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Why Finnish babies sleep in cardboard boxes (2013) (bbc.com)
442 points by Tomte 16 days ago | hide | past | web | favorite | 253 comments

Here in the Netherlands, they tend to kick the mother out of hospital as soon as feasible after the birth (typically after one night, or even on the same day), but as soon as you get home, the home nurse (kraamzorg, or "cradle care") arrives. She (and, as far as I know, it's always a she) will be at your home for something like eight hours a day for the first week or so after the birth, and will teach you how to care for the baby (even if it's your second, third, fourth, ...) and will monitor its health and progress. Remarkably, in the 'downtime' (e.g., when the baby is sleeping), she'll do household chores for you (such as clothes washing, vacuuming, washing up, etc.) and maybe even entertain any older children or go grocery shopping for you. The system works really well, and I've heard it be credited for the Netherlands' low infant mortality rate.

My family back in the U.K. can hardly believe it (especially the household-chores part); there, as I understand it, the mother tends to stay in hospital a big longer (typically for a few days), but once you're home, you're on your own...

This is why my wife almost died in the US. We left the hospital after two days, and were left to fend for ourselves. We were so busy with the newborn that we didn't notice that my wife was developing an infection. By the time she fainted from a sudden high fever, it turned out she had a uterine infection. And after lying on a stretcher in the ER for 14 hours with not so much as a glass of water, she had a full-blown septicemia.

None of this would have happened with midwife visits at home (like we had in Germany for the second child). They check on the mother as well as the baby.

And you likely paid more overall for this "service" as well!

We paid as much as the Duchess of Cambridge, who also gave birth to her first child around that time!


(Not Dying...)

Just to clarify that - having had a baby in the UK in the past 3 months - what you say isn't correct (at least for England and Wales; I can't comment on Scotland and NI but I very much doubt they have different systems).

Mothers are frequently discharged from hospital the same day, or the following day. My wife had some (relatively minor) complications and thus had a 2 day stay. This is longer than average. Even mothers who had C-sections (i.e. major abdominal surgery) seem to stay <= 3 days, unless there's bigger complications.

Once home, the mother's 'midwife' will make home visits 2-4 times in the first week before 'passing' the care onto a 'health visitor'. They will also visit at home (1-2 times a week) for the next few weeks, before this becomes an at-clinic care.

There's also 'infant feeding nurses' (i.e. breastfeeding support) as needed, although this one does vary per area.

So it's no-where near the Netherlands level of care (having someone do the chores those first few weeks would have been very useful!), but it is definitely not the case that "you're on your own" after leaving hospital after a multi-day stay.

Ah! midwifes. In Poland they are a dinging out species. Majority of them are in their 60s and... tired. Observing them washing the newborn is something to see: they use running water and hold the baby in one hand and operate faucet with the other. There's also a "patronage visit" when they strongly encourage the father to get his shit together and "just change the diaper, babies are hard to harm!". If you are lucky you may meet the midwife that helped your parents. Midwifes are also present during the birth. And they are in charge. Doctor is present. But has not much to say. He or she just has to follow midwifes directions, that's all. During my wife's first birth a doctor was over-voted and driven off by midwifes after suggesting Caesarian section. "I have 35 years of experience, do you want to deal with the next birth alone"?

Maybe worth noting that Scotland has had baby boxes for a while now:


> (I can't comment on Scotland and NI but I very much doubt they have different systems)

I can comment for Scotland: it's almost exactly the same. The territorial boards greatly prefer midwife-lead care, so the only times we saw a docter were: months before delivery, saw the GP once to confirm the pregnancy test results; a pediatrician a few hours after delivery to count fingers and toes. Everything else was midwives, and handing over to the health visitors 2 weeks after delivery.

That sounds almost identical to my (English) experience except I did it 25 years ago. In fact that's pretty much what happened when my baby brother was born 35 years ago.

Discharged the same day?!

First one was 48 hours, and we were unimpressed at them holding on to us for so long. Second was born at 02:10, we were home at 19:39. Both cases was after an induction.

Many babies are born at home.

Is it true in the U.S. that the baby doesn't sleep next to the mother in hospital? I've seen these warehouses full of babies on TV shows, like in this photo:


But it always looks a bit distopian to me.

Between the time our first (2011) and last (2017) were born, our hospital (Michigan, US) changed their policy to have the baby sleeping in the room rather than in the nursery. We weren't too thrilled with the change, to be honest—the time the baby was in the nursery allowed us to get some additional much-needed sleep.

FWIW our California-born babies slept with us (and was never taken away from me, except to be cleaned and weighed, and I was right there next to them the whole time). The "room of cribs" was the neonatal intensive care unit. It was, thankfully, empty when we were there.

> It was, thankfully, empty when we were there.

uhmmm... Won't you rather wish they were not empty? I suppose it all depends on the manner of the emptying.

I would reason that if the neonatal care units are empty, it means that all the children recently born were healthy and didn't need intensive care. :)

In a previous life I did tech support in a hospital. One day I was called down to the ER to fix a printer or some other routine thing. I was accustomed to the chaos of the ER but that day nothing was going on. I commented to a nurse that "it is dead in here". She promptly and firmly informed me that we don't say those kinds of things in the ER.

Every NOC (network operations center) I've ever been in, if you start to utter the phrase "sure is quiet today" or anything similar, someone tackles you to the ground before you finish it.

You don't tempt fate like that!

Baby making activity is not randomly distributed throughout the year.

Depending on where you live (i.e. when it is warm), the peak month changes.


It's from 5 years ago, but I don't think much has changed since https://www.theguardian.com/lifeandstyle/2014/aug/29/new-mot... was published.

I should add that, from what I've heard, same day discharges is much more common for the second (/third/etc) child compared to having a first.

We wouldn't even have gone into hospital for the second one, except the midwife was unable (or too uncomfortable) to sew up the worse than expected tearing my wife suffered. Even after being whisked to hospital in an ambulance (at about 3 am), my wife was back home the same day.

Mostly, I believe, driven by the fear of infection.

> she'll do household chores for you (such as clothes washing, vacuuming, washing up, etc.) and maybe even entertain any older children or go grocery shopping

Our kraamzorg nurse even cooked us meals! She also taught us a lot of techniques on how to get the infant to sleep. My wife looks back very fondly to the first post-natal week and the kraamzorg was a big reason. Having someone nearby who's been there before is a big stress relief for first-time parents who are full of questions and concerns that first week.

From personal experience in the UK, you're kicked out of hospital after a few days during which you received amateur advice from nursing assistants and a final discharge check for the baby if the doctor is available (if not then you have to go back for the discharge check). Back home there are irregular visits from a nurse who usually writes random statements in the a red log book but aside from that you're on your own. If you have time for the internet you might learn about why a baby doesn't latch and then maybe find a private lactation nurse who may or may not give you useful advice. Maybe one of them has heard of tongue tie because the NHS doesn't believe in it (and they're not allowed to support anything but breast feeding...)

I would like to add my own anecdata that conflicts with this. We've had four children and our experience of ante-natal and post-natal care has been nothing like this for any of them.

The home visits are regular and scheduled, breatfeeding advice was offered in hospital, a breastfeeding support clinic is run for free in our local hospital once a week and on other days in local community centres. Two of our children have been identifed as tongue-tied by midwives in hospital. The midwives in hospital provided formula for the most recent baby when my wife was having trouble feeding.

Overall, we've felt very supported by the NHS. I suspect the difference is partly timing, every team contains good staff and bad staff. It probably differs region to region as well, I'm in Buckinghamshire.

Ours is a teaching hospitals trust, and a fairly large one I suppose, and we have had good experiences each time with our three children. I think there can be a big difference if you end up in a medical-led ward instead of a midwife-led one for the actual birth, but I expect there's lots of variance beyond that.

Not to disagree with your experience, but to clarify. Postnatal checks by the doctor may be performed up to 72 hours after birth [1]. The reason that the doctor might not be available, is because they may be attending a neonatal arrest call, which can require prolonged ventilatory assistance for the newborn by the doctor. In that setting, hospitals might want to make empty beds to enable more mothers to safely give birth in the hospital of their choice. In an ideal world, there would be more beds.

Finally, sorry to hear about your experience of tongue tie. This is also mentioned in link [1], so it's definitely not something that the 'NHS doesn't believe in'.

[1] https://www.nice.org.uk/guidance/cg37/chapter/1-Recommendati...

Sorry for your experience. We've actually had a decent interactions with breast-feeding support workers (and local groups). Our first had a tongue-tie which we had cut on the NHS, though it was very difficult to get them to give us any firm advice on it either way. It's sad if different trusts have such varied support.

