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Twin Co-Bedding

Twin Co-Bedding

As multiple births become more common, the number of parents who are not sure whether they should sleep their babies together or apart rises as well. Similar uncertainty accompanies the questions of safe sleeping position and feeding. Unfortunately, the increasing need for such advice has not yet been reflected in the amount of research done on the issue.

Together or apart?

The first dilemma which parents of twins face when it comes to sleep is often this: Should the babies be put in one or two separate cots? Outcomes of studies conducted with parents of twins in New Zealand (The prevalence of cobedding and SIDS-related child care practices in twins, Hutchinson et al, 2010) shows that co-bedding (sleeping both twins together in the same cot) was practiced among 52% of the twin pairs of 6 weeks of age and reduced to 31% at 4 months and 10% at 8 months of age. Two other studies carried out by Damato (USA)(Sleeping Arrangements in Families With Twins, Damato et al, 2012) and Ball (United Kingdom)(Caring for twin infants: Sleeping arrangements and their implications, Ball, 2006; Together or apart? A behavioural and physiological investigation of sleeping arrangements for twin babies, Ball, 2007) showed very similar results. That co-bedding becomes less common with increasing age may be connected with the fact that babies become too big to sleep together in an available cot.

In Helen Ball’s research no evidence was found to support parents’ concerns about co-bedding (twins disturbing each other, risk of overheating and suffocating). On the other hand, some advantages of co-bedding were found. Co-bedded twins had synchronous sleep patterns and were subjectively easier to care for (however neither co-bedding nor separate sleeping resulted in parents obtaining more sleep). Ball suggests that this might result in co-bedded infants remaining in the parents’ room for longer. Room-sharing (with a parent), which is practised more often when babies are co-bedded, reduces the risk of SIDS. It is worth thinking about how to arrange furniture in the bedroom to enable room-sharing at least for six months from birth. Co-bedding may be one useful option.

In the US, the National Association of Neonatal Nurses’ position concerning co-bedding of twins and higher order multiples neither recommends nor warns against the practice, with the organisation emphasising the lack of sufficient body of knowledge. The American Academy of Pediatrics (AAP) recommends avoiding co-bedding twins, justifying this advice with exactly the same argument – the lack of data on the benefits of this practice. However, AAP does not concentrate on healthy, full-term babies, and seems to overlook the outcomes of the research conducted by Ball. NHS Choices (UK), on the other hand, advises that “You may put your twins to sleep in a single cot while they’re small enough, either because they slept together in hospital or because space is tight. This is called co-bedding and is perfectly safe. In fact, putting twins in the same cot can help them regulate their body temperatures and sleep cycles, and can soothe them and their twin.”