Mary Ross-Davie discusses Baby Boxes

By Mary Ross-Davie on 02 August 2018 Baby Box

Today the RCM is launching our position statement on baby boxes. The RCM team decided to write this statement as we had had a considerable amount of interest from the press asking our views on the introduction of baby boxes and also some enquiries from members.

The Scottish Government introduced a universal baby box scheme for every baby in Scotland in August 2017. As Director for the RCM in Scotland I have been asked to talk about the baby box scheme on a number of different radio phone in shows and in interviews with journalists. 

In England some NHS Trusts have made the decision, along with local authorities, to provide baby boxes, generally using the Baby box company scheme.

My own personal response to baby boxes comes largely from my experience as a Sure Start midwife in the Scottish Borders. In this role I worked with really vulnerable women – women living with a whole variety of challenges, including homelessness or insecure housing, lack of family support and social isolation, deprivation and sometimes drug or alcohol dependency.  I was able to find some extra funding at one point when I was running the teenage parents group to provide each of the Mums with a baby carrier, a hand blender and a recipe book for making home cooked food when weaning babies. 

I will always remember how bowled over they were that we cared about them enough to give them these things and I believe that this small gesture helped really encourage them to engage in the group and access all the support and services we provided. As a Sure Start midwife my car boot was always full of second hand equipment that was donated to help new families get started.  I know that the baby box would have made a huge difference to the women that I looked after at that time.  However, if the box was only given to women that fitted in to a particular eligibility criteria due to their income or postcode, the box would have missed families that might be in employment but still be really struggling financially and would bring with it the ‘stigma’ of being seen as a means tested state benefit.

Some may see the boxes as a vote winning gimmick by politicians or be concerned that it takes much needed resource away from appropriately funding maternity services.  We agree, baby boxes should never be funded from the budget that is allocated to running safe high quality maternity services – a box won’t contribute what a well trained midwife or maternity support worker can to a family.  However, we also believe, whatever the motivations of the politicians, the outcome of a universal baby box scheme will be to go a small way to reduce some of the yawning inequalities that babies face right at the start of life.  

I recently saw a woman in a supermarket carrying her three week old baby in the sling provided in the Scottish baby box – I asked her about the sling and we also chatted about the box. She said that she loved the box and everything in it as it made her feel that her baby was being welcomed.

Many midwives that I have spoken to in Scotland have found the families that they care for have really valued the baby box:

Anna, a community midwife in Aberdeenshire, told me: ‘ The baby box is absolutely brilliant. Everyone that has received a baby box has been thrilled with it. They like the fact that it contains things that they wouldn’t have thought of buying like the sling and that it can be used over 6 months. I spoke to a 19 year old mum yesterday who said that she felt it really set her up with everything she needed’.

But what about the baby box as a safe sleep space? We still need more research and evidence to definitively say that the baby box is a safer sleep space or as safe as other safe sleep spaces – like a cot or moses basket that is appropriately set up.  What we do know is that safe sleep messages have been slower to be taken up by more marginalised or deprived communities – and we see a higher rate of cot deaths or Sudden Unexplained deaths in infancy in these families.

This is often associated with unsafe co sleeping – on a sofa or settee, or in bed with parents that smoke or have taken drugs. The baby box offers a free alternative place for babies to be put down to sleep on their backs without the risk of overlying and a reduced risk of head covering with adult bedding.  During my time as a community midwife all of the incidents of ‘cot death’ in families that I was caring for were in situations of unsafe co sleeping – if these boxes can potentially contribute to preventing babies dying in similar circumstances in the future, they will have been worth it.

I hope members will find the position statement helpful as it explores some of the evidence relating to baby boxes and how they may support the ongoing work to reduce health inequalities.