Government U-turn on funding pepi-pods could save dozens of babies' lives
A humble plastic container, not much bigger than a shoe box, could save dozens of babies' lives each year.
So why did the government initially dig its heels in on the idea of "safe sleeping spaces" for infants, and then make a dramatic U-turn this week?
PROBLEM VS SOLUTION
About 50-60 Kiwi babies die in their sleep each year, many of them accidentally suffocated by a parent while co-sleeping.
It's called sudden unexpected death in infants (SUDI), and New Zealand has the highest rate of it in the western world - with Maori babies greatly over-represented.
Experts say it's almost entirely preventable. Since 2006, they've been urging parents to use "pepi-pods" (plastic boxes with a tiny foam mattress and sheets) and wahakura (woven flax sleeping baskets), which can then be placed in a bed with parents.
The idea also has the support of coroners who've ruled on babies' SUDI deaths.
In Finland, for the last 75 years, the government has given every mum-to-be a box packed with baby products - including clothing, toiletries and nappies. The box itself becomes a newborn's first bed, with a small mattress and bedding also included.
Today, Finland has one of the world's lowest infant mortality rates.
In New Zealand, there's been a decade-long push to follow suit. Over that period, hundreds of babies have died from SUDI.
Today, lobby group Change for Our Children sells a complete pepi-pod kit online for $145. And at the 2014 election, the Green Party made wahakura a policy platform, promising a "Welcome Pack", including the basket, plus a blanket, sheets, a towel, clothes, bibs, beanies, socks and reusable nappies, for every newborn baby, at a cost of about $251 per baby.
But despite experts' calls, government health officials have blocked public funding for the idea, saying there wasn't enough evidence to prove pepi-pods or wahakura would save lives.
On Wednesday, they were overruled by Health Minister Jonathan Coleman, who promised an urgent national rollout, in a letter to Auckland University infant death researcher and pepi-pods advocate Professor Ed Mitchell.
"I have asked Ministry of Health officials to work with you and other paediatric experts around the country to develop a national Safe Sleep programme that incorporates the appropriate use of Safe Sleeping Spaces," Coleman wrote.
"This work will include a review of the risk assessment approach, as well as the current distribution of Safe Sleep Spaces. The aim will be to ensure that every family of a newborn is provided with a comprehensive, but customised package of information and follow-up support.
"We also need to ensure that there are stronger and clearer guidelines in place for services to assess vulnerability, and ensure that any family offered a Safe Sleep Space is also supported to use them consistently and safely."
MINISTRY IN HOT WATER
Back in 2012, the Ministry of Health drafted a $250,000 contract with Change for Our Children, which would see the organisation distribute pepi-pods to vulnerable families - but the ministry changed its mind before the deal was agreed, the New Zealand Herald reported.
Internal emails revealed officials' concerns about promoting bed-sharing, and the potential for babies to overheat or hurt themselves in the pepi-pods.
In fact, the ministry then actively worked to stop vulnerable families accessing the devices - despite encouraging parents to use them.
Last year, the ministry increased its funding to district health boards to tackle SUDI rates among Maori babies, but specified that the money "is not to be used to cover the purchase of safe sleeping devices".
Despite this, some DHBs have rejigged their budgets to purchase a limited number of pepi-pods for at-risk babies.
Mitchell - a leading expert on the issue - has been lauded for his research into safe sleeping practices for infants. He designed New Zealand's public health programme to lay babies on their backs, instead of stomachs, with the practice later taken up by most western countries.
He was also an early supporter of the use of wahakura and pepi-pods to prevent infant deaths.
Mitchell met with Coleman last week to urge the government to contribute $1.5 million to a nationwide rollout.
Mitchell told the New Zealand Herald the policy would "almost certainly" save dozens of babies' lives each year, slashing the SUDI rate from about 50 to five.
He told Radio New Zealand the cost of pepi-pods would be about $100 each.
In his letter, Coleman told Mitchell the ministry would begin its work as soon as possible.