The announcement earlier this week that baby boxes were being introduced in a pilot scheme in Clackmannanshire and Orkney from 1 January resulted in a storm of discussion from some political commentators.
It was as if the announcement had come out of the blue, yet there has been a great deal of discussion about the introduction of the boxes both in the chamber at Holyrood and outside it. The criticism mainly centred on the way the news was presented – that the box in itself would reduce infant mortality. Some questioned whether there is any real evidence of this. Other criticism centred on the contents of the box itself – including a poem by the Makar Jackie Kay.
Jamie Szymkowiak Convener of SNP Disabled Members Group said on Twitter: “Not a bit surprised by the usual suspects queuing up to knock the baby box. I’m bored of their constant whinging.”
Not all of the comment was adverse with a couple of Labour politicians suggesting that this should become part of any future Labour manifesto.
The boxes to be given to new parents in Scotland will contain items which the new baby will need, and the box itself can be used for the baby to sleep in for the first few weeks or even months, rather depending on the size of the baby.
The First Minister was at Clackmannanshire Community Healthcare Centre to meet parents and midwives and to distribute the first Boxes.
Ms Sturgeon said: “Scotland’s Baby Box is a strong signal of our determination that every child, regardless of their circumstances, should get the best start in life.
“The Box contains around 40 different essential items for new babies and for parents. It’s a simple idea with a proven record in tackling deprivation, improving health and supporting parents, and I’m proud and excited that the pilot is now underway.
“Being a parent is the most important but also the most difficult job there is so it’s important that parents get as much support as possible. The Box complements the existing services available to help babies and parents to thrive in the crucial early months.”
Mum to be Joan McKinven said: “I’m very impressed with the contents of the box. I think any support will be appreciated by new parents. There are a lot of helpful items so I think it will be well used.”
Gillian Morton, Head of Midwifery at NHS Forth Valley said: “We are delighted that Clackmannanshire has been selected as one of the pilot sites for the new baby boxes. Pregnant women from the local area are really looking forward to receiving their boxes and we are sure the wide range of items will be very useful during those important early weeks and months.”
Scottish actor Iain Robertson has written a very personal account of why he supports the Baby Box programme here.
PROCUREMENT
The boxes which Scottish babies in the pilot areas will receive have The Scottish Government logo on them, and the boxes will be supplied by the APS (Scotland) Group. The eventual supplier will be confirmed following the completion of the government’s procurement strategy.
The Scottish Government has confirmed to The Edinburgh Reporter that they are working on their procurement strategy and supplier chain for the further roll-out of the Baby Boxes. This next stage will follow the current pilot project which the government confirmed to us will be fully evaluated before a summer 2017 rollout across Scotland.
That evaluation will include a review of the contents of the box. At present the box includes the following items:
Mattress
Fitted cot sheets
Satin edged cellular blanket
Mattress protector
Pramsuit with hood
All-in-one day suit
Romper and bodysuit set
Scratch mittens
Short-sleeved bodysuit
Long-sleeved bodysuit
Long-sleeved bodysuit with integral scratch mitten
Long-sleeved wraparound bodysuit
Footed leggings
Fleece jacket with hood
Jersey trousers
Baby wrap
Hooded bath towel
Real nappy and liners
Digital ear thermometer and replacement hygiene cover
Natural bath sponge
Bath and room baby thermometer and battery
Dribbler bib
Organic cotton muslin squares
Comforter / soother toy
PlayTalkRead play mat
PlayTalkRead travel changing mat
Baby book
Nursing pads
To get a better idea about the contents of a Finnish Baby Box produced by one company here is an unboxing video:
REAL NAPPIES
The inclusion of real nappies in the Scottish Baby Box is an important one, and follows a parliamentary debate secured by Ivan McKee MSP on 14 September 2016. During the debate politicians heard about the disposable nappy which takes anywhere between 200-500 years to degrade, and that around 160 million of these are sent to landfill every year at a huge cost to local authorities.
There was much detail produced about the advantages of reusable nappies over their convenient but long living disposable counterparts. Mr McKee explained that one of the obstacles to using the more environmentally friendly nappies is the initial cost of around £300 which requires to be paid out all at once, meaning that they are often put out of the reach of lower income households.
Mr McKee also said: “The scheme in Finland has contributed to a fall in infant mortality from 10 per cent to 0.2 per cent, which is one of the lowest rates in the world.
“Despite its great successes, though, the Finnish model is open to improvement and would benefit from some home-grown Scottish innovation. The Finnish baby box provides a single reusable nappy. Although that is useful in introducing the concept of reusable nappies to a young family, they are still required to make use of significant numbers of traditional disposable nappies or purchase their own set of reusables when that single nappy is in the wash.
