Promoting Safe Sleep to Prevent Infant Deaths

March 15, 2019
Baby box

Wyoming’s Wind River Indian Reservation has one of the highest infant mortality rates in the state, a fact that greatly concerns Dr. Vonda Wells, Administrator of the Northern Arapaho Tribe. In addition to raising four children of her own, Dr. Wells has championed the well-being of the tribe’s youngest children in her previous positions with Head Start; the Special Supplemental Nutrition Program for Women, Infants and Children (WIC); and an early childhood home visiting program.

“The Wind River Indian Reservation used to have a project called Cribs for Kids to discourage cohabitating sleeping,” says Dr. Wells. “A family could come into the WIC office and ask for one of these beds for free, and the worker would fill out a small application and do a mini-training on cohabitating sleeping and give them the crib.”

“Cohabitating sleeping” refers to infants and children sleeping in their parents’ beds, which increases the risk of injury and suffocation. “The last year we gave out the Cribs for Kids was 2014, and that year there was no infant mortality,” says Dr. Wells. “When that money ran out, I started looking for other options for our babies.”

Dr. Wells tapped part of the tribe's grant from the ACF's Tribal Maternal, Infant, and Early Childhood Home Visiting program (Tribal Home Visiting). The Northern Arapaho Tribe was one of 25 tribal organizations participating in this federal program.

“I looked online and found an article by the BBC called ‘Why Finnish Babies Sleep in Cardboard Boxes,’” says Dr. Wells. “In Finland in the 1930s, they had a high infant mortality rate. They started giving low-income mothers cardboard boxes filled with baby items, with the box to be used as a bed. Later, the government of Finland decided that every baby, regardless of income, deserved a box and what they said was a head start in life. And I thought, wow, that would be so awesome for us to do here.”

She found a company in California that produced “baby boxes” similar to the ones that the Finnish government continues to provide families today. She purchased some of the boxes and the Tribal Home Visiting Program hosted a kick-off event for new and expecting parents in December 2015.

“The parents were excited, and I think they were apprehensive, too,” says Dr. Wells. “Most were young, and a couple were first-time parents. We talked to them about babies having their own place to sleep and how important that is for their development and also for their safety.”

Each box is made of sturdy cardboard and decorated with owls or teddy bears. There is a lid in which to set the box and a firm, thin mattress the baby can lie on.

“When the parents looked inside the boxes, it was like Christmas for them,” says Dr. Wells. “The box we selected has all-natural materials, and they like the baby shampoo, the little hygiene bag with a comb and fingernail clip, the t-shirts, hat, and mittens. The box also has a muslin receiving blanket they can use to swaddle their babies. It has everything that you would need initially when you have a baby.”

The gift is accompanied by mini-trainings from program staff on timely topics for new parents, such as emotional attachment, injury prevention, and health care for both babies and mothers.

The baby boxes also send a message of welcome. “I would like for us to find funding to purchase these boxes for every baby that’s born to the tribe,” says Dr. Wells. “That would show how important our babies are for us as a tribe and for our future and that they deserve the best start that they can have.”

The Northern Arapaho Tribe of Wyoming Visit disclaimer page is one of four groups of Arapaho who originally occupied the headwaters of the Arkansas and Platte Rivers. The Northern Arapaho of Wyoming and Eastern Shoshone jointly own the Wind River Indian Reservation, which encompasses 2.2 million acres between the Wind River Range and Owl Creek Mountains and includes the city of Riverton.

ACF’s Tribal Maternal, Infant, and Early Childhood Home Visiting program provides grants to tribal entities to develop, implement, and evaluate home visiting programs in American Indian and Alaska Native (AIAN) communities. The grants are intended to help develop and strengthen tribal capacity to support and promote the health and well-being of AIAN families, expand the evidence base around home visiting in tribal communities, and support and strengthen cooperation and linkages between programs that serve tribal children and their families.