title: Safe Sleep Guideline Adherence in Nationwide Marketing of Infant Cribs and Products.
abstract: Sudden infant death syndrome and sleep-related sudden unexpected infant death remain leading causes of infant mortality in the United States despite 4 safe sleep guideline restatements over the previous 24 years. Advertising and retail crib displays often promote infant sleep environments that are counter to the most recent American Academy of Pediatrics (AAP) guidelines.
  
  
  
  Magazine advertisements featuring sleep in parenting magazines from 1992, 2010, and 2015 were reviewed for adherence. Crib displays from nationwide retailers were surveyed for adherence to the latest AAP safe sleep guidelines. The primary outcome was adherence to the guidelines.
  
  
  
  Of 1758 retail crib displays reviewed, only half adhered to the latest AAP guidelines. The most common reasons for nonadherence were the use of bumper pads and loose bedding. The depiction of infant cribs and sleep products in magazine advertising has become significantly more adherent over time; however, 35% of current advertisements depict nonadherent, unsafe sleep environments. Magazine advertising portraying safe sleep environments revealed racial and ethnic disparities.
  
  
  
  Although improvements have been made over time with increased adherence to AAP safe sleep guidelines, significant deficiencies remain. Advertising continues to depict unsafe sleep environments. Crib manufacturers and retail establishments continue to market and sell bedding and sleep products considered unsafe by the AAP in approximately half of retail crib displays. Pediatric and public health care providers should continue educational and advocacy efforts aimed at the public, but should also include retailers, manufacturers, and advertising professionals to foster improved sleep environments for all children.
authors.affiliation: Department of Pediatrics, Division of Pediatric Pulmonary and Sleep Medicine, University of Alabama at Birmingham, Birmingham, Alabama; and.
authors.forename: Matthew
authors.initials: M
authors.lastname: Kreth
authors.affiliation: Department of Pediatrics, Division of Pediatric Pulmonary and Sleep Medicine, University of Alabama at Birmingham, Birmingham, Alabama; and.|Department of Respiratory Care, Children's of Alabama, Birmingham, Alabama.
authors.forename: Tammy
authors.initials: T
authors.lastname: Shikany
authors.affiliation: Department of Pediatrics, Division of Pediatric Pulmonary and Sleep Medicine, University of Alabama at Birmingham, Birmingham, Alabama; and.
authors.forename: Claire
authors.initials: C
authors.lastname: Lenker
authors.affiliation: Department of Pediatrics, Division of Pediatric Pulmonary and Sleep Medicine, University of Alabama at Birmingham, Birmingham, Alabama; and btroxler@peds.uab.edu.
authors.forename: R Bradley
authors.initials: RB
authors.lastname: Troxler
mesh_terms: D003257:Consumer Product Safety / Q000592:standards*; D000067088:Direct-to-Consumer Advertising; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007224:Infant Care / Q000592:standards / Q000706:statistics & numerical data; D015370:Infant Equipment / Q000592:standards* / Q000706:statistics & numerical data*; D007231:Infant, Newborn; D008297:Male; D040541:Marketing / Q000706:statistics & numerical data*; D010506:Periodicals as Topic; D011795:Surveys and Questionnaires; D014481:United States; D014600:Utilization Review / Q000706:statistics & numerical data