I do agree that the health visitors probably end up being more hassle and causing more stress than they're worth. By the time of our third kid we just smiled, nodded and lied our way through every interaction until they went away.

> It's sad if different trusts have such varied support.

Different trusts in the NHS have wildly differing support, policies, physio, mobile apps, leaflets and documentation, etc etc. It makes the "N" in NHS a bit odd, and surely is tremendously inefficient!

(Having said that, and having recently had a baby the NHS and their staff have all been amazing!)

I had tongue tie until I was about 7 years old when my sister noticed something wasn't right. I was never breast fed so it didn't get picked up.

Fortunately for us, when having our first, we knew about it and in Southampton UK they are one of the better hospitals who check for it and can get it sorted at one of their breast feeding clinics.

FWIW our experience was different. We left the hospital after 3 days, during which we received advice from professional midwives, including how to breast feed (and what to do if baby doesn't latch). At home visits from health worker and midwife were regular and data and notes in the red book did not at all seem random.

Our kraamzorg experience is one of the reasons I will likely never return to the US from Holland. The amount of care that society here puts into practically solving problems, while maybe not sufficient for every societal ill, is incredible here.


There are plenty of problems that aren't solved, I'd be interested if you would like to point out some?

Could you elaborate why you think GP is incorrect?

> Here in the Netherlands, they tend to kick the mother out of hospital as soon as feasible after the birth (typically after one night, or even on the same day)[...]

For our two (both born in Amsterdam) we were out of the hospital 3-4 hours after birth in both cases (both induced, and with epidural). They do the bare minimal to make sure you're not actively bleeding (and stitching), measure the baby and then you're out.

When you get home the kraamzorg is there waiting for you. I think it's a much better system. You don't need hospital services (surgery, anesthesia etc.) anymore. Why would you want to stay in a hospital?

To add to the national comparisons - here in Japan the mother typically stays in hospital for a week to recover while getting help learning to feed, bathe and change the child. My daughter was born via C-section and so they kept my wife for 10 days. You can get a paid upgrade to a family room if you wish.

The tradition is then for the mother to stay at her parents house for a month to get help from grandma when she's learning the ropes (my wife lasted a week).

I couldn't imagine getting kicked out the same day. What a load of work! Especially if the father is expected to go straight back to work (as another comment said was typical before this year)

Paternity leave in the UK has been two weeks since at least my eldest was born, 15 years ago.

Ah sorry I was referring to the Netherlands

> credited for the Netherlands' low infant mortality rate

Wasn't Netherlands birth mortality rate actually higher when compared to neighbor countries because of the tradition of giving birth at home (which is not dangerous in itself but it means that valuable time is lost in the case the mother has to go to a hospital and the doctors there have to first sync up with the pre-natal nurse)?

It's correct that the infant mortality rate in The Netherlands is somewhat higher than neigbouring countries (the sixth highest of European countries), the cause of this is not exactly clear. There was a study in 2010 that drew much media attention, which reached the conclusion that you are talking about. However, the methodology drew some criticism, and followup research (e.g. this https://www.midwiferyjournal.com/article/S0266-6138(15)00214... from 2015) has contradicted the results.

Comparing home and hospital birth can be a difficult problem. Policy in The Netherlands dictates that women who are estimated to have a higher risk of complications must give birth at a hospital. This means that the hospital group's risk profile is inherently different, which is a factor that is difficult to compensate for. It also seems that lower educated women gain more safety from hospital birth, although the exact reasons are unclear.

Overall the question is not at all settled at the moment. The research community is also extremely hesitant to communicate with the media out of fear of causing another scare like what happened after the 2010 study. Fact is that home birth is becoming increasingly more rare, down 10 percentage points over the last 10 years.

This 2004 paper examining the difference in infant mortality in The Netherlands[1] concludes that it's basically due to immigration, parents being older (father's age is also a factor), and fertility treatments.

Some ethnic groups in The Netherlands have 2x higher infant mortality after birth than others, people are older when they're having kids, and having twins (or more) is now 2x as common as in the 1950s due to the availability of fertility treatment.

I wonder how up-to-date the results of that older paper are, the other ones discussed here seem to address much narrower questions.

1. https://www.demographic-research.org/volumes/vol11/13/11-13....

Thanks for the link to the 2015 paper. I read the original paper around 2013 and didn't actively look for followup papers in the last years.

Having a baby at home is silly given it has a higher mortality rate than in a hospital environment. I think after leaving the hospital have a helping hand is great as is before the birth with the pregnant mom's habits. However the most dangerous time is the actual birth and I would much rather have trained physicians around than a midwife.

Could be. I'm not an expert (I haven't even looked up the statistics), and I suspect that neither was the person who I heard crediting the kraamzorg system for the low infant mortality rate.

I certainly get the impression that giving birth at home is quite 'trendy' here, but my wife and I decided that there was no way that we were going to opt for that. My wife would much rather give birth in a building full of experts and specialised equipment than in the "relaxed, familiar atmosphere" of home.

Not really trendy, but more the way it has always been done. Childbirth isn't a disease and shouldn't be treated as such, is the rationale behind it.

Seems like a silly rationale to me. It’s not like evolution has optimized bodies to be amazing at childbirth. There are many possible complications that modern equipment and expertise can help with that aren’t available at home. You can do the same thing you do at home, with the security of having medical care immediately if things get complicated.

You have to keep in mind that there's quite extensive screening on eligibility and low barrier to refer to a hospital, as well as medical care will be available (experienced and well-trained midwifes are present during birth, GP will usually be on stand-by). If there is any major risk of complication, it will be a hospital birth. Living too far from a hospital? You better go there to give birth. Midwife and/or GP doesn't trust it anymore during birth? An ambulance is called and hospital it is (and you'll be there in time, as you live close enough). The distances in The Netherlands are extremely small compared to the USA, it's not like you're giving birth in the middle of nowhere.

A more recent trend is that of the 'geboortehuizen' (birth houses), which are literally what the name says: special places just for giving birth. Instead of the clinical atmosphere, it is more like a home but advanced medical care is close-by, as most of them are affiliated with the hospitals. It's seen as a good balance/compromise between the risks of giving birth at home, while still having a more quiet, 'gezellige' atmosphere.

Despite all modern equipment and expertise „Intrapartum and neonatal mortality was 0.15% for planned home births, 0.18% for planned hospital births“ (source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5465453/). Something to think about.

Disclaimer: my wife gave birth at home (but not in Netherlands)

There is nothing to think about. Most serious cases would be treated in hospitals and, alas, sometimes there is nothing medics can do. If you want to think, think about, what those numbers would be if everyone was giving birth at home.


What do you think about 60 baby birth deaths in hospitals this year alone in Lithuania? And it is shitty attitude to counter argument science with single really unhappy incident.

You can't just post a random paper and call the case closed. Some points from the paper:

- The populations studied were preselected to be low risk, because "Dutch guidelines prescribe a hospital delivery with their midwife-led delivery (no choice of planned home birth)" to women with medium risk levels. So we're not talking home vs. hospital for any women, just for those where the doctors say everything is double-plus super fine with the mother and the baby. The study did adjust for the fact that "either due to self-selection or due to the midwife’s proposal, the healthiest and most affluent women are more likely to undertake a home birth".

- From the conclusion, "the benefit of substantially fewer interventions in the planned home group seems to be counterbalanced by substantially increased mortality if intervention occurs".


So what the study says is generally, if you and your doctors are double-plus sure you're low-risk, then you can go for either home or hospital birth; but if an intervention turns out to be needed, you're in big trouble.

I agree that case is not closed, however I was responding to very specific short sighted comment. About your points: Yes, you should understand if you or your relative is in low risk group. Honestly, if possible you should always understand and evaluate risks, whatever you are doing. Problem that humans are really bad with statistics (recommended reading "Thinking, Fast and Slow").

Lastly, you have actually read what I have posted and this is awesome. You can find more scientific sources about positive benefits of home birth. Lastly, I'm not saying that you should do it. My problem is that home births are semi-legal in my country ;-) Shortsighted comment was written by person from my country :-(

For many many years (basically up to XX century) the most dangerous thing a woman could do health-wise was to get pregnant. Being pregnant is not a disease, but childbirth is a very high risk.

Less than 1% of stillbirth and possibility of mother's death is even lower. I'm pretty sure there are things that are more dangerous a woman can do.

"Stillbirth rates never exceed 70 per 1,000 total births." (source https://www.cairn-int.info/article-E_POPU_804_0683--late-fet...)

it's a disease as much as aging is a disease... extremely risky and often (always in case of aging) leathal.

