#sleepingbaby on Instagram: Nonadherence of images to safe sleeping advice and implications for prevention of Sudden Unexpected Death in Infancy

OBJECTIVES: Safe sleep of infants is important to reduce the risk of Sudden Unexpected Death in Infancy (SUDI). The depiction of infant care behavior which is inconsistent with the safe sleep recommendations on social media has an impact on parental infant care thoughts, norms and behaviors. This study aims to determine the adherence of Instagram images to the Dutch safe sleeping advice. DESIGN: A systematic social media analysis on Instagram was performed using 22 hashtags and 9 accounts of Dutch companies or platforms related to infants. Images of sleeping infants were analyzed on consistency with the criteria: supine sleeping position, own cot or crib, sleep sack, and an empty bed. RESULTS: Based on 514 collected images, 5.9% was consistent with sleep sack use, 16.8% with an empty bed, 30.7% with an own cot or crib, and 67.5% with the supine sleeping position. For 311 images (60.5%), all four criteria could be rated, as for the others, at least one criterion was not clearly depicted. Only 6 of these images (1.9%) were consistent with all four criteria. CONCLUSIONS: Although Instagram images are probably not representative of regular infant care behavior, the exposure to these images that are mostly inconsistent with the safe sleep advice can contribute to the formation of norms, and therefore influence parental care behavior. Accurate communication of the safe sleep recommendations through social media is needed, and opportunities are described for preventive health professionals to engage more in this communication with their public.