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To Reduce Infant Mortality, U.S. Cities Adopt the Finland Way

Unlike America, which has one of the highest infant mortality rates of developed countries, Finland has one of the world's lowest.

Temple University Hospital in Philadelphia started giving away so-called baby boxes to all new mothers earlier this year.
(AP/Matt Rourke)
Despite being a first-world country, the United States has a worse infant mortality rate than some second- and third-world countries. In fact, it has one of the highest rates of babies dying before their first birthday of any developed nation.

In Detroit, a baby is less likely to live to see its first birthday than if it was born in Lebanon, Bosnia or Mexico.

Those tragic statistics led Detroit's health commissioner, Abdul El-Sayed, to think outside the box -- almost literally -- and adopt a strategy that has helped Finland keep infant mortality rates down: baby boxes. They're large, usually cardboard boxes filled with baby products like blankets, diapers and tear-free bath soap. But most importantly, the boxes are lined with a mattress pad so they can serve as a functional crib.

Baby boxes, also called maternity packages, have been given to every new mother in Finland since 1938. Health experts consider it to be a major reason the country has one of the lowest infant mortality rates in the world.

The idea is now starting to catch on across America, where unsafe sleep is one of the largest contributors to infant mortality. 

In Detroit, where 21 percent of babies' deaths are attributable to sleeping conditions, El-Sayed is leveraging a public-private partnership to roll out a baby box program next year. Earlier this year, Temple University Hospital in Philadelphia, which has a higher-than-average infant mortality rate, started a universal baby box program. On the other side of the country, Alaska decided to launch a baby box pilot project at Providence Alaska Medical Center, the largest health-care provider in the state.

Jen Aist, manager of Providence’s maternity outpatient clinic and services, was skeptical at first.

“I thought maybe half of the 250 mothers who give birth per month in our facilities would take them," she said. "Every single woman took one."

The baby boxes offer parents a more portable option for laying down their sleeping newborns.

"Babies are going between households, often spending time at grandma's or a friend’s house," said El-Sayed. "While there might be a crib at their house, a parent needs to make sure there are multiple safe sleep opportunities."

It’s too early to tell if the program has had any impact on infant mortality rates in Philadelphia. Megan Heere, director of the hospital's nursery, said it will need to continue for at least three more years before they have significant data.

Providence’s pilot program ended a couple of months ago, and Aist said it’s too early to say whether they’ll bring it back. However, she says, it’s brought immeasurable awareness to the issue.

“There’s nothing magical about the box," she said. "What is magical is a baby who is sleeping safely. Sometimes you need a novelty to have a new conversation about an old problem."

Mattie covers all things health for Governing.

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