Disagree. Aging is a disease as much as cancer is a disease - you'll eventually die of it if nothing else gets you before.

The difference between pregnancy and aging is that the former is desirable, the latter is something to get rid of.

> and, as far as I know, it's always a she

As I have learned a few months ago when our midwife came by daily the first 2 weeks after our baby was born (in Germany, healthcare insurance will pay for daily midwife visits the first 10 days after you are out of the hospital, and for additional 16 times in the first 6 weeks) there are exactly 4 male midwifes in Germany, which is roughly 0.017%.

I get it, however. Our midwife had 2 children of her own, and it is extremely comfortable to know that the midwife already went through all of that herself. There are some things that cannot be taught, and giving birth is definitely one of them.

> Here in the Netherlands, they tend to kick the mother out of hospital as soon as feasible after the birth (typically after one night, or even on the same day)

My wife stayed in the hospital for 4 nights (she was definitely not able to go home sooner) and it was a very pleasant experience. She basically stayed in her bed undisturbed with the baby and if she needed anything (including some time alone) the nurses where there. We were very pleasantly surprised as we both heard horror stories from our own parents who gave birth in the late 80ies (in Germany and Switzerland) when it was uncommon to put the baby in the same room as the mother. Apparently, breast feeding was often supervised in the hospital back then and the baby was weighted before and after to check the amount of milk it drank.

PS: We were extremely grateful that we had the midwife available 24/7 the first weeks. There is just so much going on, both with the child and the mother's body. We had many panic moments where we called our midwife, and she usually came by the same day or calmed us down via phone. However, I don't think a service like that is absolutely necessary if you have family support and if the child is healthy. As we later found out, almost everything we asked the midwife or were concerned about could've been answered by our own parents. In retrospect, we were absolutely clueless.

OTH the father had to until this year go back to work the next day...

True. In my haste, I neglected to mention that until recently the Netherlands has had one of stingiest paternity/partner leave policies in Europe. It used to be (roughly speaking) one or two days, as of this year it is one week, and next year it will become six weeks. Too late for me though! In my case, I saved up some of my holiday days to be able to take time off work (fortunately you tend to get a few months' warning before a baby appears in your life).

> fortunately you tend to get a few months' warning before a baby appears in your life

Yes but the baby can come anytime within a period of about a five weeks and be within the "normal" period. You need an understanding employer to take two weeks holiday "sometime in the next 5 weeks".

You do, and any employer who won't allow it is being an ass and should get ignored. Your family and your baby is more important than your manager's power trip.

Any responsible father takes two weeks off after the birth of a child. I'm glad it's mandatory now, but even before, it shouldn't have stopped any new father from spending those first two weeks with his family.

It's a very important period where you learn how to take care of the new baby, bond with it, and need to take care of your wife who quite likely is in no condition to do anything other than recover.

Not in the US, where paid leave for either parent is not guaranteed. Mom's are allowed 12 weeks unpaid leave, but only if her employer has 50+ employees. If she works for a small company, she's SOL. Dad's have no guarantee of anything. It's pretty horrific.

Just take the time off, then. What is this, slavery?

(I'm aware that people with very low incomes and no paid holidays at all, may not be able to afford that. But that situation should be illegal in any modern, wealthy country. I guess the answer to the question above may indeed be "yes" in some cases.)

Umm, sort of - without employment, one will likely lose any health insurance that one might have had and with that can follow financial ruin. "Lives of quiet desperation" is a fairly accurate description.

Not American, but I believe taking unpaid leave is not necessarily an option there. Unless by taking unpaid leave you mean resigning.

What are you supposed to do when you are ill? What are you supposed to when a dependent is ill and in need of your care?

Never being able to take a day off for anything at all is incredibly harmful. People used to fight for these rights. What happened?

> People used to fight for these rights. What happened?

Everybody got convinced that a) those rights will be used by those people who obviously don't deserve it and b) those rights will make life harder for them when they become billionaire business owners.

The US experiment with social democracy in the 1940s, which was not terribly comprehensive in the first place, has been slowly dismantled as the employer and political class continues to concentrate as much wealth and power for themselves as possible. Key to this has been to weaken and villainize labour unions at every opportunity.

When sick, you continue going to work until you wind up in the ER. If you're lucky, you don't get fired when you're there. Only exaggerating slightly. It's pretty sad.

As for what happened, the US isn't highly unionized outside certain regions and trades. Everybody else has next to zero legal protection. White collar workers typically get some leave simply by virtue of having skills that are more in-demand. And the labor movement largely allowed conservative, anti-labor factions to cast them as evil socialists. In the US, "liberal" has long been a bad word.

"Dad's have no guarantee of anything. It's pretty horrific."

This is not accurate. If the employer falls under FMLA, then dad gets 12 weeks unpaid leave as just like mom does.

In some states there is paid family leave for both mom and dad. I've used it twice.

My mistake. FMLA does extend unpaid leave to both parents. In my experience, fathers tend not to use it because somebody has to pay the rent. The father I do know who have taken leave did so because their employer offered paid leave as a perk.

Also correct that some states have additional leave requirements. 12 of the 50 have done nothing (only FMLA applies). 14 have lowered the FMLA business size from 50 to something smaller. 7 have adopted more generous maternal leave policies, though most only offer 50% pay over a short period of time.

Only 4 states offer paid paternity leave.

Regardless, the US is the only OECD member that does not require paid maternity leave.

> The system works really well, and I've heard it be credited for the Netherlands' low infant mortality rate.

Do not agree. Netherlands has remarkably poor statistics when accounting for total incidents and outcome from the months before and after births. They have more than double the shit rate compared to other high quality healthcare western European countries. Anecdotally I've heard this attributed to the custom of having close to 30%(?) of births done at home, which is an outlier and increases risks of poor outcome when complications arise.

But parent's notes on assistance post natal is probably correct and a very good thing.

This is so amazing!

Here in the US, when we had our twins, we knew that we would need a similar service - we hired a night nanny (note: just for nights, not daytime). Price was high, but our firstborn was difficult we knew we were out of our depth with upcoming twins (not to mention actually taking care of the older kid).

The night nanny did not monitor medical though.

Family is a great ideal, but often grandma doesn't remember how to take care the newborn, or help the mom.

For comparison purposes: in France, you stat 2-3 days after birth at the hospital, then a midwife visits you 1 to 3 times at home, complemented with “PMI”: nearby newborn centres where you can go for free to get tutoring, support, fever checkups, vaccines, etc. Also the mother gets some followup in the next 6 weeks.

You can get midwife care here in Canada, but it's something you sign up for, are not guaranteed to get, is more geared towards people seeking home or 'natural' births, varies in structure and quality from province to province, city to city, and like everything with our health care system is constantly under creeping threat from politicians of the right wing bent. In Ontario more funding was recently slashed, I believe.

That said we had the same midwife for both our children and she was amazing. Like family.

Didn't do chores for us though :-)

That's kind of heartwarming to read.

Scottish babies too, as of a couple of years ago! The baby box is great: it's given to all parents pretty much automatically.

It's got everything a totally unprepared family would need to look after the baby for the first few days. Even as a not-completely-disorganised family, it was nice to have. And giving it to everyone is probably cheaper than trying to work out for which parents that level of support is necessary ahead of time. Not least because families who need the support are probably the least able to find it.

I'm very happy that my tax money is spent on preventative efforts, rather than relying on fixing things up after they've become critical.

I love the universality of these programs—there's no stigma attached to using them.

For our firstborn, we (in Michigan, US) used a county-provided program that included a quick home visit and a small welcome kit (nothing as elaborate as described in this article). While it was not presented as being only intended for impoverished/unprepared families, we couldn't help but feeling that we weren't their target audience, given our income level and family support.

All too often, US social programs are paternalistic "help the needy" regimes, often with intentional stigma (to supposedly cut costs through reduced utilization). IMHO, this is harmful for everyone.

Part of the problem is any universal program gets attacked for helping people who don't 'need' the help and that being a waste of money. And on a certain face it's true, cutting some people out of a program will make the top line number cheaper but will also require administration and get into fights about just who needs what.

It's one reason so many new social safety net programs are being suggested as variants of Universal X now, they're much less likely to get cut because everyone gets it and it's harder to do the whole 'welfare queen' style racial coding if the program goes to everyone.

In Sweden, parents automatically get money from the government for each kid that they have, regardless of their income.

This has been criticized numerous times, but every time it turns out that it's just cheaper to pay out the money to everyone, than to have some sort of needs-based evaluation machinery that you have to staff with people who have to make judgements, pisses people off, and then the whole system can be gamed anyway.

