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Below Professor Helen Ball speaks about the Durham University’s Parent-Infant Sleep Lab's findings about the sleeping habits of multiples. She speaks about the safest way to sleep your multiples and what to expect from multiples' sleep patterns. Login in or register with Tamba for free today to view the full video, which includes information about how to establish sleeping routines for your multiples.
Sleeping babies in separate cots at home isn’t absolutely necessary, at least at first.
Reducing the risk of cot deathMany parents find that sleeping their babies in the same cot (co-bedding) works well, at least for the first few weeks or months. Research has shown that sleeping similar-sized young twins in the same cot does not mean they wake more often; in fact, their sleeping patterns become more similar. Multiples that are used to co-bedding do not disturb one another.‘Co-bedding’
Sadly, some babies die suddenly and unexpectedly during their sleep for no explainable reason. This is called ‘cot death’ or Sudden Infant Death Syndrome (SIDS). Parents of multiples need to be particularly vigilant as multiple birth babies are more likely to be born premature or have a low birth weight and are therefore at a higher risk of SIDS.
Unfortunately we don't know why some babies die of SIDS. However, we do know placing a baby to sleep on their back reduces the risks of cot death, while exposing a baby to cigarette smoke or overheating increases the risk.
All the advice that we now have for reducing the risk of cot death and other dangers, such as suffocation, is listed below. Remember that cot death is rare, so don’t let worrying about it stop you enjoying your babies’ first few months. But do follow the advice below to reduce the risks as much as possible.
The Lullaby Trust gives the following advice to reduce the risk of cot death:
- Keep your babies in the same room as you for the first six months
- Place your babies on their back to sleep, in a cot in a room with you
- Do not smoke in pregnancy or let anyone smoke in the same room as your babies
- Do not share a bed with your babies if you are excessively tired, have been drinking alcohol, taken drugs or if you are a smoker. (Note: Looking after multiples in the early days is hard work, it is highly likely that you will be sleep deprived and therefore you’re likely to be extremely tired. Premature or small babies’ normal defence mechanisms are less well developed and they could therefore be less well equipped to cope with challenges that term babies can cope with (such as having their face covered with bedding) The safest place for your babies to sleep is in a cot in your room).
- Never sleep with your babies on a sofa or armchair
- Do not let your babies get too hot – keep their heads uncovered
- Always unwrap babies and remove hats when you go from a cold to warm place (for example into a shop)
- No pillows or duvets for babies under one year old
- Place your babies in the ‘feet to foot’ position- with their feet at the bottom of the cot or crib so they can't wriggle down under the covers and get their heads covered in bedding
- Make sure the cot is free from toys, pillows and loose bedding
Research conducted by Durham University’s Parent-Infant Sleep Lab found no evidence that putting twins in the same cot in the early months increases their risk. We have put together some suggestions on co-bedding multiples which you may find useful.
- It is not recommended that you co-bed in a Moses basket due to the limited space and the risk of overheating.
- In the early weeks, when your babies can't roll over onto each other, they can be placed side by side on their backs at the bottom of the cot in 'feet to foot' position (see above for explanation of the 'feet to foot' position)
- Another option is to sleep them at either end of the cot on their backs with their heads in the middle
- Follow all the same advice as for single babies - it applies to multiples, whether they are in a cot together or not
- It is particularly important that all the advice on reducing the risk of cot death is followed for babies who are born at a low birth weight (under 2.5kg or 5.5lbs) or were born before 37 weeks (multiples can often fall within this category)
- For triplets or higher order multiples, co-bedding all babies in the same cot while they are still small enough to fit is an efficient use of space. However, there has been no specific research undertaken on sleeping arrangements for triplets and higher multiples. If three or more babies are sleeping together, parents should be mindful of any size discrepancies and take note of whether the smallest one gets crowded by the others if placed between them
- If you choose to co-bed triplets and higher multiples, it is important to ensure that parents keep a very close eye on them, move them when they get more mobile
Top Tip - If your bedroom is not big enough for two cots, you could use a cot bed and co-bed your babies (following the feet to foot advice). Cot beds are bigger than normal cots and you can adapt them to become a toddler bed later on. Of course you still need to be careful that they’re not rolling on top of each other. Think about taking furniture out of your room for a short while to make more space.
