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Give Maine’s babies boxes, but give them a visit to the doctor, too

In 2014, Maine lost 6.7 babies in their first year of life for every thousand born. Finland, in the same year, only lost two babies for every thousand born.

One difference between the two places? The baby box.

In Finland every mother, should she wish, is given a cardboard box filled with bottles, clothing, diapers, books and a mattress, which fits inside the box. That box is the first bed for many Finnish babies, and it’s linked with a lower infant mortality rate because it encourages safe sleep, which means sleep without a parent in bed, on a firm mattress, without soft toys or blankets.

Finnish mothers don’t just get a free box, though. If they’d like the box, which is valued at about $155, they are required to see a doctor within their first four months of pregnancy.

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In this way, the baby box program protects infants twofold: They have a safe place to sleep, and they’re more likely to be born healthy and stay that way because a doctor can advise the baby’s parents about how to ensure their child’s well-being.

This information for parents is key to infants’ survival. The infant mortality rate in the United States is worse than the rate in Norway, the United Kingdom, Canada, and many other wealthy countries.

Researchers Alice Chen, Emily Oster, and Heidi Williams examined why the United States’ infant mortality rate is worse than other wealthy countries. They found that the difference came not in the first month of life — babies die at similar rates then — but between the first month and the first year.

They also found that babies in a lower socioeconomic class die in their first year more often than babies in a higher socioeconomic class.

Something is going wrong after the baby goes home from the hospital, only in certain families.

In Maine, it appears more has been going wrong, as the rate of infant deaths has been increasing since the 1990s, according to a BDN analysis of the data.

Even without knowing the specific reasons why more Maine babies are dying in their first year, it’s possible to envision a solution. Good prenatal care is a basic first step, followed by education on safe sleep, which is in a crib, bassinet or box without potentially suffocating toys. The odds of a baby living are greater when a mother stops smoking and drinking, eats well and takes prenatal vitamins.

She could benefit from someone telling her that’s what needs to happen — and helping her through it. Public health nurses do this kind of work along with primary care providers, often visiting mothers at home, but Maine has cut its ranks of nurses.

A baby box won’t make up for this lack of personalized care, and it certainly won’t solve the entire problem of Maine’s increasing infant mortality rate. But, coupled with other parental education efforts, it’s the least Maine can do to encourage a strong start at life.


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