Here in the USA we'd prefer to spend a thousand dollars, to prevent someone from getting a hundred, because "they don't deserve it".

Same thing in Poland. It's just cheaper to give money to everyone.

>Part of the problem is any universal program gets attacked for helping people who don't 'need' the help and that being a waste of money.

It's funny. When you suggest that everyone gets a tax cut, people whinge about the rich, the people needing it the least, getting a tax cut, yet it never seems to stop tax cuts to the wealthy. The rationale most often trotted out for this is that it will 'trickle down' because the people who need it the least will spend more which will fuel the economy. (I'm not commenting on whether trickle down works, just that it's the rationale most commonly deployed.)

So why don't people use this line of reasoning when it comes to universal basic income, money given to parents of children, etc? For the people who need it most, it can help them succeed. For the people who need it least, it can fuel sending their kid to college or pay for a family vacation which also stimulates the economy.

This times one-thousand. I'm surprised your infant child was not required to take a drug test first. j/k

We're white, so I'm sure it never crossed the worker's mind (j/k, kinda).

An ounce of prevention beats a pound of cure. From an economical standpoint (especially through the viewpoint of the situation in America) measures like these would save the taxpayer money in the long run with less emergency issues arising and needing to be covered by public funds. I'm not sure why measures like these aren't used everywhere.

These types of things are called 'entitlement' in US which apparently people are not worthy of (so the constant slashing by republicans).

I’m happy to have had my baby in Scandinavia. We read up on all sorts of literature for preparation, but it’s an ocean of disagreeing information, but because having a child is hard, you’re assigned a nurse educated in infant well being by the government for free.

They help you with a range of things, one is to setup a sleeping setting where there is minimal risk of the baby dying. Not too warm, always sleep on their backs, have room to move stuff like that.

As usual Finland is just better at Scandinavia’ning than the rest of us. Good job Finland!

Now compare this to Italy, where my wife was denied an epidural injection for 4 hours, depleted all of her strength from enduring so much pain for so much time, finally got the epidural which an apprentice failed to perform properly resulting in my wife having her right side paralyzed for the rest of the childbirth.

That led her having to stay completely laid down, and to several nurses literally hopping on top of her and pushing our baby into life using their elbows like it's 1900 again.

Then, nobody helped her into start feeding our baby and while the baby was loosing more and more weight day by day, once at home we had to call a private obstetrician and I BEGGED HER ON THE PHONE to come save my baby and my wife.

She came over to our house, showed us what to do and how to do it, and almost two years later my baby is now a giant just like me.

Here in Norway we my wife and I stayed in a family room in the hospital "hotel" both times, but the last time I left the next day with our older daughter and my wife joined with the youngest a day later.

We both automatically get two weeks off work as a birth leave and option to have a "jordmor", what you would call a midwife in English, visit and help if needed. Then we had ten months of parental leave combined, I had four months and my wife had six.

One thing foreigners freak out over is that during the day we have the babies sleep outside in the strollers in winter. They're usually wrapped in wool materials and are very warm. Is this common elsewhere in Scandinavia? They sleep very well out in the cold :)

Same in Iceland. I slept outside all year round as a child and now my daughter does. And also in wool clothing.

> Is this common elsewhere in Scandinavia

Same in Sweden, babies are left outside while the parents sit in a coffee shop and kindergartens have a line of baby strollers outside for the young ones to sleep in.

Used to be common in Scotland too, not sure about England so much. Me and my brother were put out in the front garden by my granny!

Can confirm it's still going; our first was an autumn baby and had his daytime naps by the open tenenment window. Sash and case barely keeps the cold out anyway when they're closed!

Hypothesis: this practice prevents or delays atrophy of the brown adipose tissue used for non-shivering thermogenesis.

Why would it? The kid isn't sleeping in the snow outside like a Husky, they're in a stroller, sleeping bag, wool etc. All put together it's probably better insulated than your house.

In France hospitals usually keep the mother and new born baby for about 5 days. They use that time to teach the mother how to care for the baby and to monitor how she's coping so that they can refer her to get more social help if needed.

We live in France and we've just had our 3rd baby and the quality of care that we've got is simply amazing here. Hospital facilities are good, well designed and people there are very welcoming, helpful and polite. You stay 3-5 days in hospital, you can have a dedicated room and everything is taken care of. I contrast this with the country I'm born in (Eastern Europe) were the care is not bad, but very far from standards in France.

Also, my mother was shocked when we went to a pharmacy to 'buy' some stuff for newborn and my partner, and we didn't pay anything at all. I think you can fully appreciate all that only if you were raised elsewhere, otherwise you just take it for granted.

Stupid question : where is the father supposed to learn ?

For our firstborn, the (finnish) hospital provided us with a family room for 3 days. Due to the circumstances of the birth, it was me (father) who got all the instruction at that point. I actually got to teach my wife how to change nappies and bath the baby afterwards :)

We also had a family room, to ourselves, for 3-4 days post-birth over Christmas. I was also the one who got the most instruction too.

It does have to be said that the rest of the talk/instruction/help was very focussed upon the mother (as you'd expect). I remember that all the meals we were provided with had labels:

* The meals for the mother had her full-name on them.

* The meals for me just said "father".

To some extent, the meals thing is probably just because the mother is the one who is the admitted patient, so her name will be readily on record. As the father is likely both a) not in need of even a contingency of medical care related to the birth process and b) not even necessarily well-established, present, or even alive at time of birth, I can see that being a more ephemeral label.

I remember our first night home with our first child. It was an extremely difficult birth(long labor followed by a C-section due to complications) and so my wife needed lots of sleep(we only got 3 nights in the hospital and she was in no way recovered). I very vividly remember standing there, carrying a 3-day old baby crying while covered in poop and trying to figure out WTF I was supposed to do...

The answer is: you eventually figure it out after lots of panicking :P

In Germany (and probably most other central european countries), it has become common for the father to stay with the mother and the kid in the hospital for the first few days (if job conditions and the income situation permits this), at least for the first child. This way, the father is also able to learn from basic child handling from the nurses in the hospital right from the beginning.

The father has 11 days of paternity leave in France.

In Iceland the father has 3 months of paid paternity leave. It is required, however, that parents leave the hospital the next day if everything is normal.

From the mother, for example.

And the midwife will visit at home 2-3 times in the following weeks

We had a child in the US and the overall experience was pretty decent: there was a nurse who gave us some basic info (that's how you wrap it, that's how you wash it and you sleep it on the back) and a separate breastfeeding consultant.

Probably depends on the hospital.

As for the sleeping box, we just put our son on our bed where he slept happily for the first year.

In germany, a similar feature exists. Unfortunately, these nurses are so much in demand that you have to book them when you are planning on having a child (atleast where I reside).

The problem is not necessarily high demand (although our birthrate has started to recover). Insurance premiums are killing the occupation: https://www.theguardian.com/lifeandstyle/womens-blog/2017/no...

(We couldn't find one either.)

My son was born in Vienna, and their system required parents to enrol infants in child care 24 months before they are born!!!! Well, they told us the waiting list is 2 years for infant care.

Its not very different here :/. We have to register kids to school as soon as they are born, else its extremely hard to get one. (There are new laws combating those, but i don't know how effective they are).

Where I live, there has been a massive boost in population because of rapid expansion of industries here. Unfortunately, the other services are unable to keep up.

Its amazing how much we've been impoverished in America by anti-socialist sentiment.

In the US, we’ve had access to free birthing classes, infant CPR, and a lactation class. At the hospital we will be assigned a nurse and a lactation expert to help my wife. The infant CPR and birth class covered sleeping.

All the above are free and provided by the hospital. It helps that we are going to the hospital with the most births in the US.

“Free”!!! You will be paying 10k+ after the birth if you dont have excellent insurance. At least thats what I had to do.

"All the above are free"

No, just no. If you have insurance, there will be copays, and they can vary from trivial to significant.

If you don't have insurance, enjoy the massive debt.

You are mistaken. Free classes like this are common at hospitals in the US. Not paid by insurance... free. Do a quick search and I’m sure you’ll find plenty. They’re typically called “community wellness” or “community education” programs.

Nothings free wether it’s a baby box given by a Finland hospital or an infant CPR class. It’s all paid by you either with tax or post tax depending on your country.

Except that taxation is relative to income but the services are the same for everybody, and in a single-payer system you can’t be denied insurance based on ”preexisting conditions”. Massive difference.

Being pregnant and other pre-existing classifications were fixed by ACA aka Obamacare in 2014.

>Insurance companies can't refuse to cover treatment for your pre-existing condition or charge you more.


