DAVID GREENE, HOST:
We head to New Jersey, where a growing number of babies are sleeping in cardboard boxes. This is an idea borrowed from Finland, where for decades, the government has given expectant moms a package of maternity items to take home, including a sturdy box that doubles as a crib. Several American states are now giving away these baby boxes, sparking a debate about safety. NPR's Maureen Pao went to New Jersey recently to check out the first of these programs in the U.S.
(SOUNDBITE OF KNOCKING ON DOOR)
MAUREEN PAO, BYLINE: On a recent afternoon...
MARCIA VIRGIL: It's Miss Marcia.
PAO: Miss Marcia Virgil is meeting Mr. Solomon Murphy for the first time.
VIRGIL: Hey, look at you. He's beautiful.
MAISHA WATSON: Aw.
PAO: Miss Marcia is a family support worker with the Southern New Jersey Perinatal Cooperative. She's making a house call on Solomon, who just turned a month old, and his mom, 26-year-old Maisha Watson.
Marcia asks a few questions about how baby's doing. Over on the bed, there's a cheerfully decorated box.
VIRGIL: Are you finding the baby box helpful for you?
WATSON: Yes, I love it.
PAO: Maisha wasn't always so enthusiastic. When Miss Marcia first told her about the box, she thought...
WATSON: Why would I want to put my baby in a box? (Laughter). Like, I don't understand.
PAO: Yes, it is a cardboard box. But, Miss Marcia explained, it's actually a good, safe place for a baby to sleep. It comes with a firm mattress and a snug sheet, all in line with the American Academy of Pediatrics recommendations. They're meant to protect against sleep-related deaths, including sudden infant death syndrome, also known as SIDS. Solomon's slept in it ever since he came home from the hospital.
WATSON: I don't want to just leave him on the bed. And then we don't have room for a crib or a bassinet, so the box is good.
PAO: That's because Maisha, Solomon and Solomon's dad are living in a cramped motel room outside Atlantic City.
WATSON: You see him? Look at him - he's got his eyes open.
PAO: Maisha's been here a year, after a bad car accident made it hard for her to work and stay in school.
WATSON: Mommy's sorry - OK.
PAO: The box that my Maisha and Solomon are using is one of about 20,000 that New Jersey has given out since January. The goal is to provide a box for every newborn in the state. To get one, a parent must watch a series of online videos that focus on how to keep babies safe while they sleep.
Organizers say the cute box is just a hook. The real point is education, and the need for education becomes clear soon after Marcia walks into Maisha's room and finds a thick blue blanket in the baby box.
VIRGIL: ...You going to lay him down.
VIRGIL: Very good. This needs to come out.
WATSON: OK, well, I...
PAO: In New Jersey, sleep is a factor in most sudden unexpected infant deaths - a baby sharing a bed with an adult or being suffocated by something like that fluffy blanket. Dr. Kathie McCans chairs the state board that reviews child fatalities. The board partnered with the California-based Baby Box Company to provide the boxes and videos. She says teaching parents about known risks - that's the heart of the program.
KATHIE MCCANS: My hope is that we will not have people making the errors of putting a baby in a sleep surface that has blankets and pillows and crib bumpers, that everyone will know that a baby needs to be put to sleep on their back each and every time.
PAO: Not everyone has jumped on the baby box bandwagon. The American Academy of Pediatrics says there just isn't enough evidence yet to show the boxes play a role in reducing infant mortality. Dr. Thomas Hegyi agrees. He's medical director of the SIDS Center of New Jersey.
THOMAS HEGYI: We're very concerned, as pediatricians, in adopting interventions for babies without thoroughly testing them because, historically, we've been burned.
PAO: He says that a lot of things that sounded like a good idea at first turned out to be dangerous, like crib bumpers, which can smother babies.
HEGYI: There are so many questions that need to be answered before we can give this product to healthy babies.
PAO: A task force is already working to establish safety standards for baby boxes, but it's unclear when they'll be ready. Dr. McCans agrees that testing is necessary. But she says the boxes' benefits outweigh the potential risks.
MCCANS: How many babies should die while we wait for the Consumer Product Safety Commission to do that testing? The reality is babies die in cribs. They die in bassinets.
VIRGIL: So you'll have a crib soon. No stuffed animal...
PAO: Back at the motel, Miss Marcia is wrapping up her visit with Maisha.
VIRGIL: Never put him in the bed with you.
VIRGIL: For this new mom, the small, portable baby box has bought her some time to figure out a permanent place for her son to sleep. Until then, Maisha lays him gently in the baby box...
WATSON: See, he's sleeping peacefully. As long as he comfortable and safe - that's the main key. As long as he's safe, then it works out good.
PAO: Maureen Pao, NPR News.
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