4A’s Guidance: Safe Sleep Advertising

The 4A’s, in partnership with Cribs for Kids and First Candle, formerly the National SIDS (Sudden Infant Death Syndrome) Foundation, is providing guidelines to its member agencies on how to accurately portray sleeping babies in advertising.

SIDS is the leading cause of death for infants one month to one year of age and claims the lives of nearly 2,500 babies each year. In addition, there are up to 2,000 sudden, unexpected infant deaths (SUID) caused by accidental suffocation or accidents during sleep each year. It’s important to follow the safe-sleep and safety recommendations set forth by First Candle and the American Academy of Pediatrics, and supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development. According to Cribs for Kids, more than 35,000 children and adults are alive today because they slept on their backs as infants.

A recent study conducted by Children’s National Medical Center found that in magazines targeting women of childbearing age, more than one-third of the images showed babies in unsafe sleep positions and more than two-thirds showed babies in unsafe sleep environments.

In response to these statistics, the 4A’s and infant sleep safety organizations recommend that agencies and advertisers create, select and use only images that depict babies (who appear to be 18 months of age or younger) in safe-sleep positions and safe-sleep environments.

The following are safe-sleep image guidelines:

  • All babies should be shown sleeping or being put to sleep on their backs. Babies who sleep on the stomach are twice as likely to die of SIDS.
  • All babies should be shown sleeping in a crib that meets current safety standards (available at the Consumer Product Safety Commission website), play yard or similar safe, but separate sleep environment. Babies should not be shown sleeping with an adult or on an adult bed, sofa, chair or other unsafe place. Babies who share any sleep surface are three times more likely to die of SIDS and five to 10 times more likely to die if less than three months old.
  • Babies should not be shown sleeping in car seats, infant carriers, swings, slings or other similar products. There are many reports of babies dying while sleeping in these devices.
  • Never show babies sleeping in positioners or on wedges. These items can cause suffocation or increase the risk of SIDS.
  • Where possible, photos should demonstrate room sharing for babies under six months of age; showing the baby’s separate, safe sleep area in the room with, or alongside, the adult bed.
  • Photos should not show soft or loose bedding items such as blankets, quilts, soft or pillow-like bumpers, pillows or stuffed animals in the baby’s sleep space. Loose bedding has been shown to increase the risk of SIDS and possibly suffocation. Bumpers have also been associated with deaths and are not recommended.
  • If possible, show sleeping babies dressed in a wearable blanket or other sleeper to keep them warm instead of loose blankets. Loose blankets can cover the face and mouth leading to SIDS or suffocation. Avoid excessive layers of clothing; overheating is associated with SIDS.
  • Never show babies sharing a sleep space. Even multiples should each have their own crib. Infants dying of SIDS are five times more likely to have had another child in bed with them.
  • Consider showing a pacifier with a sleeping baby greater than one month of age. A specific reason has not been determined, but studies consistently show a protective effect against SIDS.
  • The baby’s sleep space should be shown a safe distance away from windows. If a window shade is shown, the cord should not be in close proximity to or within reach of the baby.
  • The crib mattress height should be shown at the lowest level for babies who appear to be able to pull or stand up.
  • Crib gyms or mobiles should not be used in photos of babies who appear to be five months of age and older.

Click here to see guidelines for safe-sleep images.

Click here for complete safe-sleep guidance.