"Except that taxation is relative to income but the services are the same for everybody"

That's a shortest complete rebuttal to the idea that "nothing is actually free" I've seen so far, thanks!

I had the same thing in the US and no, there were no copays or insurance billing associated, beyond the fact you're getting your care at that hospital.

But... Finland is not in Scandinavia.

FWIW, https://en.wikipedia.org/wiki/Scandinavia points out:

> In English usage, Scandinavia also sometimes refers to the Scandinavian Peninsula, or to the broader region including Finland and Iceland, which is always known locally as the Nordic countries.

See also:

https://www.dictionary.com/browse/scandinavia?s=t "and sometimes Finland, Island, and the Faeroe Islands".

https://www.merriam-webster.com/dictionary/Scandinavia "Note: Some people also consider Iceland, the Faeroe Islands, and Finland to be part of Scandinavia"

https://www.goodreads.com/book/show/1187923.History_Of_Scand... - "History Of Scandinavia: Norway, Sweden, Denmark, Finland, And Iceland"

https://www.worldcat.org/title/live-work-in-scandinavia-denm... - "Live & work in Scandinavia : Denmark, Finland, Iceland, Norway, Sweden"

https://shop.lonelyplanet.com/products/discover-scandinavia-... - "Discover Scandinavia" travel guide "Coverage Includes: Reykjavik, Southeastern Iceland, the Blue Lagoon and the Golden Circle, Oslo, Norway’s Fjords, Stockholm, Gothenburg, Copenhagen, Tallinn, Estonia, Helsinki, Lakeland (Finland), the Far North and the Arctic Circle, and more"

To me (born and raised in Spain) "Scandinavia" and "The Scandinavian Peninsula" have always been synonyms. I was not aware the term had different acceptions.

To me, until now, Denmark was not in Scandinavia.

As another example of the cultural difference in what seems like a standard definition - English cultures generally says there are 7 continents, while Spanish cultures generally says there are 6, and that North and South America are two subcontinents. https://en.wikipedia.org/wiki/Continent#Number

You seem quote excited about ~300 dollars of services. I wonder if $300 is a lot of money in your area.

The median income in Sweden is $27900 USD (give or take). So $300 would be about ~10% of your monthly income, in other words: a fair bit of money.

Earlier on HN:

261 comments in 2013 https://news.ycombinator.com/item?id=5817728

262 comments in 2016 https://news.ycombinator.com/item?id=12547353

Let's see if this time it gets 263 comments.

It could be not just an arithmetical progression, like A(260, m). If this one gets 523, we better not discuss it fourth time ever.

I'm a happy recipient of this box 5 years ago. In the fog of the first days of learning to care for your newborn, it was a godsend. It felt like someone actually cared, rather than a bureaucratic handout.

I'm not ashamed to admit that I cried when I unpacked ours:


Even now I recognize other children wearing the same clothes that we received - though our child is 2.5 now the items have obviously been passed along to neighbours and new siblings.

Thanks for the photos. You can tell that they are nice items and -- coming from the perspective of an American -- don't look "government issued" in the slightest. Neat.

Agreed. My wife and I used baby boxes for the first 4-5 days with our twins. We've since gone on to recommend them at least a dozen times through various twins support groups. They really are a godsend in those first few days of chaos.

That's really lovely, thanks for sharing.

It's good to see tax money spent on such a comforting program. I think it lends to a sense of national pride when policies like this lead to good feelings in the citizenry.

That said, I think articles like this contribute to science illiteracy and innumeracy.

A layman could easily come to the conclusion that the baby box caused the drop in infant mortality after reading this article, but infant mortality has been dropping everywhere over the the same time period, regardless of policy.[0]

While the article does briefly mention the Finnish government's broader support for new families, like the free health checks early in pregnancy that is actually incentivized by the box, it doesn't include the overarching worldwide, postwar technological and economic trends that have been driving infant mortality down everywhere.

The whole piece reads like a very literal endorsement of the nanny state, rather than a celebration of human flourishing that it could have been if written in the proper context of broader trends.

Edit: Almost all the replies (and I suspect the downvotes) to my comment are making my point. I wasn't disparaging the box or Finnland's broader policies to combat infant mortality. I'm disparaging the article's failure to paint Finnland's progress in the context of a wider trend of lowering infant mortality AND Finnland's broader efforts to do so. That failure leads to overly simplistic conclusions that contribute to scientific illiteracy and innumeracy, exactly like the conclusions below.

Does anyone believe Finnland could provide these services without the broader technological and economic progress?


Here are some infant mortality numbers from your link:

1947: Finland: 6.5% US: 4.3%

2013 (when the article was written): Finland: 0.3% US: 0.7%

How can the tiny country of Finland be so much better at this than the US? It's because of what they talk about in the article, i.e., a government actually caring for its citizens (read, "welfare state").

Not sure about Finland but some countries have different criteria for a viable baby. Basically if a baby is born too early or too low a weight they are not counted in the statistics. So you you need to also count for these differences.

Always take cross-nation comparisons of statistics like this with a grain of salt. It's rarely a guarantee that each country tabulates statistics using exactly the same parameters and methodology.

See other thread that the Netherlands has one of the worst infant mortalities in Europe. It's not due to these gov't programs (or lack thereof), but rather the demographics of the population.

Do you have evidence to suggest that it isn’t exactly programs like this that responsible for dropping the infant mortality rate worldwide? Your argument is an odd one.

The article is presenting a claim which needs to be backed by sound evidence, like research papers. That's where the burden of proof lies, not on those who reject the claim on face value. That aside, I do believe that the box does in fact contribute to reducing child mortality, though I also think that there are many more good initiatives worldwide.

The evidence is that almost all other countries don't have the boxes while infant mortality dropped nearly everywhere. Your attack is an odd one.

Just because infant mortality dropped nearly everywhere doesn't mean that this "baby box" didn't help reduce infant mortality _specifically in Finland_. The infant mortality rate dropped from 7% in 1935 (already extremely low compared with the global rate in 1935) to .02% (much lower than the global rate now).

> Your attack is an odd one.

I wouldn't call wmeredith's comment an "attack", it's a civilly written challenge.

That aside. It may be true that baby boxes in and of themselves aren't directly responsible for the reduction of child mortality rates (say from sudden cot death); there doesn't seem to have been any research into the long term benefits of the "box" itself. But it's the holistic approach to ensuring kids get a good start in life and the box, the contents etc is one small part of that.

If not for 'programs /like/ this', how else has 'infant mortality dropped nearly everywhere' ??

Just because Finland introduced boxes and other countries didn't does not mean that the Finland's contribution to the overall decrease to infant mortality was not due to boxes.

Also, for gp comment -- nanny is a odd way to spell welfare.

> Just because Finland introduced boxes and other countries didn't does not mean that the Finland's contribution to the overall decrease to infant mortality was not due to boxes.

You're arguing against a straw man. The article implies that the boxes are driving the decrease in infant mortality. The OP points out that this is ignoring the global decrease in infant mortality. The OP did not assert that the boxes made no contribution to the decrease in infant mortality.

> Also, for gp comment -- nanny is a odd way to spell welfare.

I genuinely don't understand your point. "Nanny state" and "welfare state" are synonymous, at least in the U.S.

From a UK perspective "nanny state" is somewhere pejorative description of a "welfare state" (we don't use 'welfare' to describe payments from the state to individuals or families).

Brit here.

I'd use 'nanny state' more to refer to indirect effects. Stuff like the sugar tax, smoking packaging, cameras etc - the sort of 'nanny knows best' thing.

Benefit payments and taxes usually don't come under the banner.

>I genuinely don't understand your point. "Nanny state" and "welfare state" are synonymous, at least in the U.S.

The term "nanny state" typically refers to legislation that aims to protect people from their own worst impulses - laws that ban the sale of large-sized soft drinks, sin taxes on cigarettes and alcohol, and giving tickets to drivers who don't wear a seat belt would all be examples of the "nanny state". In contrast, the "welfare state" refers to redistributive social programs that aim to mitigate the effects of capitalism on vulnerable populations (i.e. Social Security, Medicare, Unemployment Insurance, etc. ).

Oh, I wasn't aware of the nuance. Thanks for educating me.

their argument makes perfect sense to me. they're complaining the article makes a claim, then fails to support it, and provides a pretty straightforward counterpoint (the variable in questions seems at best weakly correlated with the activity), which contributes to scientific illiteracy (general problem with poor scientific journalism).

according to that site, Finland's infant mortality has dropped a lot more than US (as control where there is no nannystate)

The US has medical & food programs for impoverished families and children. You might have to find a different non-nanny state.