How much sleep do babies need?
The average amount of sleep per day for a one month old baby is about 16 hours, but it can range from 8 to 20 hours. If your babies are born prematurely, they will not follow the 'normal' pattern of sleep development according to their birth age. Try to avoid comparing your multiples' sleep patterns as there is a lot of variation in how sleep patterns mature.
One of my multiples sleeps better than the other/s. What should I do?
All babies have different sleep needs. Follow your babies’ cues, if one is sleepier than another then you may find it better to develop different sleep routines for each baby. If you start this from an early age you are less likely to get protests when the children are older.
Coping: you and your partner
Broken sleep makes it harder to carry out tasks and puts a strain on your temper. But there are things you can do about it. Take regular naps when you are tired. They don't have to be long, maybe 15 minutes, but they will make all the difference and mean you are less likely to fall asleep accidentally. Place you babies in a safe place and shut your eyes. Planning to have naps in the day when you know you become sleepy means you are less likely to fall asleep by accident.
Recognise that caring for more than one baby is hard work. If one parent stays at home to look after the babies and the other goes out to work, you are both working. Neither parent should be expected to deal with the nights alone. Share the burden of broken nights as much as possible, or find a relative or ‘night nanny’ who is specifically responsible for sharing the night-time care when adequate sleep is vital for one or both parents to function safely at work.
If you are bottle-feeding, you and your partner could take responsibility for alternate nights. Some couples operate a shift system for the first few weeks or months when there is a lot of getting up in the night. An example of this would be one person sleeping from 7pm till 1am while the other naps when they can but is on hand to attend to the babies; you then swap roles from 1am to 7am. This way both parents get a guaranteed chunk of sleep.
If you are a lone parent, ask a friend or relative if they would stay for a night and attend to the babies so you can get some proper rest.
For mothers who are breastfeeding, you may want to have your babies’ cot next to your bed so you don’t have to get up to feed. If you think you may accidentally fall asleep with your baby (or babies) in bed (and many breastfeeding mothers find they do so) make sure you have thought about how to bed-share as safely as possible.
Tamba’s top 10 tips for good sleep
1. Give your babies the opportunity to sleep. With all the stimulation around them they can find it hard to sleep unless prompted to do so.
2. Develop a routine early on that fits with your family.
3. Differentiate between day and night. At night time keep the lights low to give minimal stimulation if your babies wake. Very young babies need contact with their parents to be able to relax and fall asleep. As they get older parents can encourage babies to get to sleep on their own (self-settling) rather than by rocking or cuddling them to sleep.
4. Try not to rush and pick up your babies if you hear them stir. As babies sleep they go through cycles so will stir and seem to be waking at various times. If left alone, they will learn to get themselves back into a deeper sleep.
5. It is most helpful if one or both of the parents are the primary carers for the babies so the babies become familiar with these one or two people and experience consistency. Other willing volunteers can help with other family members or household duties!
6. Exposing your babies to natural daylight throughout the day will help develop their biological day/night cycle and help to trigger sleep in the evenings.
7. Give your babies’ cues to sleep such as repeating a key phrase such as night, night
8. Take your babies out in the fresh air every day. Research has shown that babies who go out sleep better.
9. Some parents find that once their babies reach six months or so, they will entertain each other when they first wake up.
10. Visit ISIS, (Infant Sleep Info Source) a research based infant sleep website for more information. You can also read Tamba’s free guide Twins, Triplets or More: The First Year for more on how to get your babies sleeping well. The Tamba’s members-only messageboards are a good source of tips, information and parent-to-parent support on sleep and multiple children. You can also find out more information on sleep by reading Dr Helen Ball's research on co-bedding twins.
Follow the links to find out more about managing in hospital, coming home, feeding, concerns and development.
Tamba would like to thank Awards for All Northern Ireland and the James Tudor foundation for providing funding for our sleep video series.