Sunday, November 13, 2011

Why I hate these anti-SIDS shock ads

Shock advertising is on its way out in social marketing in general. But if there's one target audience that still responds strongly to fear, it's new parents.

Which is why this campaign by the City of Milwaukee Health Department (via Osocio) does everything I hate. It dramatically overstates a risk, increases the fear and anxiety of new parents (especially mothers), and it is a lazy bid for attention and/or awards by the agency, Serve:

Co-sleeping is one of those issues that really polarizes parents. On one side, you have the "rule follower" parents, who accept the risk-averse dictates of public health authorities who say that babies sleeping in their parents' beds are more likely to die. Then you have the "intuitive" parents who question these dictates, based on their own feelings and diverse cultural practices.

According to celebrity baby-care expert Dr. Sears, there is a third way to look at the issue: statistically.

"During the 8-year period of this study, about 34,000 total cases of SIDS occurred in the U.S. (around 4250 per year). If 65 cases of non-SIDS accidental death occurred each year in a bed, and about 4250 cases of actual SIDS occurred overall each year, then the number of accidental deaths in an adult bed is only 1.5% of the total cases of SIDS. 
There are two pieces of critical data that are missing that would allow us to determine the risk of SIDS or any cause of death in a bed versus a crib. 
How many cases of actual SIDS occur in an adult bed versus in a crib? 
How many babies sleep with their parents in the U.S., and how many sleep in cribs? 
The data on the first question is available, but has anyone examined it? In fact, one independent researcher examined the CPSC's data and came to the opposite conclusion than did the CPSC - this data supports the conclusion that sleeping with your baby is actually SAFER than not sleeping with your baby. As for the second question, many people may think that very few babies sleep with their parents, but we shouldn't be too quick to assume this. The number of parents that bring their babies into their bed at 4 am is probably quite high. Some studies have shown that over half of parents bring their baby into bed with them at least part of the night. And the number that sleep with their infants the whole night is probably considerable as well. In fact, in most countries around the world sleeping with your baby is the norm, not the exception. And what is the incidence of SIDS in these countries? During the 1990s, in Japan the rate was only one tenth of the U.S. rate, and in Hong Kong, it was only 3% of the U.S. rate. These are just two examples. Some countries do have a higher rate of SIDS, depending on how SIDS is defined."
What is going on here?
"Who is behind this new national campaign to warn parents not to sleep with their babies? In addition to the USCPSC [U.S. Consumer Product Safety Commission], the Juvenile Products Manufacturers Association (JPMA) is co-sponsoring this campaign. The JPMA? An association of crib manufacturers. This is a huge conflict of interest. Actually, this campaign is exactly in the interest of the JPMA."

I understand that many parents would rather not go against authoritarian advice when they believe it is a matter of life and death. I wouldn't advise them to. But my wife and I made the informed decision to keep our infant son in our bed. It actually made breastfeeding much easier for her, as she barely needed to wake up for night feedings. We believed it was far better for him, too, because he was fed at the first signs of restlessness and never had to wake up feeling abandoned and alone. (Dr. Ferber is an asshole, BTW.) And safety? We believed that it was far safer to have the baby with us, where we could directly detect and address any issues of respiratory distress, rather than trusting wireless technology to do it for us.

We also believe that SIDS has many causes, that are not well understood. Second-hand smoke, parental drug (including alcohol) abuse, poor nutrition, and suffocating bedclothes have all also been blamed. Breastfeeding, on the other hand, has been linked to lower SIDS rates. There are various explanations given for this, but I have my own theory: that close encounters with an engorged breast while feeding strengthens the baby's awareness of, and response to, the anti-smothering instinct. But I'm not a scientist. I'm just an adman who plays one on his blog.


  1. Tom -- This is a terrific and well-reasoned piece on the strategic (if not ethical) flaw of a specific social marketing campaign. As you note, the social marketing specialists in the advertising industry are too often guilty of producing attention-getting ads to win awards rather than achieve a larger social good through sustainable behavior change. Kudos for calling them out in a way that may keep it from happening again.

  2. Thank you, Pat. This was one of my rare serious moments on this blog.

  3. So I noticed, Tom! A little diversity is always good for the brain though...

  4. I saw this on Osocio and was equally annoyed. I then came across your comment and was glad others out there understand the benefits of co-sleeping. Thank you.

  5. I've just stumbled across your response to these ads and I have to say THANK YOU for post. We have successfully co-slept with our son and then benefits are incredible. It's nice to know that not everyone believes everything they read. Thank you for your research and statistics.

  6. Great post! As a proud co-sleeper and one who works with statistics (hence the co-sleeping, babywearing, breastfeeding and most other decisions I have made regarding my child) I totally agree, but I don't think it's the ad agency's fault. That was the message they were paid to deliver. I do, however, blame people who have no background in statistical testing or a health care background dictating policies like this and misleading the public as a whole. And I totally agree, Dr. Ferber is an A-hole.

  7. statistics state that about 1.something% of infants that sleep with their parents are at risk.. personally? that is 1% more than I'm willing to risk on the safety of my child.. But I guess for those who risk it, it's God's way of weeding out the dumb ones.
    yea, for natural population control.

    1. To each their own, I suppose. All I have to say is that putting a butcher's knife next to infants in bed would put a hell of a lot more than 1.something% of them at risk.