Parent experiences and perceptions of twin cobedding in the NICU and home - A qualitative descriptive study

Aims and objectives: To explore parents of twins’ perceptions of, and experience with, twin cobedding across Neonatal Intensive Care Units and home settings in Australia. Background: Twin cobedding has been used by many parents over the decades however, practices vary globally as research surrounding benefit and risk has not been definitive enough to inform guidelines. There is a significant gap in the literature exploring what is involved in parental preferences, experiences, and decisions related to twin cobedding. Design: A qualitative descriptive design, using reflexive thematic analysis. Methods: Data were collected through ten individual, semi-structured interviews with parents of twins who had been admitted to a Neonatal Intensive Care Unit (NICU) and discharged home. This paper is reported following the COREQ guidelines and checklist. Results: Four themes were identified which spanned the experience of pregnancy, premature birth, NICU admission, and home. ‘Bonding’ focused on parents’ perceptions of the importance of the twin bond and the use of twin cobedding to facilitate it; ‘Influence’ explored how information, the internet, and community influenced twin cobedding perceptions and decisions; ‘Impact’ of the NICU/SCN and separation on cobedding decisions and experiences; and ‘Coping’ focused on how the twin workload on decisions regarding sleeping arrangements. Conclusions: This study identifies that decisions made by twin families to separate or cobed their twins, go beyond simply following guidelines, or even role-modelling hospital practices. The decision is multi-factorial, yet ultimately centers around facilitating a bond, the relationship between their twins, and which method best supports their twins’ sleep/feed routine. Implications for the profession and/or patient care: Families of multiples would benefit from improved guidance and advice whilst in hospital that considers their unique needs. It is important for healthcare workers to consider the decisions twin parents make surrounding sleeping arrangements within the context of coping with the twin workload. Patient or public contribution: No patient or public contribution.