ASA Adjudication on Hertfordshire Safeguarding Children Board
Hertfordshire Safeguarding Children Board t/a
8 August 2012
Internet (on own site)
Number of complaints:
Summary of Council decision:
Two issues were investigated, both were Not upheld.
A downloadable poster and leaflet, on the Hertfordshire Safeguarding Children Board's (HSCB) website, offered advice on the risks of Sudden Infant Death Syndrome (SIDS). Both ads featured a picture of a children's story book open at a page which stated "ONCE upon a time, I was with my mummy. She fed me and we both fell asleep together. I didn't wake up. THE END". Below this, further text stated "The safest place for your baby to sleep is in a cot in your room Falling asleep with your baby if you are a smoker or have been drinking alcohol increases the risk of sudden infant death". Both ads encouraged readers to find out more information by visiting www.fsid.org.uk or speaking to their midwife or health visitor.
The leaflet provided more advice to minimise the risk of SIDS including a list of 'dos' and 'don'ts'. Guidance included the text "Do not share a bed with your baby while under the influence of; any drugs that cause drowsiness, cigarettes, alcohol, or if you are excessively tired".
1. Four complainants challenged whether the ads were misleading, because they implied that bed sharing in general was harmful and could cause SIDS, whereas they understood that there were numerous benefits to bed sharing if carried out in a safe manner.
2. Three of the complainants challenged whether the ads were alarmist and could cause distress to parents who were safely bed sharing with their baby or had lost a child to SIDS.
CAP Code (Edition 12)
HSCB said the ads were part of a wider campaign to raise awareness of the risks of co-sleeping. They said the key message of the campaign was that co-sleeping increased the risk of SIDS, particularly if certain modifiable factors were involved, and therefore that the safest place for a baby to sleep was in a cot.
They said the campaign had been designed with a sense of responsibility to members of the public and that its primary aim was to promote the welfare of children. HSCB said the campaign had been instigated at the request of the Hertfordshire Child Death Overview Panel (CDOP), which had identified that a high number of babies had died in Hertfordshire as a result of SIDS. Further, they identified that some of these deaths were related to co-sleeping where modifiable factors such as drugs, alcohol and smoking had been involved.
HSCB explained that they had used a campaign designed by a partnership of the Bolton, Wigan and Salford Local Safeguarding Children Boards (LSCB), which had also been supported by the Foundation for the Study of Infant Deaths (FSID), as a base for their own campaign. HSCB made slight amendments to the Bolton Partnership material but overall the concept and presentation was broadly the same.
HSCB believed that the ads did not materially mislead as they clearly identified that bed-sharing in certain circumstances increased the possibility of co-sleeping and therefore the risk of SIDS. They stated that this claim was based on acknowledged and respected research and they pointed to various advisory documents published by UNICEF, the Department of Health (DH) and FSID which supported the claim. HSCB also said the ads, particularly the leaflet, provided balanced information by stating that breastfeeding, which is often encouraged by bed-sharing, reduced the risk of SIDS by a third. HSCB provided comments from the Bolton Partnership which highlighted that their campaign made a clear distinction between bed-sharing and co-sleeping. The Bolton Partnership noted that they did not condemn bed-sharing as it encouraged important skin-to-skin contact between mother and child, and helped mothers to breastfeed. The Partnership said they wanted to encourage parents who shared their beds with their baby to take precautions so they did not accidentally fall asleep with their baby in their bed. They said it was safer for parents who bed-shared to return their baby to their own cot before falling asleep themselves.
HSCB admitted that the ads were hard hitting, but said they felt this approach was merited by the importance of the issue. They said they had purposefully chosen a very visual campaign to ensure that the key message could be understood by the diverse population of Hertfordshire. The Bolton Partnership said they had tested the story book branding with a number of parents, including those who had lost a child to SIDS. They stated that "the story book branding evoked a strong reaction, with parents frequently commenting that 'the messages were strong but they needed to be'". The Bolton Partnership also said they had worked closely with the FSID when devising the campaign, and that the charity had approved the poster and endorsed the campaign in May 2011.
