Effect of cobedding twins on coregulation, infant state, and twin safety

To evaluate the efficacy of cobedding on twin coregulation and twin safety.

Randomized controlled trial (RCT).

Two university affiliated Level III neonatal intensive care units (NICUs).

One hundred and seventeen sets (N = 234) of stable preterm twins (<37 weeks gestational age at birth) admitted to the NICU.

Sets of twins were randomly assigned to be cared for in a single cot (cobedded) or in separate cots (standard care). State response was obtained from videotaped and physiologic data measured and recorded for three, 3-hour sessions over a one-week study period. Tapes were coded for infant state by an assessor blind to the purpose of the study.

Twins who were cobedded spent more time in the same state (p < .01), less time in opposite states (p < .01), were more often in quiet sleep (p < .01) and cried less (p < .01) than twins who were cared for in separate cots. There was no difference in physiological parameters between groups (p = .85). There was no difference in patient safety between groups (incidence of sepsis, p = .95), incidence of caregiver error (p = .31), and incidence of apnea (p = .70).

Cobedding promotes self-regulation and sleep and decreases crying without apparent increased risk.