Co-bedding Versus Traditional Bedding of Multiple-Gestation Infants in the NICU

Abstract

This study was part of a large departmental performance improvement initiative to implement and evaluate developmental and family-centered care as "best practice" in the neonatal intensive care unit (NICU). The goal was to evaluate the safety, effect on infant clinical and developmental outcomes, and maternal satisfaction of co-bedding of multiple-gestation infants compared to traditionally bedded infants/mothers. A secondary purpose was to evaluate co-bedding and American Academy of Pediatrics-recommended "back to sleep" behaviors in the same infants/mothers after discharge. A retrospective, comparative, descriptive design was used. Chart reviews and mailed written surveys were used to collect study data. Findings showed no significant differences in demographic variables or clinical and developmental outcomes between the total traditionally bedded and co-bedded groups. All mothers reported positive experiences with the NICU. Co-bedding may promote maternal bonding and has no negative clinical or developmental outcomes. Once policies and education are in place, parents should be offered the option to co-bed multiple-gestation infants in the NICU. There is a performance improvement opportunity regarding the education provided to parents of multiple-gestation infants before discharge on the "back to sleep" recommendations.

Cobedding Twins and Higher-Order Multiples in a Hospital Setting

“…37,38,40,41 In addition, 2 analytic studies concluded that although they found statistically significant differences between cobedded and separately bedded multiples, the findings were either "not clinically significant" or likely to be "spurious." 36,43 However, these studies were limited by their small sample size and lack of long-term follow-up.…”

“…Of the 5 analytic studies that examined differences in weight gain and growth between cobedded and separately bedded multiples, 36,37,40,41,43,44 2 experimental studies suggested that cobedded multiples may gain weight more readily than separately bedded multiples. 36,44 Researchers who performed a small prospective, randomized study that compared 16 cobedded and 21 separately bedded infants found that cobedded infants had a higher 5-day average daily weight gain.…”

“…37,[41][42][43] Only 1 of these studies, a large retrospective study, found a significant difference in clinical outcomes between 94 cobedded and 112 separately bedded preterm twins of 23 to 35 weeks' gestation. 42 Cobedded twins had fewer positive blood-culture results during their hospitalization than separately bedded twins (3 [3.2%] vs 5 [4.5%]; P ϭ .043).…”

Communicating with parents in neonatal intensive care units: The impact on parental stress

“…Baylis et al, for instance, express that current routines in the NICU may foster parental role alteration by moderating an early contact between parents and their child [70]. Several authors indicate that enabling early skinto-skin care for parents [71,72] and the provision of rooming-in [74] or co-bedding [75] contribute to parental role alteration. However, in line with other studies, our findings suggest that routines are not consistent from NICU to NICU [37,73].…”

Cobedding and Recovery Time After Heel Lance in Preterm Twins: Results of a Randomized Trial

“…Given that the practice of cobedding simulates numerous aspects of environmental and maternal context (proximity, tactile, olfactory, auditory, and memory) that have been shown to provide comfort to newborns, 8,9,[11][12][13][14][15][16][17][18][19] it was reasonable to propose that contact with or the presence of a twin who has shared the same uterine space since conception would have a similar comforting effect. Therefore, we conducted a randomized controlled intervention trial to determine the efficacy of cobedding preterm twins during a tissue breaking procedure (heel lance) in the NICU.…”