HSCB therefore believed that the campaign was socially responsible and had made an invaluable contribution to educating people about the risks of bed-sharing and co-sleeping with their baby whilst under the influence of alcohol, if they were smokers or had taken drugs.
1. Not upheld
The ASA considered UNICEF guidance on bed sharing which stated "Mothers take their babies into their beds in order to breastfeed, comfort, settle and get to know their baby. Bed-sharing encourages intimate contact between mother and baby which facilitates a close and loving bond. Successful breastfeeding and better sleep are more common among mothers and babies who share the same bed". We noted, however, the distinction made by the Bolton Partnership between bed sharing and co-sleeping. We acknowledged that co-sleeping was understood to increase the risk of SIDS as an infant could overheat, have their breathing obstructed or become tangled in the sheets of an adult bed. Whilst we understood that bed sharing was a positive and beneficial activity, when carried out in a safe manner, we also acknowledged that guidance produced by UNICEF, the DH, FSID and the NHS all advised that in certain circumstances bed sharing could lead to unintentional co-sleeping and was, in these instances, potentially dangerous. These bodies all advised that if a parent had been drinking, had taken prescribed or non-prescribed drugs, was a smoker or was feeling very tired, all of which would reduce their responsiveness and awareness of their infant in their bed, then they should not bed share with their baby. They all advocated that regardless of whether these risk factors were present, the safest place for a baby to sleep was in a cot, crib or moses basket in their parent's bedroom for the first six months.
We considered that the HSCB campaign informed parents about particular circumstances when they should not bed share or co-sleep with their baby. Whilst the ads did not advocate an outright ban, we understood that they were encouraging parents to take greater precautions when bed sharing to avoid unintentional co-sleeping. We understood the content of the ads was consistent with key advice that bed sharing was a safe and beneficial activity but that ideally an infant should be returned to their own cot when their parents wished to fall asleep.
We noted that the limitations of the medium, particularly in the case of the poster, meant that all the nuances of the issue could not be presented, but that ultimately the ads' key message was that bed sharing in certain circumstances could be dangerous. We also considered that both ads signposted the reader to more information by visiting the FSID website, or discussing bed sharing and co-sleeping with their midwife or health visitor.
We considered that the ads did not state or imply that all bed sharing was dangerous and could lead to SIDS. We understood that they reflected guidance produced by a number of professional bodies and ultimately sought only to discourage parents from bed sharing when they were unable to respond to their child's needs effectively, or were likely to unintentionally fall asleep. We therefore concluded that the ads were not likely to mislead.
On this point, we investigated the ads under CAP Code (Edition 12) rules 3.1 (Misleading advertising) and 3.7 (Substantiation) but did not find them in breach.
2. Not upheld
We understood that SIDS was a national concern which many LSCBs were trying address by educating parents about the risk of bed sharing and co-sleeping with their children. We noted that the Hertfordshire CDOP was motivated to launch a hard hitting campaign because of the high number of deaths in the Council as a result of co-sleeping, a number of which involved preventable risk factors.
We noted that some individuals may have been upset or concerned as a result of the emotive image and headline text used, especially if they had lost a child to SIDS or were currently safely bed sharing or co-sleeping with their child. We understood, however, that the Bolton Partnership had chosen to test the story book idea with a number of parents before launching their campaign, including those whose children had died because of SIDS. We noted that the response from these tests was broadly positive and that individuals often felt that the hard-hitting nature of the ads was necessary to promote an important safeguarding message and stimulate local debate and awareness. We also acknowledged that FSID had advised the partnership when they were creating the campaign and signed off on the poster and other campaign materials, which were very similar to those produced for the HSCB campaign.
We considered that because the key purpose of the ads was to inform parents about an important issue and increase the welfare of children in Hertfordshire, the hard-hitting approach could be justified. We also acknowledged that the story book imagery had been trialled with a number of parents and the FSID. We therefore considered that the ads were not alarmist and were unlikely to cause distress.
On this point, we investigated the ads under CAP Code (Edition 12) rules 1.3 (Compliance) and 4.2 (Harm and offence) but did not find them in breach.
No further action necessary.