Sending Office: Honorable David N. Cicilline
Ask for a Safety Study on Infant Sleep Products
Each year, about 3,500 infants in the United States die suddenly and unexpectedly in their sleep. While the exact causes are largely unknown, research shows that not creating a safe sleeping arrangement for a baby’s area may lead to strangulation, suffocation,
or other causes of accidental death. While we commend and encourage efforts to reduce the rates of these tragic deaths, we are concerned about a rising trend in the distribution of a product called a “baby box.”
A “baby box” is generally a compact cardboard box that contain a firm mattress and tight-fitting sheet and is meant to create a crib-like space for infants. Inspired by the use of these products in other countries, enthusiasm has skyrocketed in the United
States. Across the country, states—including New Jersey, Alabama, Ohio, Pennsylvania, Colorado and Texas—are adopting baby box programs at a rapid pace, with some states even planning to distribute a baby box to every expectant or new mother.
However, baby box products are not currently regulated by the federal government and have not been tested to meet mandatory safety standards required of all other infant sleep products on the market. Pediatric experts have urged caution around the use of
baby boxes, questioning whether there are unforeseen safety hazards in using these products and if they are actually effective at preventing sleep-related infant deaths.
Given their growing popularity in the United States, we believe it is imperative that baby boxes are tested expediently so that states have the necessary information to understand whether distributing baby boxes is a safe and effective option in addressing
sudden and unexpected infant deaths. Please join us in sending a letter to the Consumer Product Safety Commission asking for a study into whether baby box products pose a safety hazard to infants.
If you have any questions about or would like to sign on to this letter, please contact Renuka Nagaraj in Congressman David Cicilline office (Renuka.Nagaraj@mail.house.gov) or Sarah Laven in Congresswoman
Rosa DeLauro’s office (Sarah.Laven@mail.house.gov).
David N. Cicilline Rosa DeLauro
Member of Congress Member of Congress
Text of Letter
February XX, 2018
Ann Marie Beuerkle, Chairwoman
Robert S. Adler, Commissioner
Elliot F. Kaye, Commissioner
Joseph P. Mohorovic, Commissioner
Marietta S. Robinson, Commissioner
U.S. Consumer Product Safety Commission
4330 East-West Highway
Bethesda, MD 20814
Dear Chairwoman Buerkle and Commissioners Adler, Kaye, Mohorovic, and Robinson:
We are reaching out regarding the safety of a new infant sleep product, which is commonly referred to as a ‘baby box.’ The baby box is a cardboard box that holds a firm fitted mattress, a tight-fitting sheet, and infant care supplies for caregivers. Baby
boxes have received a tremendous amount of attention from the press and state and local governments in recent months, and are being distributed by hospitals around the country to parents of newborns as a safe place for babies to sleep. We commend businesses
for creating innovative solutions to problems in an effort to help keep Americans safe, especially newborn babies. However, it has recently come to our attention that baby boxes have not been tested to meet mandatory safety standards and are not regulated
by the federal government. Given the widespread interest in baby boxes and some of the questions surrounding their safety, we urge the Consumer Product Safety Commission (CPSC) to investigate the safety of these
products to determine whether they are a safe sleeping option for newborns.
Deaths among newborns are extremely heart-wrenching. While they can be difficult to explain, they can be prevented by ensuring babies are sleeping in safe and secure spaces. According to the Centers for Disease Control and Prevention (CDC), in 2015, there
were approximately 3,700 sudden unexpected infant deaths (SUID) in the United States. Of this number, roughly 1,600 deaths were due to sudden infant death syndrome (SIDS). While 1,200 of these deaths were due to unknown causes, nearly 900 deaths were due to
accidental suffocation and strangulation in bed. SIDS deaths are most prevalent between the first and fourth months of a baby’s life and are the leading cause of death of infants between 1 month and 1 year
of age. We share your deep concern over infant mortality in the United States, and want to work proactively to ensure the safety of newborns.
In order to help prevent SIDS and SUID deaths, the CPSC issues important safety standards for cribs, bassinets, and play yards to help ensure safe sleeping environments for infants. Since June 28, 2011 the CPSC has enforced a standard for cribs that requires
“all cribs manufactured and sold (including resale) must comply with new and improved federal safety standards.” However, the baby boxes that are currently being promoted widely and distributed by hospitals
have not been evaluated under these same standards. An additional concern is that the boxes are primarily given to parents that might not have another sleep option, putting babies at a higher risk of SUID after outgrowing the baby box. With the growing nationwide
interest in baby boxes and the potential for hundreds of thousands to be used in the United States, I encourage the CPSC to ensure that the baby box meets the safety standards.
Today states across the country are distributing high numbers of baby boxes to new parents with the hope that the boxes will be a useful tool in preventing deaths among newborns. A
New York Times article from March reported that New Jersey plans to distribute 105,000 baby boxes, Ohio has plans to distribute 140,000, Alabama is looking to give away 60,000 and organizations in Texas plan to give out 400,000.
Champions of baby boxes point to the low infant mortality rate in Finland, a country where baby boxes have been used for over 80 years through a maternity package provided by the Finnish social security system. Through the Finnish social security system, Finnish
mothers are given a maternity package which includes a baby box. Their enthusiasm is understandable, as baby boxes are cheap and easy to distribute. However, there are many differences between the American
and Finnish health and social services system, and at this time it is unclear whether Finnish newborn mortality rates correlate to the use of baby boxes, or whether they are a result of other Finnish practices or lifestyle habits. Before more baby boxes are
distributed to American families, we urge the CPSC to examine these safety issues by testing the safety and viability of baby boxes as a safe sleep space for infants.
We advocate for broad-based efforts to reduce the unnecessarily high levels of infant sleep-related deaths. We urge the CPSC to conduct a study on these baby boxes and determine whether or not these products pose a safety hazard to infants. We would like
to be updated about the CPSC’s execution of this study, including a review of the potential safety, longevity, and other concerns regarding baby boxes. Thank you for prompt attention to this matter.
David N. Cicilline Rosa DeLauro
Member of Congress Member of Congress
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