The ABCs of safe sleep (Alone, on their Backs, in a flat Crib or bassinet) means, in practice: no blankets, no crib bumpers, no stuffed animals, no pillows, no loungers, no sleeping in car seats outside of the car, no sleeping on adult mattresses, no sleeping on couches or in swings, no putting babies down on their tummies, no bed-sharing. 

This can feel like pretty harsh advice, as every exhausted parent of a crying baby can attest. It also doesn’t always feel intuitive: To some parents, a baby sleeping alone on their back in a bare, flat bassinet may look a bit exposed, a bit cold. Wouldn’t they be so much more comfortable on a soft pillow, or having their heads raised up a little? Just one blanket over them, maybe? What about just for naps? Can we put them to bed on their stomachs, because it just looks so much more natural? Just once?

Research shows that the extent to which we deviate from expert advice, and how often, depends a lot on what we hear from people we trust—our family and friends. Our behavior is also (consciously or not) influenced by what we see online, even if it’s content from people we don’t know.

“When you look at how people make their healthcare decisions, social media and images online play a big role in that,” says Michael Goodstein, the neonatologist and member of the AAP subcommittee on sudden unexpected infant death. “The images that show unsafe sleep undermine our messaging and really suggest to families in their decision-making that maybe those things are okay to do.”

The problem is, sleeping babies are cute. And they’re so much cuter when they look cozy. The AAP guidelines are decidedly not cozy. 

This isn’t exactly a new problem. A 2009 study looked through dozens of print magazines that were geared toward new mothers and found that only 36 percent of the hundreds of photos in the magazines showed babies in a safe sleeping environment, on their backs, by themselves. Another study found a similar percentage in ads for cribs.

Social media has only accelerated our access to images and information of all kinds—it’s in our pockets, and, unlike our pediatrician, it’s available all day and all night. As a new parent, Googling a question is a reflex, like breathing. We search and post and cycle through Bluesky, Facebook, Instagram, Reddit, Threads, TikTok, YouTube, and X for information, for emotional support, and for a sense of community in an often lonely time. And we do it while we are trying to stay awake, when we’re feeding our babies in the middle of the night.

A 2024 study analyzed baby photos shared by parents in a Facebook group discussing infant sleep, and found that only 14 percent of the photos reflected a safe sleep environment that adhered to AAP guidelines. The majority of the photos showed newborns sleeping on their stomachs or with pillows, or else images of bed-sharing, says the study’s author, Kelly Pretorius, PhD, RN, assistant professor at Baylor College of Medicine in Houston and adjunct faculty at The University of Texas at Austin School of Nursing. 

“Parents are going to social media for support: It can be information, it can be emotional, but they are seeking support, and that is where they’re finding it,” says Pretorius, who in addition to her academic and clinical work on infant healthcare, also remembers going online to try to stay awake while breastfeeding her newborn in the early days of her rigorous PhD program. “We know how much time people are spending in these forums, and that influences the perceived social norms.” 

A 2021 study of images on Instagram found that only 7 percent of those images were consistent with AAP guidelines. A similar analysis in 2023 found that under 2 percent were.

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