Empirical data on effect of boxes on infant mortality does not exist, Finnish agency says

This article is more than 2 years old

This article is more than 2 years old

The Finnish welfare and benefits agency that pioneered the use of baby boxes has challenged claims in Scotland that the temporary cribs can reduce infant mortality.

The agency, Kela, supported warnings by a leading expert on infant health, Dr Peter Blair, that it was wrong to say that Finland’s scheme had been proven to prevent or reduce infant mortality.

Blair said baby boxes should only be used for sleeping babies in an emergency or when no cot was available.

His warnings, first reported by the Guardian on Wednesday, prompted a furious outburst by Nicola Sturgeon’s official spokesman. He denounced reports of the criticism as “absolutely ludicrous” and “nonsense”.

Sturgeon unveiled the baby box scheme two years ago saying they would cut infant mortality – a claim that has been repeated by other Scottish National party (SNP) leaders.

The first minister, speaking at the height of the 2016 Scottish parliament elections, told her party’s conference in March that year: “This simple but powerful idea originated in Finland. It provides practical help for parents and has reduced infant mortality and improved child health.”

But Kela told the Guardian it had never made that claim and there was no evidence to support it.

“We don’t want to promote the idea that there is evidence the baby box as such has decreased infant mortality in Finland or that Finland has made such claims. Rather, it has been the improving of our healthcare system of which the baby box is a part of, that our low infant mortality can be attributed to,” a Kela spokesperson said.

“Empirical data on the effect of the maternity package on infant mortality does not exist.”

The Scottish Conservatives asked Sturgeon at first minister’s questions on Thursday about a statement from the British Standards Institution disputing her government’s statements that its boxes met safety standards as cribs and cots.

The BSI, the UK’s national product-safety standards body, said no such standards existed for cardboard baby boxes. The Scottish government responded by citing the safety certificates for the boxes. Those showed the cardboard used for the box was tested under toy safety legislation, and not under the safety standards for cribs and cots.

Sturgeon said the Tories “should be deeply ashamed of themselves for needlessly trying to frighten parents”. She said the boxes conformed to all the relevant safety standards, including for fire safety and mattress quality.

Facebook Twitter Pinterest Nicola Sturgeon responding to first minister’s questions on Thursday. Photograph: Ken Jack/Corbis via Getty Images

Sturgeon publicised the scheme in the Sunday Mail in early April 2016, saying: “The baby box is such a simple idea but has been shown to have a real impact, reducing child mortality.”

In January 2017, that claim was repeated on Twitter by Angus Robertson, then deputy leader of the SNP, as the first pilot schemes were launched.

In a tweet alongside a BBC photograph of Sturgeon handing over a baby box to a mother and her newborn, Robertson said: “Hugely proud of the SNP for launching baby box in Scotland to reduce infant mortality and give best start in life.”

Sturgeon’s spokesman said these claims had not been repeated by the Scottish government since the scheme began last year. It is understood charities and infant mortality experts had warned ministers those claims could not be substantiated, but ministers have continued to describe the boxes as a “safe sleeping space” for infants.

The UK arm of the UN children’s agency, Unicef, stated in November last year that this could not be substantiated. It said it had received a number of queries about whether baby boxes met the accreditation standards under its Baby Friendly initiative on infant healthcare.

It cited the Scottish government scheme and said: “As yet, there is little evidence regarding the efficacy of such schemes and so it is not possible to state whether they offer benefits or harm to babies and their parents.”

Asked about the Finnish agency’s remarks, Sturgeon’s spokesman refused to discuss the basis of her claims in 2016 or to disclose the evidence that led her to make them.

He said: “Some of the criticisms around this have been utterly ludicrous. We’ve been attacked for not applying a safety standard which doesn’t even exist.

“The baby box is a very very helpful, progressive measure. People with common sense around Scotland will recognise that and will see this nonsense for exactly what it is.”

A Scottish government spokeswoman said: “As Kela state in relation to Finland: ‘It has been the improving of our health care system of which the baby box is a part of, that our low infant mortality can be attributed to.’ In Scotland the baby box is accompanied by other improvements to the support available to new and expecting parents and offers health professionals the opportunity to engage with parents at timely intervals throughout pregnancy.”

