Vogue is a fashion magazine and mostly everyone on the cover is someone very famous, likable, and beautiful. This is representing how skinny is supposed to be "in". Its ironic because the skinny girl is dead because she is so skinny
This is a picture of a little person, Edward Garrett, who played a baby in the farce "The Little Stranger" on Broadway. So, the picture is not as weird as it looks. It is a picture of a man, not a child.