According to the US Department of Agriculture[1]

- 6.0 million children lived in food-insecure households in which children, along with adults, were food insecure.

- 540,000 children (0.7 percent of the Nation's children) lived in households in which one or more child(sic) experienced very low food security.

According to the CDC[2]

- 1.6% of women received no [prenatel] care at all.

- 15.0% of women received inadequate prenatal care.

You may want to use a non-US definition of "nanny state" ...

[1] https://www.ers.usda.gov/topics/food-nutrition-assistance/fo... [2] https://www.cdc.gov/nchs/data/nvsr/nvsr67/nvsr67_03.pdf

>> - 1.6% of women received no [prenatel] care at all.

That is a statistic that is very difficult to change. A certain percentage of women will simply not present, not request any help. Some honestly do not realize they are pregnant. Other live in denial. And, particularly in the US, there are some religious communities that actively avoid the medical system. So even with total free coverage of all mothers, there will always be a 1% who first seek a doctor only once contractions start.

The fact that members in those religious communities actively avoid the medical system is a factor that needs to change and isn't the case across the globe - people being unaware of their pregnancy is an issue with a lack of education and test availability, and that factor is particularly easy to change except within those cloistered religious communities.

It seems like the USDA includes people on federal food assistance programs as being "food insecure. From your first link defining "Low Food Security"[1]:

""" These food-insecure households obtained enough food to avoid substantially disrupting their eating patterns or reducing food intake by using a variety of coping strategies, such as eating less varied diets, participating in Federal food assistance programs, or getting emergency food from community food pantries. """

Since you seemed to have these ready, do you have these same numbers but for people without access to any (federal / state/ local) food assistance programs?

[1] https://www.ers.usda.gov/topics/food-nutrition-assistance/fo...

> Since you seemed to have these ready

Not at the ready, I found those links in a couple of minutes buy searching for "US children food insecurity" and "US prenatal care". I remembered reading a study that the increase in US infant mortality was related to lack of prenatal care and food insecurity so I just googled those.

Find me another nation of that size (and of similar multiracial diversity) that has anything of similar or greater success. Don't bother listing countries that are 1/20th the size and non-diverse. It's not an equal comparison.

You might also want to remember that all US agencies use the broadest statistics that justify their budget and size when you cite the US Dept of Agriculture and the CDC.

The US has bad medical & food programs..

FTFY, it's remarkably expensive, low touch, and uninformed vs other countries. The US's medical and food programs focus exclusively on money rather than quality of care or informing parents. We simply give out prepaid 'credit' cards and medical cards, there is little to ensure that they are used correctly or in a healthy manner. We don't do much to ensure that kids actually see doctors, we don't do much to ensure quality of food choices, cooking, or health, the school lunch programs are littered with terrible nutrition and only covers lunch and sometimes breakfast.

The most telling thing about America is that we honest to goodness keep infant formula in grocery stores...in security cases.

This statement must be qualified. Stores experience shoplifting of formula due to cost. The locked cabinets protect expensive stock.

WIC programs specifically include X amount of baby formula as part of the program. Especially in low-income areas (and increasingly higher level income areas) formula has become a form of currency and an easy way to launder drug money. https://www.nytimes.com/interactive/2018/05/02/magazine/mone...

The amazing part is the inefficiency of the WIC program made the formula black market possible.

And why is baby formula so expensive? And why has the US stigmatized breast feeding so much? Maybe the two are related...

If anything you're stigmatized in the US if you don't breast feed. Not sure where you're getting your info from.

> The most telling thing about America is that we honest to goodness keep infant formula in grocery stores...in security cases.

Not in any store I have ever shopped in.


I suspect it's primarily in low-income areas.

Why? The whole point is to compare strategies, so this would, if anything, provide a stronger test than comparing against some dystopia where children are born and left to their own devices.

Likewise, despite what Stats 101 would tell you, we don’t actually run a ton of placebo-controlled clinical trials. Instead, the new thing (a baby box) gets compared against the current standard.

any suggestions?

>It's good to see tax money spent on such a comforting program.

I think that 'comforting program' is what might be called a sense of community. And the wisdom of investing in a future. Something which, in many so-called 'advanced' countries, has been under attack (by ignorance or deliberation) for generations.

There's also a "hidden agenda" behind this supply box.

In order to receive it, the mother needs to sign up for a health check (provide by the public health care system) and I believe you are supposed to do that before the 5th month of pregnancy.

This gives the opportunity to detect potential problems early on, offer guidance if there's reason to suspect substance abuse and so on.

It seems like a good direction to heading. Not sure why it is considered as a hidden agenda.

Because it's not expressly stated to the people who are subject to it.

Right... I'm not sure how you end up going to a health check at a hospital "without realising it".

This is a case of a state providing exactly the sort of support to their citizens we could do with far more of.

This is mentioned early on in the article

I love this and wish it were a more widespread practice.

Baseline education of infant care is difficult for low income families. There's just too much to deal with.

A cardboard box will appear crude to many, especially those of higher income, but the cardboard box removes a lot of the guess work about what's allowed in while sleeping - which is essentially nothing.

Anyone who's had an infant before - there's too much conflicting information and it's downright scary because it's difficult to know what's right/wrong. I love this establishes a clear baseline.

When my Daughter was born everything said do not let the baby lay on their side or tummy. I tried hard but she turned to her side every time you put her down. If she was on her back she would wake and cry. I spoke to my mum and she said when I was a baby I slept on my tummy, as did my brother and sister. None of us slept on our side or back. We just made sure we bought a breathable mattress so if she ended up face down she could breath. Now she’s almost 1 and sleeps however she feels. Which is usually cuddled up against me while I feel stressed all night.

Putting a baby to sleep on their stomach is a SIDS risk factor, but not if they switch on their own. But nobody really tells you that last part.

I kept flipping my daughter over until I spent some time googling it.

I had my baby sleep in the cardboard box even though we had a suitable bed at home already. It's so cozy and the baby slept really good in it.

Here in Argentina we had that program canceled by the current President Mauricio Macri, and the former was prosecuted for pushing for this program to be implemented nation-wide. There was also a big media campaign from the local multimedia monopoly to lay shame of the program [1][2], although it covered way more items than in Finland.

The boxes (qnitas) were left to rot in a warehouse. Trully fascist.

This was later found to be without basis and the goverment have been ordered to restart the program, without effect.

[1] https://www.clarin.com/politica/paso-paso-fraude-licitacion-... (in spanish)

[2] https://www.lanacion.com.ar/politica/plan-qunita-inseguros-c... (in spanish)

Thanks for posting. I was instantly reminded of qnita and its shameful persecution by the macrismo. What's worse is that the political points scored by Macri were never retracted -- few if any Argentinians know how the program ended, or that all the accusations were baseless.

I remember that. Really a shame that this plan wasn't executed. We can't have nice things

i would use a lighter term to describe rotting baskets. words have meanings and "fascist" means something else.

2: a tendency toward or actual exercise of strong autocratic or dictatorial control.

I think that most rational people would agree the already-existing baskets should be distributed instead of being left to rot, so the president deciding against that in order to strengthen his position could be seen as tending towards autocracy or dictatorship.

many parents then can be called fascists - they exercise strong autocratic or dictatorial control over their children. diluting the "fascist" term is a huge disservice to countless victims of real еvil.

Related: I've begun to put people who are extra-pedantic about the word fascist into their own little silo.

I don't know what you mean by extra-pedantic but the site guidelines ask users not to call names in arguments, and that certainly covers the F-word.


one doesn't have to be extra-pedantic to see the difference between rotting card box and gas chamber.

Just before my kid was born here in the US, we got two boxes from Finnish families, and they were great.

It was approximately 100% of my son's wardrobe for the first several months, and we actually did have him sleep in it for a couple weeks early-on, putting the box on a (large, well-supported) stack of books next to our bed before we moved him into his own quarters. The clothing was unique (in the US) and attractive in a very Scandinavian sort of way, and held up really well. We've passed most of it on to other families, and each piece has probably been used by three or four different kids at this point.

I did a significant write-up on it here: https://www.care.com/c/stories/580/a-year-with-the-finnish-m...

NB: It was on Kinsights back when that existed, and Care.com's redesign kinda botched the formatting. Sorry to myself and others!

Social policies work best when it appears the government is doing something to actually care for the population. It sounds like such a great way to help grow a healthy new generation. Investing in the youth!

Yes but it needs a desire to be helped on part of the populace. If the popular narrative is that anyone receiving govt help is receiving handouts[1], as is the case in the US, there's little that can be done that won't be seen as shameful charity.

[1] Unless the handouts are in the form of tax breaks for big companies, in which case they are the most patriotic thing to do.

