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Article

Holding Advertisers to Account May Help Reduce Infant Deaths Linked to Unsafe Sleeping

Marketing
Published on:

In Europe, nearly 80% of diaper packaging depicting a sleeping baby show unsafe sleeping positions – that’s the shocking finding from Professor Anne Laure Sellier of HEC Paris and her colleagues from across Europe.

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One diaper package shows a dozing infant nestled into its father’s chest. On another, a baby is tucked beneath a white duvet, its fists propping up its cheeks from the squashy pillow. A different package shows a sleeping newborn lying up against a soft toy rabbit almost equal in size. While these images may be cute, they are potentially dangerous. 

Safe sleeping practices for babies help reduce the risk of sudden infant death syndrome (SIDS), the unexpected and unexplained death of an infant under the age of one. And we've known since the early 1990s that putting babies to sleep on their tummies was a major risk factor for SIDS. Today, any expectant parent joining an antenatal class will find that establishing safe sleeping habits is a cornerstone of the syllabus. This includes placing infants on their backs on a firm, flat mattress in an enclosed sleeping area free from other people, toys, pillows and other soft furnishings.

 

The power of imagery in advertising shapes behavior.

 

Thankfully, this knowledge, information-sharing and the ‘Back to Sleep’/ ‘Safe to Sleep’ campaigns have led to a significant drop in infant deaths over the past few decades.

But as they step out of antenatal classes and into the real world, parents may be confronted by opposing messages on safe sleeping from their families, other parents, social media and – new research shows – adverts for baby products.

Although progress has been made, SIDS still results in approximately 1,400 deaths per year in Europe. Research has estimated that these deaths could be prevented by better educating parents on the risk factors.

The occurrence and power of misleading images in advertising

Since the afore-mentioned high-profile campaigns, parents’ behavior in terms of safe infant sleep recommendations is becoming increasingly inconsistent, according to recent evaluations. Why could this be?

Aware that pictures have the power to actively shape behavior, we decided to explore the imagery used in baby product packaging. We looked specifically at disposable baby diaper packaging, comparing the images used with safe infant sleep recommendations and looking for inconsistencies.

We found over 600 baby diaper packages designed for infants weighing under 5kg and at the highest risk of SIDS. We analyzed the images on the packaging and compared them to the sleeping practices endorsed by most European countries. What we found was shocking: 79% of packages depicting a sleeping infant were inconsistent with at least one recommendation for the prevention of SIDS. 

Just over half of the packaging depicted a sleeping baby, and of these, only 21% showed babies sleeping safely. Of the remainder:
- 45% showed a baby lying on its tummy or on its side,
- 51% showed soft objects or loose bedding (pillows, pillow-like toys, stuffed toys, quilts, comforters, sheepskins, blankets, non-fitted sheets, or bumper pads),
- 10% depicted a baby sharing its sleeping area with another person. 

What to do? We do know that advertisements (from the French word meaning ‘warning’) conveying implicit or explicit messages have the potential to actively shape what we do through the influence of authority and social proof. And while we often reduce advertising to a persuasive tool, let us remember that it is first simply a source of information for consumers.

Legislating against unsafe images

To maximally reduce the number of babies dying from SIDS, we need to reduce parents’ exposure to images depicting unsafe sleeping practices. In protecting this vulnerable group, we want to see manufacturers of baby products held to higher standards.

In Europe, baby diaper manufacturers are already subject to the European General Product Safety Directive to ensure the products themselves are safe, but we want to see this extended to their packaging. 

 

Legislation enforcing adherence to safe sleeping practices in packaging imagery is crucial to protect infants from SIDS.

 

But stronger legislation could demand that manufacturers only depict babies sleeping per the most recent safe sleeping practices outlined by the American Academy of Pediatrics. This would not be the first time that the persuasive power of images has been used in legislation: a decade ago, images of infants on infant formula packaging were banned to prevent the idealization of breast milk substitutes over breast milk. Such a move could contribute positively to the messaging around SIDS, acting as social proof and indirect information for parents about how to minimize the risk for their baby.

Methodology

We identified 631 disposable diaper packages designed for babies at the peak risk of SIDS across 11 European countries (Belgium, Czech Republic, France, Germany, Greece, Ireland, Italy, the Netherlands, Portugal, Romania, and Spain). We then analyzed the images used on the packaging in accordance with the recommendations of the American Academy of Pediatrics, classing the pictures as inconsistent if one or more of the following three criteria featured: baby lying on side or on tummy; soft objects or loose bedding; sharing a sleep surface with another person.

Applications

Recent research has suggested that around 200 infant deaths per year in France alone could be prevented. To minimize the risk of babies losing their lives to SIDS, parents’ exposure to visual imagery depicting unsafe sleeping practices should be reduced. Manufacturers of baby products need to take responsibility for the images on their packaging and ensure they promote the safe sleeping practices described by the American Academy of Pediatrics. Legislating against using inconsistent images in commercial and governmental communications would be one way of achieving this.
Based on Anne Laure Sellier’s paper “Inconsistency Between Pictures on Baby Diaper Packaging in Europe and Safe Infant Sleep Recommendations”, co-written with Sophie de Visme, Daniel A. Korevaar, Christèle Gras-Le Guen, Alix Flamant, Martina Bevacqua, Anna Stanzelova, Nhung T.H. Trinh, PharmD, Dalia-Alexandra Ciobanu, Ana Araújo Carvalho, Ifigeneia Kyriakoglou, Maria Fuentes, Yacine Refes, Elisabeth Briand-Huchet, Inge Harrewijn, Jérémie F. Cohen, and Martin Chalumeau, published in The Journal of Pediatrics, January 2024.