There are few things cuter than a tiny baby curled up and fast asleep, perhaps gripping a stuffed animal or a blanket.
The cute factor is one of the reasons pictures of babies sleeping work in advertisements for a variety of consumer products, but curled up on their sides or prone on their stomachs is not the safest position for sleeping babies.
Guidelines from the American Academy of Pediatrics (AAP) advise caretakers to put infants to sleep on their backs and to avoid loose bedding, soft sleeping surfaces and bed sharing in order to reduce the risk of Sudden Infant Death Syndrome (SIDS), the leading cause of death in children between one month and one year of age.
But a study published today in the journal Pediatrics found that, contrary to these recommendations, magazines geared toward women ages 20 to 40 often portray infants in unsafe sleeping positions, which could be detrimental to new parents.
"It's a subliminal message. If a mom sees that [unsafe ad], she may think it's OK to sleep her baby in that particular position," said Brandi Joyner, a SIDS researcher and health educator at Children's National Medical Center in Washington, D.C., and lead author of the study. "That causes confusion as far as complacency in infant sleep practices."
Study Shows Babies Sleep in Precarious Poses
The study examined almost 400 pictures of sleeping infants from 28 magazines, including Parenting, Pregnancy and Baby Talk, with an average female readership of five million. In most cases, media portrayals were not consistent with AAP recommendations for safe sleep practices. Infants were photographed on their stomachs or sides 36 percent of the time, and 63 percent of the images depicted unsafe sleeping environments containing pillows, stuffed animals and blankets, or sharing a bed with an adult.
Pediatricians agreed that messages to parents about child care should be consistent across all channels and up to the proper safety standards.
"I think it is interesting and not surprising that the authors found inconsistencies in what is portrayed in the media and what is actually recommended," Dr. Ari Brown, a pediatrician and author of the book "Baby 411." "If the media would be more aware of some of these [AAP] recommendations when they are claiming to educate their readers [...] we could be doing a real service to the public."
Magazines Can Influence Child Care Practices
Although magazines may not be the "most important" source of information on child-rearing practices, as the study authors suggest, they are a ubiquitous source that experts agree have the potential to influence parents.
"I recall the images of Jennifer Lopez's nursery [from People magazine] for her newborn twins," said Dr. Fern Hauck, a member of the AAP Task Force on SIDS and director of the International Family Medicine Clinic at the University of Virginia. "Fluffy comforters, bumper pads [...] totally wrong message. You can be sure that all those readers took away the message that this was the nursery to yearn for."
But there is no clear consensus about who should take responsibility for an advertisement featuring an infant in an unsafe sleeping position.
"If [advertisers] are going to use babies that are sleeping, it's very important that they need to know and be aware of infant safe sleep practices," Joyner said. "I think everyone should be on one accord."
And even when magazines seek medical approval for articles, they may not apply the same standards to their other content.
Brown, who serves on the medical advisory board for Parents magazine, which was one of the magazines included in the study, said the board pays close attention to the magazine's editorial content but not advertorial or graphical content.
Baby Safety Challenges Advertisers
Some advertisers are aware of the challenge posed by attempting to make their products appealing in an image without doing parents a potential disservice -- on the page or with their products.
"Our primary message with our ads is to [...] create an aesthetically pleasing, fun, inspiring room," said Susie Fougerousse, president of Rosenberry Rooms, a high-end baby furniture company. "Style is important, safety is important. Style can't come at the expense of safety -- we're certainly not wanting to promote bad safety standards."
Fougerousse pointed out that featuring a crib with a blanket in it is safe if the blanket were to be used at an age appropriate time, not for a newborn, say, but for an older child.
"Aesthetics are really important when you're trying to show the potential of a room. It wouldn't be very enticing to look at a bare crib with just a sheet," Fougerousse said. "Something might be shown in a picture, but it's up to parents to know what might be used and when."
AAP Guidelines Saved Lives
The simple efficacy of safe sleep habits in infants, especially as it is protective against SIDS, may be the best argument for a consistent message about safe sleep environments and positions across media platforms.
After the AAP first published guidelines on safe infant sleep habits in 1992, the SIDS rate dropped over 50 percent from 1.2 deaths per 1,000 live births that year to 0.57 deaths per 1,000 live births in 2001, according to the Centers for Disease Control and Prevention.
"If parents put the baby down on his or her back, and the baby rolls over to stomach, no worry -- that kid is old enough to be past the risk of SIDS," said Dr. Lee Green, professor of Family Medicine at the University of Michigan. "But sleep position affects survival. Hard to take that one too far."
Christine Koh, editor of the parenting resource site bostonmamas.com, said while she would probably flip past advertisements in magazines, some information may leak into the subconscious.
"There is an impact, and we see it with breast feeding versus bottle feeding. People might try [baby] slings more if they see ads," Koh said. "There's a big responsibility for companies who produce products related to sleep [...] and find a creative way to demonstrate things correctly. ... You can still take incredibly adorable pictures of infants when they're on their backs."
ABC News' Courtney Hutchinson contributed to this report.