Temple study: Baby boxes help improve infant sleep safety

A Temple University Hospital initiative that coupled "baby boxes" – portable cardboard bassinets – with personalized safe sleep instruction cut down on the hazardous practice of parents and infants sleeping in the same bed, according to study results released Monday.

Temple researchers found the hospital's SAFE-T program – Sleep Awareness Family Education at Temple – reduced the rate of bed sharing in the first eight days of life by 25 percent.

"We are pleased with the results of this first-of-its-kind study," said Megan Heere, lead investigator and medical director of the Well Baby Nursery at Temple University Hospital. "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."

Bed sharing has been linked to sleep-related deaths in infants, including sudden infant death syndrome (SIDS) and accidental suffocation. The American Academy of Pediatrics has recommended that babies sleep in the same room as a parent or caregiver for the first six months of life and preferably the first year, but that they not share a bed. Babies should also be put to sleep on their backs on a firm mattress without blankets or other loose bedding, bumpers, or stuffed toys.

Temple started the SAFE-T program last year, yet hospital staff found through surveys that many parents still were sleeping with their babies.  The hospital is in North Philadelphia, an area with high infant mortality rate, where many children are born into low-income households and to young mothers who lack resources to care for their newborns.

Last May, the hospital increased its helping efforts and began providing free baby boxes to all mothers who gave birth there, as well as offering additional safe-sleep education. The owl-decorated bassinets were outfitted with mattresses, fitted sheets, and goody bags with baby supplies. Similar bassinets have been provided to newborns in Finland since the 1930s and have been credited with helping to cut that country's infant mortality rate.

The Temple study included two groups of mothers and infants. The data for the control group were collected between Jan. 1, 2015, and Feb. 7, 2016, and included mothers who received standard nursing discharge instructions. The second group's data were collected from Feb. 8 to Nov. 15, 2016.  These mothers were given education that included the AAP recommendations delivered in person by nurses under the direction of a pediatrician. They also got a door hanger that summarized the teaching points.  Mothers were also given the boxes, and they watched an instructional video about how to use them.

The researchers found the face-to-face education and bassinets reduced bed sharing by 25 percent in the first eight days, and cut bed sharing by 50 percent for exclusively breast-fed babies – a population that tends to be at higher risk of bed sharing. Of the mothers who exclusively breast-fed, 59 percent said the boxes made breast-feeding easier.

About 12 percent of the mothers used the baby boxes as their babies' primary sleeping places. Heere said most of the mothers said they used the boxes as portable bassinets, especially useful when moving around their homes or visiting outside the home.

Heere said the Temple hospital plans to continue giving out the baby boxes and do further study on whether the intervention's results can be continued for longer periods of time.