JMIR Publications

ABSTRACT

Background:

Parents are increasingly using smartphone apps to help guide decision-making around aspects of caregiving, including safe sleep. However, it remains to be known whether the guidance provided aligns with best practice guidelines.

Objective:

This review aimed to identify smartphone apps that provide safe sleep guidance and to assess their content, technical features, functionality and quality. A secondary aim was to make recommendations on the improvements existing and future apps can make to provide safe sleep guidance.

Methods:

In January 2026, we searched the UK Google Play and Apple App stores for safe sleep guidance apps for parents/carers of newborns and infants (babies aged up to 12 months). Information regarding content, technical and functional features was extracted and summarised descriptively. Each app was evaluated by two raters using the Mobile App Rating Scale (MARS) and the IMS Institute for Healthcare Informatics functionality score. Adherence to best practice sleep guidance was assessed using bespoke criteria. Inter-rater reliability was calculated.

Results:

A total of 1,345 apps were identified with 12 meeting the inclusion criteria. All were free to download with 41% containing in-app purchases. Only 17% were affiliated with a professional health, medical, clinical or government body. All 12 apps contained some information regarding safe sleep practices, although this was addressed and named differently (e.g., calling it cot death, sudden infant death syndrome (SIDS) or safe sleep). Of the 11 criteria relating to safe sleep best practice guidance, the apps mentioned an average of 6.83 criteria each (SD: 1.75; range: 3-9). Some promoted unsafe sleep practices (i.e., around swaddling and co-sleeping). The apps included an average of 5.4 of 11 of the IMS functionality criteria (SD: 2.5; range: 2-9). The mean MARS score was 3.7 out of 5 (SD: 0.43; range: 2.92 - 4.13) and most (92%) had a minimum acceptability score of 3 or above. Two had been formally trialled or tested. Although the language used was considered accessible (easy to understand), none of the apps allowed for the language to be changed (beyond English) and very few (25%) enabled users to change to night/dark mode which would be considered essential when using these apps at night-time.

Conclusions:

Several apps about safe baby sleep exist. Not many discuss safe sleep guidance comprehensively or raise awareness about SIDS and its links with unsafe sleep. All the reviewed apps met the minimum acceptability criteria for quality however not many were formally trialled or tested. More long-term research should be conducted on the effectiveness of safe sleep apps on adherence to safe sleep guidance. We recommend that apps relating to infant and baby safety in general include information surrounding safe sleep practices that are informed by best practice guidelines. Clinical Trial: Not applicable.