so readily, with companies such as Baby Box Co. offering free baby box packages after watching a series of videos. This source describes the benefits and drawbacks of the baby box program on an infant’s health. It mainly discusses how baby boxes lessen bed-sharing instances, but also decrease breastfeeding habits. Bedsharing is a common cause of SIDS, but the article also draws attention to other factors in infant fatalities, such as smoking, alcoholism, and extreme poverty. On the other hand, research from the Department of Medicine may have found that “Baby boxes disrupt 'breastsleeping' (breastfeeding with co-sleeping) and may undermine breastfeeding.
This study shows the different perspectives of people toward safe sleep spaces for infants. It compared men and women of different races and backgrounds. Men scored lower than women across all races and backgrounds, with education level not being a major component. I will use this study to describe public perceptions of safe sleep spaces.
In Finland though why the requirement of attending medical appointments is so critical… The effect of attending prenatal appointments-why education/healthcare is so important for a healthy pregnancy. The baby box program is not as effective in the US because the government cannot force people to attend medical appointments as an incentive. Also, in Finland, the initiative is a government-run operation, in the United States, the majority of baby boxes are provided by independent corporations. Evidence for the fact that the US cannot force people to go to the doctor. Is there a way to fix this?
What can be fixed about the current system? Fixing the public perception/ providing safety standards for the baby boxes. Should baby boxes be offered as a safe sleep space? Also, baby boxes should not be promoted as the “only safe infant sleep space”, cribs and bassinets are still perfectly safe options. Baby boxes may be a viable option in lowering SIDS cases in the United States, however; it would be more beneficial if they were accompanied by required prenatal appointments.
