Purpose
The present study fills an important gap in pediatric literature as it evaluates whether the provision of the baby box offers any additional benefit over that of safe sleep education alone. To assess this we provided the same AAP safe sleep education to all participants, and then randomized them to receive either a diaper bag or the baby box. The purpose of this study was to promote safe infant sleep practices and to assess specifically if the provision of the baby box improved safe sleep practices in a low-resource peri-urban community in Ecuador. The aims were: 1) to describe the participants’ intentions regarding the infant sleep environment prior to the AAP education including location, use of soft items, position, and risk or protective factors such as maternal cigarette, alcohol and other drug use and breastfeeding; and 2) to evaluate the changes over time and between intervention groups in prenatal intentions and post-birth behaviors related to infant sleep practices at 1 month and 6 months. Our hypothesis was that the provision of the baby box would decrease maternal-infant bed-sharing and improve sleep safety by deterring the use of loose or heavy blankets or soft items in the place where the infant slept. We did not anticipate that there would be a difference in the sleep position of the infant based on the provision of the box.