Medical Student University of Virginia University of Virginia School of Medicine Charlottesville, Virginia, United States
Background: Although there may be ample public health guidelines and education in the health care professional’s office before and after birth, other influences outside the health care setting may have an even stronger impact on sleep practices, and inconsistent messages about where and how the infant should sleep are associated with nonadherence with safe sleep guidelines. Parenting practices are highly influenced by perceived social norms. Of these potential influences, Instagram has become one of the most popular among young adults (including many expectant and new parents).
Objective: We hypothesized that the majority of Instagram images of infant sleep and sleep environments are inconsistent with AAP guidelines, and that the number of “likes” for each image would not correlate with adherence of the image to these guidelines.
Design/Methods: Data from 27 hashtags were collected using an open-source web scraper. The first 200 images from each hashtag were utilized for this analysis. All images were preliminarily sorted into groups that either depicted a sleeping infant or a sleep environment without an infant. Afterwards, they were analyzed more thoroughly for adherence with AAP safe sleep guidelines. Each image was analyzed by 2 authors, and any discrepancies were reconciled by a third
Results: A total of 1563 images (1134 of sleeping infant; 429 of infant sleep environment without sleeping infant) met inclusion criteria and were analyzed. Only 117 (7.5%) of the 1563 images were consistent with AAP guidelines. The most common reasons for inconsistency with AAP guidelines were presence of bedding (75%) and non-recommended sleep position (42.2%). The number of “likes” was not correlated with adherence of the image to AAP guidelines. Conclusion(s): Although individuals who use Instagram and post pictures of sleeping infants or infant sleep environments may not actually use these practices regularly, the consistent portrayal of images inconsistent with AAP guidelines reinforce that these practices are normative and may influence the practice of young parents. It is imperative that health care providers at least know the landscape of practices on social media so they can best tailor either specific patient advice or public health approaches. Additionally, campaigns to promote safe sleep may require health care professionals and officials to work with influencers and social media companies to promote up-to-date, evidence-based information about current recommendations that are trustworthy and engaging.
Authors/Institutions: Samuel Chin, University of Virginia School of Medicine, Charlottesville, Virginia, United States; Rachel Y. Moon, University of Virginia School of Medicine, Charlottesville, Virginia, United States; Rebecca F. Carlin, Columbia University Irving Medical Center, New York, New York, United States