Cardboard baby boxes should not be promoted as a safe alternative to a cot or bassinet, experts have warned.
The boxes, which come with items including clothes and blankets and can be used as a bed, are offered to new mums in Scotland and parts of England.
Experts have now raised concerns over the “scarcity” of observational evidence that such sleeping items can be used safely.
The idea of baby boxes originates from Finland, where pregnant women have traditionally been given a cardboard box full of free baby care items, including a mattress which fits inside the bottom of the box so it doubles up as a bed.
Baby boxes have become increasingly popular in Britain, with a number of NHS trusts offering them to new mothers, as well as private companies.
A letter published in medical research journal The BMJ says the use of baby boxes in Finland and relatively low rates of cot death are “not evidence that the boxes reduce SIDS”, otherwise known as sudden infant death syndrome.
Cot death rates in Sweden and Denmark are equally low, despite them not traditionally providing the boxes, added the academics and Francine Bates, chief executive of the safe sleep charity the Lullaby Trust.
The authors also raised concerns over the “lack of safety standard regulation in place” surrounding the boxes and fears that promotion of the items could undermine current messages about sleeping safety for babies.
The letter concluded: “Without supporting evidence, the cardboard baby box should not be promoted as a comparable alternative to cots, bassinets, or Moses baskets, but as only a temporary substitute if nothing else is available – if the device meets accepted safety standards.
“We encourage rigorous controlled studies to better understand how families use the cardboard baby box and its safety implications.”
The Lullaby Trust has previously warned that while a box may be a better alternative than co-sleeping with a baby in hazardous circumstances, there is no evidence linking its use to a reduction in infant mortality or SIDS.
Cot death is the unexplained death of a child that usually occurs during sleep and is the most common cause of death between one month and one year of age.
About 90% of cases happen before six months of age.