“I encourage the Scottish Government to engage with manufacturers to ensure that the Scottish baby box provides a solution that exceeds that of the Finnish baby box by enabling families to make a real and decisive rather than token move away from the use of disposable nappies.”
FINLAND
Baby boxes have been used in Finland for some time where there is a definite downward trend in infant deaths from a startlingly high one in ten to less than two in a thousand. Although we have struggled to find any real evidence that this is due to the use of the baby box alone, and not also due to improved medical care, the Finnish model has been referred to repeatedly during the debates at Holyrood as something to emulate.
Statistics Finland noted in April 2016 that the number of infant deaths had dropped by 27 to 97 children who died during their first year. The total population of Finland is just over 5.5 million as at November 2016 so it is directly comparable to Scotland. With only a few spikes the trend was downward since 1900 and particularly since around 1940.
DESIGN
A competition was launched last year to design the Scottish baby boxes, and the shortlist was announced in early December by the V & A Museum of Design Dundee. Over 70 designers entered and from those there are three from Edinburgh.
The competition asked students to design a way for families to interact with the pattern on the Baby Box, by customising it to record key stages in a baby’s first year such as date of birth or weight, and perhaps include space for their hand or footprint.
The shortlisted designers are:
· Grace Brown, North East Scotland College
· Marwa Ebrahim, Glasgow School of Art
· Ruth Hamilton, Edinburgh College of Art
· Lena Sakura, Edinburgh College
· Monika Stachowiak, North East Scotland College
· Leanne Young, Edinburgh Napier University
Mark McDonald MSP, Minister for Childcare and Early Years, said: “I am absolutely delighted that this competition to design Scotland’s Baby Box has captured the imagination and fired the creativity of so many young designers. The quality of all the entries received has been highly impressive.
“The shortlist announced today is packed with the very best of all this creative talent and I look forward to working with my fellow panel members to pick the winning design. The winner will not only see their idea rolled out on every box for every baby and family in Scotland but will also receive exclusive mentoring from leading Scottish designers and a prize of £1,000.
“We want Scotland’s Baby Boxes to become a key and enduring part of the lives of parents and children, so the design needs to be bold and inspirational. The designs we have seen so far definitely achieve this and I congratulate and thank all the entrants for taking part.”
LONDON to LIMERICK
According to a BBC report a hospital in London became the first in the UK to hand out baby boxes last summer, although it is by no means a UK wide scheme. In September last year University Maternity Hospital in Limerick handed out the first baby boxes there. All mothers of newborns will receive the boxes which carry with them an important educational message. The infant mortality rate in Ireland is 3.7 deaths per 1,000 and the hope is that all babies will have an equal chance of survival.
Baby box scheme introduced at the University Maternity Hospital, Limerick https://t.co/j6Ra87e6nO
— RTÉ News (@rtenews) September 23, 2016
In Scotland the infant mortality rate reported in 2010 was 3.7 per 1,000 births AND in 2016 UNICEF calculated that the UK had risen up the league table of the well-being of children to 16th out of 29 developed countries, from a lowly 21st in the previous table produced in 2007. The Netherlands is in first place followed by Norway and Iceland, but Finland also features in the top half of the list.
POLITICAL COMMENT
Commenting on the introduction of the Baby Box pilot scheme Lothians MSP Miles Briggs said: “The Scottish Conservatives were sceptical about the baby box proposal as we believed it made better sense to focus resources on those most in need of support, for example by creating an additional 500 health visitors with a particular concentration in areas of high health inequality so that parents had access to high quality, practical and ongoing support with their child’s upbringing for the first seven years.
“The evidence base behind the baby box and its effectiveness is limited to say the least.
“However, given that the SNP Government is going ahead with the policy, we believe it should incorporate as much information about infant health as possible. One area I would like to see a focus on is baby’s dental health.
“I hope the government will assess the baby box pilots very carefully and take into account the views of mothers and fathers who have received it and adapt it accordingly to ensure it is providing the best assistance to parents and the best value for money for taxpayers.”
Miles Briggs also said during a parliamentary debate: “I have asked a number of parliamentary written questions on the proposed contents of the baby box but have not yet received an answer. I would like to find out how the policy is to be developed and what, broadly, will be included in the box. An Edinburgh constituent of mine who is an English teacher recently contacted me regarding her positive suggestion that the box should contain a good-quality baby book. She suggested that that would make a statement about our country’s belief in literacy and would show parents that it is never too early to talk to and read to their baby.”
