Sleep baby on the back from birth, not on the tummy or side 2. Sleep baby with head and face uncovered 3. Keep baby smoke free before birth and after 4.
Provide a safe sleeping environment night and day 5. Sleep baby in their own safe sleeping place in the same room as an adult care-giver for the first six to twelve months 6.
Safe sleeping recommendations target known risk factors associated with SUDI. Where studies specifically define the population as SIDS, this specific term will be used to describe the study findings. If twins must share the same sleep space, a cot is the most suitable, do not use bedding such as sheets and blankets and place them at opposite ends of the cot.
The one overriding concern is safety. With them, they had the added benefit of not being alone in the room, which helped them feel less scared.
An infant sleeping bag used for each baby may be useful in this situation. When the babies have reached the age where they can move freely around the cot, they must be placed in separate cots. Babies should not co-bed with any other children. Premature and low birth weight babies are at increased risk of SUDI Their longer postnatal stay allows an opportunity to target parents and staff with risk reduction messages.
Below are the Red Nose recommendations for sleeping twins safely. For higher order multiple births triplets, quadruplets, quintuplets , please refer to your health professional for advice on providing a safe sleep environment for each baby. Co bedding in the hospital setting Co-bedding of twins was introduced in neonatal units predominately in the US from the s.
Co-bedding aimed to continue this fetal co-regulation and potentially promote growth and neurodevelopment 6,7.
When one wakes up, don't tiptoe around the other baby. Don't share a bed with your baby if you or your partner:
Other proposed advantages of co-bedding include heat conservation, apnea reduction, improved bonding between infants, improved parental and staff satisfaction 6, and saving of cot space. However, concerns regarding co-bedding include risk of infection, possible medication error, difficulties involving the routine care of individual infants, less reliable incubator temperature control, mutual disturbance leading to reduced sleep quality, and possible physical injury 7.
A recent Cochrane Review 8 included six mostly small studies with some limitations in their methods. All studies were conducted in the neonatal nursery of a major tertiary hospital and enrolled preterm infants of average postmenstrual age of 29 weeks.
Overall, the review reported no differences between the co-bedded group and the group receiving care separately in terms of weight gain, episodes of major disturbances in their breathing, heart rate or oxygenation level apnea, bradycardia, or desaturation episodes , length of hospital stay, and occurrence of infection.
Current research into the co-bedding of twins does not provide sufficient evidence to guide policy and guidelines for or against the practice in NICU 8,9. More research is required. Prior to discharge from hospital Nursing staff and midwives should use the back sleeping position for all babies prior to discharge to establish a safe sleeping model for parents to follow when their baby is discharged. When the babies are ready for discharge, staff should ensure that the parents know how to reduce the risk of SUDI and fatal sleep accidents.
It should not be assumed that parents have this information already as they may have missed other opportunities to learn about safe sleeping environments for babies. The American Academy of Pediatrics also advises separate sleep surfaces and to avoid co-bedding for twins and higher order multiples in both hospital and at home Co-bedding twins would be dangerous if one part of the body of one twin were able to accidentally cover the face of the other causing an interference with breathing.
A small observational study of 10 twin pairs sleeping in various side by side and head to head configurations showed that twins sleeping side by side occasionally impinged on, although did not obstruct, the airway of the other twin Sleeping twins safely when separate cots are not available Sometimes parents and carers of twins may need to sleep twins in the same cot temporarily, for example when travelling or visiting, if there is insufficient space for two cots in the room.
In these circumstances, ways to minimise the risks for twin babies sharing the same cot include: Place the babies head to head, at opposite ends of the cot see diagrams below Never place the baby in the cot with any other children Do not use bedding. Safe alternatives to bedding include: For more information on the sleeping of twins at home visit the Red Nose website at rednose. In Australia, between and approximately 5, babies died suddenly and unexpectedly.
For further information visit the Red Nose website at rednose. National Scientific Advisory Group This information statement was first posted in October, Most recent revision March View the references for the article here.
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