We evaluated images in popular stock photography websites for adherence with American Academy of Pediatrics (AAP) guidelines for safe infant sleep practices. Three top stock photo websites were used to collect photographs generated from key phrases. All images depicting an infant sleep environment were analyzed for consistency with AAP guidelines. Descriptive statistics, chi-square and z test of proportions, were conducted. A total of 1233 of 1947 stock photographs showed sleeping infants on a flat surface. In all, 627 (50.8%) photographs showed the infant in the supine position and 79 (5%) of all infant sleep environments were adherent with AAP recommendations. Bedding inconsistent with safe sleep recommendations was identified in 1133 images (71.3%), with blankets noted in 49.5%. Images depicting sleeping infants on stock photography sites do not routinely adhere to AAP recommendations. Media messages inconsistent with health care messages create confusion and misinformation about infant sleep safety and may lead inadvertently to unsafe practices.

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pregnancies were planned; 42% of patients reported any preconception counseling; 48% were informed of the importance of preconception HgbA1c; and 57% were advised how diabetes may impact their pregnancy. Although obstetricians were more likely to review some critical elements of preconception counseling, there was no difference in total amount of preconception counseling between provider types once maternal characteristics were adjusted for. Early HgbA1c was lower among patients who saw an obstetrician compared to other provider (7.6% vs 8.3%, p¼0.045), but when maternal characteristics were adjusted for, there was no association between HgbA1c and provider type. CONCLUSION: Given the low rate of preconception counseling among obstetricians and other providers, education is needed advocating that all reproductive aged patients with pre-existing DM receive information on the importance of optimizing glucose control for improved pregnancy outcomes.

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