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

J Pediatr. 2024 Jan:264:113763. doi: 10.1016/j.jpeds.2023.113763. Epub 2023 Sep 29.


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.

Keywords: legislation; meta-analysis; packaging; sudden infant death.

Publication types

  • Meta-Analysis

MeSH terms

  • Child
  • Drug Packaging
  • Europe
  • Humans
  • Infant
  • Infant Care / methods
  • Parents
  • Sleep
  • Sudden Infant Death* / prevention & control