Claire Baker Labour MSP for Mid Scotland and Fife said: “The baby box has an interesting history. It was introduced in Finland in 1938 for low-income families before it was rolled out to everybody in 1949. In the 1930s, Finland had a high infant mortality rate. Legislation was adopted to introduce the box, for which mothers-to-be had to visit a doctor or a municipal prenatal clinic before the fourth month of pregnancy. That steered women into the emerging welfare system and national health service, which improved the health outcomes of babies and families.”
Mark Ruskell Green MSP for Mid Scotland and Fife said in the debate: “The baby box is a fantastic idea. It is perhaps a key point where we can influence behavioural change. Indeed, whenever our life circumstances change, there is an opportunity to influence behaviour. Many members have spoken tonight of the baby box’s impact in Finland and how it has slashed mortality rates there. Another interesting thing about the Finnish example is that parents are offered a cash equivalent—they can take €140 in cash or the baby box—but 95 per cent of parents go for the baby box. That underlines the strong social welfare culture in Finland.”
Gail Ross MSP said: “Finland’s baby box has been providing support for mothers and babies for more than 75 years. In that time, as Ivan McKee mentioned, infant mortality rates have dropped considerably, and the social benefits are almost immeasurable.”
Kenneth Gibson SNP MSP for Cunninghame North asked last year what impact the new baby boxes would have on infant health.
The Minister for Public Health and Sport, Aileen Campbell replied : “The boxes will be based on the successful Finnish model which has a proven record in tackling deprivation, improving health and supporting parents.
“The boxes will provide a range of essential baby supplies, equipment and simple, consistent information for new parents, and will help to ease the financial burden of providing for a new born child. We are still at the very early stages of engagement and design of the baby boxes and plan to hold discussions with education and health partners, parents and carers to discuss content and other aspects of the box.”
THE COST
The scheme will cost £6 million per annum to run, according to an answer given to Lothians MSP Jeremy Balfour last year. This works out at about £100 per box. Some dissenters clearly have issues with spending so much money on a scheme which may not be wholly based on purely scientific evidence, but another part of the reasoning behind the scheme is to offer every child born in Scotland an equal start.
The Directorate of Children and Families, Creating Positive Futures Division will be responsible for overseeing the Baby Box Scheme in close partnership with other policy areas across the organisation according to Minister for Public Health and Sport, Aileen Campbell MSP. She explained: “The Scottish Government is working with a variety of stakeholders and with parents to agree which items will be included in the boxes. Options for distribution are being considered and will form part of the procurement exercise in the coming weeks. The proposal is for a Scottish baby box of the same standard as the Finnish model.”
It is hard to find anything specific that says the Baby Box scheme will definitely save lives, since Sudden Infant Death Syndrome or Cot Death is said to be due to causes which are not always clear. Current NHS advice on Sudden Infant Death Syndrome explains that there is no one cause, but that placing a baby on its back to sleep is believed to help avoid it. The current Scottish Government advice to reduce the risk of cot death includes the advice that parents should place the baby on their back to sleep in a cot in the same room – and specifically warns that parents should avoid sharing a bed with their baby.
Jamie Hepburn MSP said: “Starting in two pilot areas from 1 January, with roll-out across Scotland from the summer of 2017, every newborn in Scotland will receive a baby box of essential items, including clothes, nappies, bedding, books and baby-care items. That initiative is very much informed by the experience of other European countries—which Alison Johnstone spoke about—especially Finland, which has seen a significant reduction in infant mortality largely because of such initiatives.”
If the baby box provided by The Scottish Government allows new parents simply to have somewhere suitable to lay the baby down to sleep for even a few weeks or a couple of months, then it may avoid a baby overheating in an adult bed or indeed reduce the risk of suffocation, and allow them to comply with government advice. And it may save lives.
MANIFESTO
If those who dissent were taken by surprise at the announcement, then we might remind them that the baby boxes were first mentioned in the SNP Manifesto published ahead of the Scottish Parliamentary Elections in May 2016 which included this provision:
Every new-born in Scotland will be entitled to a ‘baby box’ offering essential items for a child’s first weeks – adapting the successful Finnish model which has helped to improve lives for babies and toddlers.
Finally one last suggestion. Could we (as suggested by Katriona Gillespie in Product Magazine and on Bella Caledonia) maybe call them Bairns’ Boxes?
Of course that introduces an apostrophe into the discussion. One Bairn’s Box, Two Bairns’ Boxes?
Founding Editor of The Edinburgh Reporter.
Edinburgh-born multimedia journalist and iPhoneographer.
