Caring for twin infants: sleeping arrangements and their implications

Abstract

Aim. The study aimed to assess sleeping arrangements used by parents for twin infants and to determine what information might be useful for health professionals and parents regarding twin infant sleep. Method. A self-selected sample of 60 families recruited via Tamba (Twins and Multiple Births Association), local health professionals and newspapers maintained sleep logs and participated in telephone interviews when their twin infants were one, three and five months of age. Results. The authors found significant associations between home sleeping arrangements and sleeping arrangements on the postnatal ward (chi-square=9.5, df=1, p=0.002), infant age (chi-square=5.45, df=1, p=0.0195), and sleep furniture used in the home (chi-square=36.13, df=1, p<0.0001). At one month of age, 60% of twins were co-bedded, 92% of which shared a cot while 86% of twins sleeping apart were in separate Moses baskets. Co-bedded twins were initially positioned side-by-side (68%), however eight co-bedding configurations were documented over the first three months. Sleep duration was the primary reason given by parents for sleeping twins either apart or together, but no significant differences were found for parental or infant sleep duration. Co-bedded twins were less likely to be moved from their parents' room than those who slept apart (9% versus 33%), however a few parents of co-bedded twins introduced unnecessary hazards into their twins' sleeping environments with the inappropriate use of bedding and make-shift barriers between the babies. Conclusions. Department of Health advice to parents on reducing the risk of sudden infant death syndrome (SIDS) recommends sleeping infants in their parent(s) room for the first six months of life. Co-bedding appears to facilitate compliance with this recommendation via the use of a single cot. The strong association between hospital and home sleeping arrangements suggests that co-bedding twins on the postnatal ward may encourage parents to do so at home. By discussing sleeping arrangements for twin babies with parents, both hospital and community midwives could help to educate parents about the most appropriate ways of co-bedding twin infants and avoidance of unsafe practices.