Safer Sleep Guidance in Standalone UK Smartphone Apps for Parents of Newborns and Infants: Systematic mHealth App Review

Clinical Snapshot

Key Findings

• P Value: Not applicable; no inferential statistical testing conducted

• Effect Size: Mean MARS quality score: 3.7/5 (SD 0.43; range 2.92–4.13). Mean IMS functionality score: 5.4/11 criteria met (SD 2.5; range 2–9). 92% (11/12) of apps met the minimum MARS acceptability threshold of ≥3.

• Primary Outcome: Adherence to safer sleep best practice guidelines: apps covered a mean of 6.75 of 9 safer sleep criteria (SD 1.71; range 3–9). Only 17% (2/12) were affiliated with a professional health, medical, clinical, or government body. Some apps actively promoted unsafe sleep practices including unsafe swaddling and cosleeping guidance.

• Nnt Or Sensitivity: Not applicable for this study design. Interrater reliability was calculated between two independent raters for MARS and bespoke criteria scoring, though specific reliability coefficients (e.g., ICC or kappa values) are not reported in the abstract.

• Confidence Interval: Not reported; descriptive statistics only (means and standard deviations provided)

Clinical Application

The findings highlight a significant gap between available digital health tools and evidence-based safer sleep guidance. Clinicians should exercise caution when recommending or implicitly endorsing infant sleep apps, given that some promote unsafe practices. The low rate of professional or government body affiliation (17%) suggests most apps lack adequate clinical oversight. Feasibility of implementing app-based safer sleep education is contingent on app quality improvement and formal clinical validation. In Australia, safer sleep guidance is primarily governed by Red Nose Australia (formerly SIDS and Kids), whose recommendations align broadly with UK Lullaby Trust guidance but include specific Australian contextual adaptations. The Therapeutic Goods Administration (TGA) does not currently regulate most consumer health apps unless they meet the definition of a medical device. The RACGP and Australian College of Midwives do not currently provide specific guidance on recommending infant sleep apps. Australian maternal and child health nurses (a key touchpoint for new parents) should be aware that commercially available apps may contain unsafe sleep guidance. PBS considerations are not directly relevant, though the broader digital health agenda under the Australian Digital Health Agency (My Health Record, telehealth frameworks) underscores the importance of quality standards for consumer-facing health apps. The findings are directly transferable to the Australian context, where similar app store ecosystems operate and parental digital health tool use is comparably prevalent. Parents and caregivers of newborns and infants aged ≤12 months who use or are likely to use smartphone apps for infant care guidance, particularly in the context of safer sleep education. Clinicians advising on digital health tools for new parents, including midwives, maternal and child health nurses, general practitioners, and paediatricians.

Abstract

BACKGROUND: Parents are increasingly using smartphone apps to help guide decision-making around aspects of caregiving, including safer sleep. However, it remains unclear whether the guidance provided aligns with best practice guidelines. OBJECTIVE: This review aimed to identify smartphone apps that provide safer sleep guidance and to assess their content, technical features, functionality, and quality. A secondary aim was to make recommendations on the improvements that existing and future apps can make to provide safer sleep guidance. METHODS: In January 2026, we searched the UK Google Play Store and Apple App Store for safer sleep guidance apps for parents and caregivers of newborns and infants (babies aged ≤12 months). Information regarding content, technical features, and functional features was extracted and summarized descriptively. Each app was evaluated by 2 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. Interrater reliability was calculated. RESULTS: A total of 1345 apps were identified, with 12 meeting the inclusion criteria. All were free to download, with 42% (5/12) containing in-app purchases. Only 17% (2/12) were affiliated with a professional health, medical, clinical, or government body. All 12 apps contained some information regarding safer sleep practices, although this was addressed and named differently (eg, calling it cot death, sudden infant death syndrome, or safe sleep). Of the 9 criteria relating to safer sleep best practice guidance, the apps mentioned an average of 6.75 (SD 1.71; range 3-9) criteria. Some promoted unsafe sleep practices (ie, around swaddling and cosleeping). The apps included an average of 5.4 of the 11 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 (11/12, 92%) had a minimum acceptability score of 3 or above. Two had been formally trialed or tested. Although the language used was considered accessible (easy to understand), none of the apps allowed the language to be changed (beyond English), and very few (3/12, 25%) enabled users to change to night/dark mode, which would be considered essential when using these apps at night. CONCLUSIONS: Several apps about safer baby sleep exist. Few discuss safer sleep guidance comprehensively or raise awareness about sudden infant death syndrome and its links with unsafe sleep. All the reviewed apps met the minimum acceptability criteria for quality; however, not many were formally trialed or tested. More long-term research should be conducted on the effectiveness of safer sleep apps on adherence to safer sleep guidance. We recommend that apps relating to infant and baby safety in general include information on realistic safer sleep practices that are informed by best practice guidelines and take a risk minimization approach.

References

1. 1.Yousef, S., Meaney, N., Dowding, D., & Gasteiger, N. (2026). Safer sleep guidance in standalone UK smartphone apps for parents of newborns and infants: Systematic mHealth app review. JMIR mHealth and uHealth. https://doi.org/10.2196/95642