Conclusion
SEPARATION
While the baby box is not a panacea to the very complex health challenges surrounding the infant sleep environment, they may serve as a prompt or cue to action towards safer sleep practices. Compared to those who were randomized to receive the diaper bag, the provision of the baby box was associated with improved and sustained safer sleep practices (including infant sleep position, sleep location, and loose items or heavy blankets in the sleeping environment) in this small sample in an Ecuadorian community.In Finland the baby box has a symbolic meaning in that the country invested in the idea of maternal equality and an equal start to life [Baskets are very common in Ecuador and this may be a more desirable, culturally resonant, homegrown, and easily reproducible option to have in the family bed while providing some separation, similar to the wahakura basket [Future research should be directed towards testing culturally appropriate safe sleep devices with a larger range of options, but with a focus on those that continue to serve as a prompt to change caregiver behavior and reinforce optimal practices. Further testing and qualitative investigations are warranted. Additionally, future research in safe sleep promotion within Latin America should include follow up education, further exploration of the use of soft items, as well as observations in the home delivered by trusted members of the community; there should also be an emphasis on taking a harm reduction approach, since parents and educations need to work with what they have available in the given context.