Inconsistency Between Pictures on Baby Diaper Packaging in Europe and Safe Infant Sleep Recommendations

Sophie de Visme, Daniel A. Korevaar, Christèle Gras-le Guen, Alix Flamant, Martina Bevacqua, Anna Stanzelova, Nhung T. H. Trinh, Dalia-Alexandra Ciobanu, Ana Araújo Carvalho, Ifigeneia Kyriakoglou, Maria Fuentes, Yacine Refes, Elisabeth Briand-Huchet, Anne-Laure Sellier, Inge Harrewijn, J. rémie F. Cohen, Martin Chalumeau

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Objective: To describe the level of inconsistency between pictures on baby diaper packaging and safe infant sleep recommendations (SISRs) in Europe. Study design: We attempted to identify all packaging of baby diapers sold in 11 European countries for infants weighing less than 5 kg through internet searches from July 2022 through February 2023. For each type of package, we extracted whether there was a picture depicting a baby, whether the baby was sleeping, and whether the picture of the sleeping baby was inconsistent with ≥1 of 3 SISRs: (i) nonsupine sleeping position, (ii) soft objects or loose bedding, or (iii) sharing a sleep surface with another person. Data were aggregated at the country level, and a random-effects meta-analysis of proportions was used to obtain summary estimates. The outcome was the summary estimate of the proportion of pictures that were inconsistent with SISRs. Results: We identified 631 baby diaper packaging types of which 49% (95% CI: 42-57; n = 311) displayed a picture of a sleeping baby. Among those 311 packages, 79% (95% CI 73-84) were inconsistent with ≥1 SISR, including a nonsupine sleeping position, 45% (95% CI 39-51), soft objects or loose bedding such as pillows or blankets, 51% (95% CI 46-57), and sharing a sleep surface with another person, 10% (95% CI 4-18). Conclusions: Pictures on baby diaper packaging in Europe are often inconsistent with SISRs. The prevention of sudden unexpected death in infancy requires action from manufacturers and legislators to stop parents’ exposure to misleading images that may lead to dangerous practices.
Original languageEnglish
Article number113763
JournalJournal of pediatrics
Publication statusPublished - 1 Jan 2024
Externally publishedYes


  • legislation
  • meta-analysis
  • packaging
  • sudden infant death

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