#sleepingbaby on Instagram: adherence to Dutch safe sleeping advice

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. A systematic social media analysis on Instagram was performed using 22 hashtags and 9 accounts of Dutch companies or platforms related to infants to determine the adherence of Instagram images to the Dutch safe sleeping advice. 514 images of sleeping infants were analyzed on consistency with the criteria: supine sleeping position, own cot or crib, sleep sack, and an empty bed. 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

#sleepingbaby on Instagram: adherence to Dutch safe sleeping advice

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. A systematic social media analysis on Instagram was performed using 22 hashtags and 9 accounts of Dutch companies or platforms related to infants to determine the adherence of Instagram images to the Dutch safe sleeping advice. 514 images of sleeping infants were analyzed on consistency with the criteria: supine sleeping position, own cot or crib, sleep sack, and an empty bed. 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

Renewed Attention Needed for Prevention of Sudden Unexpected Death in Infancy in the Netherlands

Background: The incidence of sudden unexpected death in infancy (SUDI), which includes sudden infant death syndrome (SIDS), has declined in developed countries since the 1980s, including the Netherlands. To identify improvement opportunities in SUDI prevention, we monitored the adherence of parents to the prevention advice on infant care habits over the past 20 years, especially in relation to the SUDI incidence over time. Potential changes in parental adherence between the latest surveys are of specific interest, as these indicate where current focus is needed. Methods: Description of the prevalence of infant care factors related to the risk of SUDI, assessed from five Dutch national surveys from 1999 to 2017 among parents of infants under 12 months, and analysis of the potential differences in these prevalences between the two latest surveys in 2010/11 and 2017 with a z-test. Results: Supine sleeping position decreased from the highest prevalence of 92% in 2010/11, to 83% in 2017. Sleep sack use has increased to 55%, the highest prevalence up to now. Avoiding a duvet has remained reasonably stable since 2002/03 and now 95% of parents do not use a duvet. The prevalence of room-sharing, without sharing the bed, increased from 14% in 1999 to the highest prevalence in 2017 (31%). However, also bed-sharing almost doubled from 5.6% in 2010/11 to 10% in 2017. Breastfeeding decreased between 1999 and 2010/11, but increased from 34% in 2010/11 to 42% in 2017. An increased prevalence of mothers who abstained from smoking during pregnancy, as well as both parents not smoking, was observed, although mostly higher educated parents showed this beneficial behavior. Discussion and Conclusion: Much has already been achieved first by decreasing prone sleeping since the 80's, and subsequently promoting supine as the safest sleep position. The decrease in duvet use and smoking, and an increase in breastfeeding have also had impact. Indications of a recent decreased prevalence of the supine sleeping position and higher prevalence of bed-sharing might relate to the slightly increasing SUDI incidence in the Netherlands. Renewed attention for prevention of SUDI and specific advice targeting high-risk groups is needed. Modern, picture driven information via internet is recommended

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

ObjectivesSafe 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.DesignA 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.ResultsBased 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.ConclusionsAlthough 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

Risk and Preventive Factors for SUDI: Need We Adjust the Current Prevention Advice in a Low-Incidence Country

Background: The incidence of Sudden Unexpected Death in Infancy (SUDI) is low in the Netherlands, with an incidence rate of 0.18 per 1,000 live births. Therefore, prevention advice may receive less attention, potentially leading to increasing incidence rates. It is currently unknown whether the risks for SUDI changed in the Netherlands, and if other risk factors might be present. The aim of this study was to examine the current risks and preventive factors for SUDI in Dutch infants, in order to determine if it is necessary to adapt the prevention advice toward the current needs. Methods: A case-control study was conducted comparing SUDI cases aged <12 months from 2014–2020 in the Netherlands (n = 47), to a Dutch national survey control group from 2017 including infants <12 months of age (n = 1,192). Results: Elevated risks for several well-known factors were observed, namely: duvet use (aOR = 8.6), mother smoked during pregnancy (aOR = 9.7), or after pregnancy (aOR = 5.4) and the prone sleeping position (aOR = 4.6). Reduced risks were observed for the well-known factors: room-sharing (aOR = 0.3), sleep sack use (aOR = 0.3), breastfeeding (aOR = 0.3), and the use of a pacifier (aOR = 0.4). For infants <4 months, the risk for SUDI was higher when bed-sharing (aOR = 3.3), and lower when room-sharing (aOR = 0.2) compared to older infants. For older infants, the sleep sack was found to be more protective (aOR = 0.2). A high risk for SUDI when bed-sharing was found when mother smoked, smoked during pregnancy, or if the infant did not receive any breastfeeding (respectively aOR = 17.7, aOR = 10.8, aOR = 9.2). Conclusions: Internationally known factors related to the sudden unexpected death of infants were also found in this study. Relatively new findings are related to specific groups of infants, in which the strengths of these risk factors differed. In a low-incidence country like the Netherlands, renewed attention to the current prevention advice is needed. Furthermore, additional attention for prevention measures in low educated groups, and additional advice specifically targeting high-risk groups is recommended