> "shameful charity" I can't imagine what it must be like to live in a society where charity is seen as shameful

It is rooted way way way back to the Puritan ideal of doing the hard work yourself and not needing to rely on anyone else to succeed.

One big difference to the scandinavian mindset is that children are much more seen as individuals than dependents belonging to their parents. If it's unacceptable that a child is less successful because its parents did not work hard (or any other reason they aren't well off) then a lot of social welfare programs will follow naturally.

For example, having time with parents (parental leave) is a right of the child, not a luxury for the parents. In that perspective it's much harder to frame tax-financed parental leave as a handout to the parent. Without it, some children would miss out on something through no fault of their own.

On the other hand, I've had female coworkers carefully plan pregnancies to chain the maximum amount of paid leave. Others taking as much paid leave (100% pay, then diminishing, then almost nothing) as possible and then resigning on the first day coming back to work. It's a double-edged sword, in most cases.

Resigning on parental leave is probably common, but on the other hand the paid leave was at least not paid by the company. And at that point the company will most likely have a trained temp, so seen that way it's not a bad time to quit (although you could of course have given that notice a while before returning).

Maximizing the use of paid parental leave I see as pretty much a given. I don't think many see it as the most important factor for planning a pregnancy, but I absolutely want to maximize the amount of paid leave I can take. My kids are 6 and 8 and I still do multiple weeks of parental leave per year. Typically doubling my summer holiday from 4 to 8 weeks or similar. It's a benefit I have paid for many times over. There have been suggestions though that this is an unncessarily luxury and it would be better (for children) if parents had to use the majority of the parental leave before age 3 instead. I kind of agree.

I'm on the opposite side on this issue, I don't like publicly funded leave nor benefits and as a taxpayer this kind of opportunistic behavior further cements my view that the state should not spend public money into helping parents.

> spend public money into helping parents.

For these policies to be even remotely understandable I think the key is as I said to fundamentally see it as money spent towards children, not parents.

Fine, but downvotes for a civil discussion?

Does that logic extend to all public assistance? All systems will be gamed to some extent, even corporate welfare and programs available to professionals (mortgage income tax deduction in the US, EV car rebates in the US, etc). I'd much prefer to see a program like "babies in boxes" that extends to all families than programs like a massive EV subsidy given to rich dentists and VCs who don't need the money.

> On the other hand, I've had female coworkers carefully plan pregnancies to chain the maximum amount of paid leave.

So, taking the maximum amount of paid leave they are allowed. How is this an issue? Do you take less pay than offered? Please explain how maximizing your benefits if wrong.

i guess they are just maximising what they can get out of the system, which is far less than if the system was setup with above-mentioned scandinavian mindset

It's more complicated than that. Charity is seen as something your community and private institutions are supposed to provide out of the goodness of their heart, not something the government should 'force' onto people. There is not the same shame in getting help from your church, your neighbors or some other similar group, but being reliant on the government is by many seen as a failing.

Imagine it like this: It feels like toxic propaganda that doesn’t jive with reality or empathy for anyone- an every man for himself lack of community and warmth. And for some, it feels even worse: it feels like the pressure to pretend you are slways doing well, even when homeless and starving, lest you appear weak and thus marked as such in a society that shuns anyone who doesn’t look wildly successful and wealthy and somehow like a celebrity.

> shameful charity

I suppose that's one way of looking at it. I see it as getting some return of investment for all the taxes I pay. During the course of one year, I pay the state back for the box many times over.

In Finland, there is an option to take an "equivalent" cash grant, but the box is likely better value (if you were going to get all that stuff anyway), because of the big batches the state orders.

I'm sure there are also some who get neither the box nor the grant, all you have to do is to not apply for it.

Here in Finland it seems (to an expat) that the baby is the one getting handouts, not the parents. The social program is about making sure every child gets what they need, regardless of the ovarian lottery.

Here it is quite frowned upon for men to take parental leave.

My wife read this exact article from 2013, purchased a 'Finnish Baby Box' from a private company that makes and exports them from Finland, and our baby slept in it for his first seven or eight months. It actually turns out the idea for the company itself was inspired by the same article too. Here's the follow-up from 2016 https://www.bbc.co.uk/news/magazine-35834370

When I was pregnant (in Canada), I watched a series of videos about safe sleep and got a free Baby Box (Telus sponsored it): https://www.babyboxco.com/about/

Baby arrived 2 months early. When we brought him home 6 weeks later, I was amused by the contrast. Going from a fancy NICU bed to a cardboard box was a big change for him. He didn’t mind and slept in it for 5 months.

That’s so adorable :)

We got our cardboard box yesterday. It sure does help. Lot of clothes for the upcoming xmas package. Suitable clothing for even -10 °C naps outside.

From CPS professional point of view this box rocks. Absolutely a perfect thing for young mothers without the usual social network. Just if they would choose the box instead of money...

When this last came up on HN, the Scottish Government was in the process of rolling this out. It seems to have happened and baby boxes are now given to all newborns: https://www.parentclub.scot/baby-box

Just wanted to point out that Scotland has a baby-box scheme inspired on the Finnish: https://www.mygov.scot/baby-box/ It was introduced after our wee one was born, though, so can't comment on the content, but friends seemed to be quite pleased with it.

They actually do this in some states in the US. I live in Ohio and I received a box when my son was born. It's very nice and I hope everyone, especially the people who need it are aware of the program.


Just thought someone should start a company that lets people purchase the Finnish baby box worldwide - I know I would have if it'd been an option for any of our kids.

Looks like someone already has:

https://www.finnbin.com https://www.finnishbabybox.com

Didn't expect them to be $300+ though. I wonder what the government is paying for these.

Hi @atourgates - Shawn (Founder of Finnbin) here. Not all of our baby boxes cost $300+ - our most basic baby box starts at $65 (https://www.finnbin.com/products/babybox-boxinet).

To answer your comment & questions: The reason our most expensive box (The Finland Original) costs $450 is because it contains over $700 worth of stuff - at least on the shelf if you are purchasing each item individually. For a bit more insight, the bulk of that cost is the organic clothing that we include. Also, baby boxes have a lot of volume (or dimensional weight if you want to use the shipping jargon) so baby boxes are incredibly expensive to ship. Because most consumers would be shocked at the actual cost of shipping, we've factored shipping costs into the total cost of the box.

To answer your question about what the government pays for these: Finnbin does have contracts with hospitals, insurance companies, and government entities who typically purchase hundreds boxes at a time and often thousands - The average metro hospital does about 1,500 births per year. Like any other product, volume orders obviously get a price break and because baby boxes take up so much space, they also tend to receive the boxes on a pallet shipped flat - which can also lower their costs. Each government order is slightly different and thus there is no specific cost to a government entity, but they still pay in the hundreds of dollars if they are purchasing the baby box containing all of the goods.

Happy to provide additional insight if you'd like.

That's great - glad someone is offering this. Any plans to offer Scotland's box?

Unfortunately, Finnbin is not the current supplier for Scotland's baby box program.

Oh nice - that's a distinction I didn't understand. You're saying that your company actually supplies the boxes given away under Finland's program, and you make those same boxes available to consumers?

I was imagining you and your competitors would either obtain the boxes from the assembler/manufacturer directly or assemble close replicas. Not that you were the actual supplier.

Not exactly. Although we do supply healthcare organizations and government entities domestically and abroad, we are not the suppliers for Finland. The Finnish baby box program is conducted by Kela, a Finnish government agency in charge of settling benefits under national social security programs. Unfortunately, they took some heat earlier this year for their labor practices to make some of the products they include in their baby boxes (https://yle.fi/uutiset/osasto/news/finnwatch_majority_of_fin...).

From what I understand, the company Finnish Baby Box (based in Finland) uses the same products from the same suppliers and makes those same boxes available to consumer.

Finnbin, the company I founded, manufactures our own boxes and sources the materials for our box from US-based companies who utililze managed forestries and are certified to Sustainable Forestry Initiative (SFI) standards, created to promote responsible forest management.

And, although the original Finnish government program was the inspiration for our product, we've tailored our product offering to the American consumer and with American brands. For example, the Finnish baby box contains a regular sheet rather than a fitted sheet. This would not adhere to the American Academy of Pediatrics safe sleep recommendations. Therefore, we include a fitted sheet custom to the waterproof mattress we provide.

Additionally, much of the clothing in the Finnish government boxes program is designed for a much colder climate than we're used to here in the US. Rather than including similar products that many people wouldn't likely use, we've replaced them with more universal clothing and products.

I visited Finland recently and everybody was so proud of the baby box! I hope it gets more popular worldwide.

