Stock photography isn't known for its realism. Sure, Getty, Shutterstock and other repositories for generic images have evolved in their depiction of daily life. In the past decade, for instance, photos of young, thin women laughing alone with salads, or lying half-naked under towels, have given way to photos of a more diverse group of women climbing mountains, fixing computers and doing push-ups. But, when it comes to sleep, stock photography still has a ways to go.
Not only do stock photos often portray sleep as an improbably beautiful act, performed by Instagram-ready boho-beauties on grassy knolls. But, according to a new study, stock photos of sleeping babies rarely comply with pediatric health guidelines. More often than not, researchers at WellSpan York Hospital and the University of Virginia School of Medicine found, infants are shown dozing in positions and environments deemed unsafe by the American Academy of Pediatrics (AAP). Given how influential media images can be, researchers argue, stock photo sites are missing an opportunity to help parents keep their kids safe and undermining efforts to promote healthy sleeping practices.
According to the AAP, here's how an infant should sleep: on their back, in a safety-approved crib (or bassinet) that contains only a firm mattress and a fitted sheet. (That means no stuffed animals, head coverings or fluffy, soft bedding.) The crib should be placed in the parents' room and shouldn't have a crib bumper. The baby should not be "overbundled" and should be offered a pacifier at bedtime once they're breastfeeding. The baby should not be sleeping in the same bed as another person.
The AAP devised these guidelines based on epidemiological studies that identified risk factors for Sudden Unexpected Infant Death (SUID). In 1996, the AAP began to run safe-sleep public awareness campaigns. But, despite these efforts, rates of SUID haven't really declined since 2000. And nonadherence to safe-sleep guidelines, researchers wrote, remains widespread. It's possible that media exposure has something to do with these dispiriting trends.
In addition to relying on doctors, family members and friends for advice on sleep practices, parents are likely to take cues from the media. Previous research has found that sustained media exposure guides health-related decisions on topics such as breastfeeding, diet and, most pertinently, infant sleep position.
A few studies have analyzed sleep-related images of infants used in magazines and advertisements. The findings aren't terribly consistent but suggest that at least 16 percent, and as much as 65 percent, of media images flout safe-sleep guidelines. Researchers behind the current study wondered if media outlets are depicting babies sleeping improperly because of a "dearth of available appropriate images." And where does the media find generic photos of babies in repose? Stock photo sites. So, researchers decided to dig in.
They searched the top three stock sites, Fotolia, Shutterstock and Getty, for photos of babies sleeping and analyzed the resulting images based on seven criteria: sleep position, sleep location, sharing of sleep surface (with another person who's asleep), presence of bedding, presence of stuffed animals, head covering and pacifier use.
Researchers ended up with 1233 photos of babies sleeping (not in someone's arms or positioned sitting up) to analyze. Only 39 percent, they found, showed infants sleeping in the proper position (on their backs). Photos were even less likely to depict safe sleeping environments; more than 90 percent failed on at least one criterion.
In all, only 5 percent of the photos met all seven safe-sleep criteria. The photos were most likely to violate recommendations about bedding: Verboten soft bedding, loose sheets and soft sleep surfaces appeared in more than 70 percent of photos. Bedding recommendations are commonly violated in real life, too, even though the use of soft bedding is associated with a 5-fold increased risk of SIDS. Studies suggest this ill-advised practice is most often driven by parental concerns over comfort and warmth.
Slightly more than 20 percent of photos that featured cribs also featured crib bumpers, which have been implicated in a series of accidental deaths.
The photos were most successful when it came to bed-sharing; only 10 percent of photos depicted infants sharing a sleep surface. But, researchers noted, it's concerning that a sizeable chunk of photos still showed adults sleeping with infants on a couch, which greatly increases an infant's risk of SIDS.
Overall, the findings suggest that unsafe infant sleep practices are widely depicted on stock photo sites. And, while we may not consciously look to stock photos to guide our decisions, their omnipresence makes them more influential than we might realize.
"Consistent imaging is a critical component of the national effort to promote infant sleep safety," researchers wrote. "Safe sleep advocates and public health officials need to work together with photographers, stock photography companies, advertisers and the media to develop and promote culturally congruent images of infants in safe sleep environments."