Our policy statementon baby boxes to sleep babies

The Lullaby Trust supports all efforts to promote safer sleeping to reduce Sudden Infant Death Syndrome(SIDS).We are concerned about the current popularity ofbaby boxes made from cardboard,which are being promotedas a sleeping place for babies which will reduce infant mortality and SIDS

Is a cardboard baby box a safe place to sleep a baby?

Whilst research findings have clearly demonstrated certain unsafe sleeping environments will increase risk of infant death, (such as co-sleeping on a sofa), there is currently, to our knowledge, no robust evidence to demonstrate conclusively that a cardboard box on its own will reduce SIDS or indeed is a safe place to sleep. [i]

In some areas, health and social care professionals are distributing boxes as part of a wider educational initiative to encourage parents to follow safer sleep guidelines. We accept that for some parents who do not have an enclosed space for their baby to sleep such as a Cot or a Moses basket, a box may be a better alternative than co-sleeping with a baby in hazardous circumstances.While these efforts are commendable, based on the evidence currently available, we do not believe it is factually correct to directly link the use of a baby box with a reduction in infant mortality or SIDS.

Compliance of cardboard baby boxes with relevant safety standards

The safety of baby products is paramount to The Lullaby Trust. We therefore urge all agencies,as well as parents who are considering purchasing or using a baby box,to ensure that the box and also the mattresssupplied comply with British and European Standards and existing UK fire regulations.All manufacturers should attach a permanent label to the mattress confirming that the product is regulation compliant.

The current British and EU standard[ii] for cots,cribs and bassinets was developed over many years for what is referred to as “nursery furniture”, made of wood or wood material.In our opinion, this standardwas not developed with baby boxes in mind.

Therefore, The Lullaby Trust believes that while babyboxes may be capable of complying with elements of EU 1130, such as composition of material (e.g.cardboard isclearly a wood material), we do not consider that they can meet the full requirements of the standard.

The position of The Lullaby Trust

Based on existingresearch undertaken by leading SIDS researchers across the world over the last 25 years, The Lullaby Trust continuesto recommend that a cot or Moses basket is still the safest place for a baby to sleep.[iii]

The Lullaby Trust will not directly associate with the promotion of baby boxes as a product supplied by a manufacturer or retailer due toour opinion that there is a lack of a robust evidence to suggest that on its own it will reduce SIDS or indeed is a safe place to sleep.

We are happy to provide manufacturers and retailers with safer sleep guidelines on request which they can incorporate within the box and in their marketing should they wish to do so. We will no longer allow our branded leaflets to be enclosed with baby boxes as this suggests we endorse the product. We have produced a specific leaflet for parents on the use of boxes as a sleep environment and we are happy to supply this at net cost to manufacturers on request.

We urge the nursery industry to work with the infant health community to invest in robust academic research in the UK to properly evaluate the use of baby boxes as a safe sleeping product.

Our guidance to parents who choose to use a baby box

If you choose to use ababy box as a sleep space, please make sure you follow the safer sleep guidelines issued by the Lullaby Trust which are available on our website

  • Be aware that there is no direct evidence that the use of a baby box will reduce SIDS or lower infant mortality(despite use in some countries like Finland)
  • Be aware that some boxes may be of a higher quality than others
  • Be aware that there is no safetystandard in existence anywhere in the world that specifically applies to a baby box as a sleeping place for a baby
  • Be aware that some manufacturers state that their boxes meet European Union 1130 standard for cots, cribs and bassinets. While some elements of a cardboard box may comply with this standard, for example, wood material, structure and smooth edges, remember that EU 1130 is a furniture standard for traditional cots, cribs and bassinets.
  • Ensure that the mattress and mattress filling meets the British Standard 7177 and the 1988 UK fire regulations as amended. The mattress should also meet the British Standard 1877 and this should be clearly and permanently labelled on the mattress.

We also stronglyadvise the following:

  • If you decide to use a box to sleep your baby, use for daytime naps only and sleep your baby in a cot or a Moses basket next to your bed during the night
  • Do not lift or carry the box around your home if your baby is in it
  • Do not put the lid on the box if your baby is in it
  • Always keep the box clear as a sleeping space
  • Do not place additional bedding on top of the mattress to raise your baby up to a higher level
  • Ensure the box is placed on a solid surface and cannot topple over
  • Do not use the box if it gets wet or soiled
  • Do not put a box on anunder heated floor
  • Ensure that any pets stay away from the box
  • Do not leave the baby in the box unattended or out of view
  • Do not use the box once your baby is able to roll
  • Ensure that you comply with any instructions relating to the maximum age and weight of the infant for which the box can be used

[i] Do Baby Boxes really Save lives, BBC Online 25/3/17

[ii]EN 1130

[iii] The Lullaby Trust Evidence Base – June 2016