Even simple help/reminder can make a big difference. I recall a bunch of research on how simple checklists in operating rooms improve prognosis by a huge margin (and yet they aren't as widely used as they should be).

“Not for long. At the turn of the century, the cloth nappies were back in and the disposable variety were out, having fallen out of favour on environmental grounds”

im guessing this is a non-starter for most Americans? i remember seeing an editorial [1] about how in American Prisons ..they are charging the family of prisoners a huge fee to send their $ to the inmate..and how one mom had to choose between buying diapers or supporting her husband with prison toiletries. She said it was a very hard decision to make.

1- https://youtu.be/AjqaNQ018zU

Follow up from 2017 "Do baby boxes really save lives?" https://www.bbc.com/news/magazine-39366596

"[...] leading baby box companies sells its products as an essential gift for new parents, claiming studies have proven the link.

I asked the company if I could see these studies, but they said that studies showing positive results had not been published yet. Experts say that there are no studies showing the efficacy of baby boxes."

Likely because it's not selling them that's the beneficial part: it's the "giving them to everyone for free" part.

I bet the company is selling them, otherwise it would be a charity, no?

Right, but what I'm saying is that the study they are citing likely shows the results of parents being given a baby box, not buying one.

I don't think buying vs giving is important per se. I'm just saying that the aggregate data will likely show more benefit from people being given the boxes, as that will have more impact on people of lower means.

Shawn, founder of Finnbin Baby Box Company, here.

It is true that there are not many published studies with empirical evidence in the public domain and most of the data comes from 90 years of anecdotal evidence; however, the issue is not that baby box manufacturers are against studies, it's that there is not a lot of funding for SIDS research. We've actively reached out to research organizations to test our product, but they do not have the financial resources to do so.

That said, there have since been some published studies about the efficacy of baby boxes (here is one from Temple University: https://medicine.temple.edu/news/temple-study-shows-baby-box...). There are also some ongoing studies that I'm aware of that have yet to be published. Here are the findings from the Temple study:

5,187 dyads received baby boxes and follow up phone calls 2763 parents completed the follow-up survey Patient satisfaction with the distribution of the bassinet was high.

25% reduction in bed-sharing for all infants. Face-to-face sleep education and providing a baby box with a firm mattress and fitted sheet reduced the rate of bed-sharing by 25% in the first eight days of life.

50% reduction in bed-sharing for breastfed infants.For exclusively breastfed infants, a population at increased risk of bed-sharing, bed-sharing was reduced by 50%.

Mothers use the baby box. Of the mothers who received the baby box, a majority said they used the box as a sleeping place for their infants.

12% of mothers use the baby box as a primary sleep space. Of the mothers who received the baby box, 12% said they used the box as the primary or usual sleeping space for their infants.

Looking specifically at the breastfed infant population (breastfeeding has been shown to reduce the risk of SUIDS but also increase bed-sharing):

92% (184/199) of the breastfeeding respondents used the bassinet;

52% (104/199) used the bassinet as a sleeping space; and 11% used the bassinet as the primary sleeping space.

Of the 104 recipients who used the bassinet as a sleeping space, 63 (60%) responded the bassinet makes breastfeeding easier.

In the present study, a majority of bassinet recipients used it as an infant sleeping space. A majority of exclusively breastfeeding mothers reported that the cardboard bassinet facilitated breastfeeding.

I hope that helps...

i don't understand how reduced bed-sharing is a benefit. according to my understanding and our experience, co-sleeping is actually the best experience babies can get. and it also facilitates breast-feeding at night as mom just needs to roll over and provide access, and not get out of bed if the baby wakes up hungry.

how exactly does the bassinet facilitate breastfeeding, and how were they feeding before?

This could be a much larger discussion and probably better suited for another forum; however, there is a big distinction between co-sleeping and bed-sharing. Long story short: Bed-sharing means sharing the same sleeping surface, such as a family bed, with your baby. Co-sleeping means sleeping in close proximity to your baby, sometimes on the same surface and sometimes not (in other words, bed-sharing is one way to co-sleep, but not the only way).

The American Academy of Pediatrics (AAP) recommends room sharing because it can decrease the risk of SIDS by as much as 50% and is much safer than bed sharing. In addition, room sharing will make it easier for you to feed, comfort, and watch your baby.

The AAP goes on to say: Bed-sharing is not recommended for any babies. However, certain situations make bed-sharing even more dangerous. Therefore, you should not bed share with your baby if: * Your baby is younger than 4 months old. * Your baby was born prematurely or with low birth weight. * You or any other person in the bed is a smoker (even if you do not smoke in bed). * The mother of the baby smoked during pregnancy. * You have taken any medicines or drugs that might make it harder for you to wake up. * You drank any alcohol. * You are not the baby's parent. * The surface is soft, such as a waterbed, old mattress, sofa, couch, or armchair. * There is soft bedding like pillows or blankets on the bed.

With that being said, bed sharing is common in certain cultures where the prevalence of SIDS is low, including Asian communities (Japan, Hong Kong, Bangladesh, and those in UK) and Pacific Islander communities in New Zealand. Actually, it is not the bed sharing that distinguishes these cultures, but other factors (e.g., smoking and use of alcohol/drugs) which in conjunction with cosleeping may put infants at risk. However, there is conflicting evidence regarding the safety and efficacy of bed sharing during infancy—while it has been shown to facilitate breastfeeding and provide protection against hypothermia, it has been identified as a risk factor for SIDS.

If this is of interest to you, a published study called Is “Bed Sharing” Beneficial and Safe during Infancy? A Systematic Review can be found here (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3941230/).

Finally, to answer your question: breast feeding and bed-sharing are often linked. Having a lightweight bassinet, such as a baby box, decreases the practice of bed-sharing and thus decreases the risk of SIDS.

you are right, this is a much larger discussion. so i just want to mention this. what is missing in the research is other purported benefits from bed-sharing, such as the mental development of the baby as suggested by the attachment theory.

it is not clear from the mentioned study if research on other benefits of bed-sharing doesn't exist, or whether such studies were excluded because they didn't fit the focus of the review.


Why is bed sharing more risky if you are not the baby's parent? The other guidelines seem like common sense, but that one sticks out.

It also makes me wonder how they define "parent". Does it include legal guardians who are not biological parents?

That's a great question! I wish I could answer that, but its well above my pay-grade and better suited for a pediatrician or the AAP.

What a fantastic idea. As a new mother, I cannot tell you how nice this would have been to get from the hospital. Luckily, the nurses we had were fantastic, and I had an older sister who gave me many hand me down materials. Some of the materials she gave, I had no idea what to do with, but because I had them, I asked, and they turned out to be extremely helpful. I can only imagine how a box like this could help a less educated, or person with less economic means than I had. Way to go Finland.

This reminds me of the Skinner Air Crib (https://en.wikipedia.org/wiki/B._F._Skinner#Air_crib)

Finland also has some of the best primary and secondary education in the world. I work in an education company and we regularly make trips to Finland with teachers to show them how modern education should be.

We got one of these kits when my first was born. Having an easily mobile sleep space is the best thing ever. ( Canada)

Shawn, founder of Finnbin Baby Box Company, here. Happy to answer any questions there might be about baby boxes.

This is what a society looks like.

Why condoms? Finnish birth rates are at all time lows.

For the health of the mother it’s wise to space pregnancies apart, by 18 months according to the WHO. There’s increased risk for a lot of things for closely spaced pregnancies, so the condoms are a pretty good idea.

Perhaps for STDs, any infection is more difficult during pregnancy - and an active infection of the birth canal can also complicate delivery.

Because with modern nutrition a woman can get pregnant again very soon after giving birth. But that is not healthy for the woman or her babies.

Developing world can imitate it

The developed world could too.

I see a lot of corruption opportunities that would make this inefficient if not dangerous in most 3rd world countries. I think They should start by rethinking their governance, moral values first.

This is worth over a hundred dollars, not a small amount for many countries, I can totally see corners being cut everywhere at every level if implemented in China, recipients will probably just throw it out upon receipt if they don't want to do harm to their babies.

You got downvoted, but this sound very similar to a discussion I had with an Indian friend recently.

Can one think theselves into the moral values? I'd say by the time you are an adult you either have them or not.

Of course, this symbol of egalitarianism provides the ideal concept for companies to exploit for financial gain: https://www.finnishbabybox.com/en/

We are living in the UK and we ordered this one. If we buy the items one by one, we would ended up paying more for it. Both me and my wife was super happy with the box and my daughter slept in it for about 6 month (we also had a cot, but we realised very early that the box mobility is an unbeatable feature)

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