Does your NICU practice Co-bedding? Do you have a specific policy or guideline regarding your practice? If you can not share your guildlines, would you include a person I could contact? (you could notify my private email if you wish).
We have done Co-bedding for a number of years in an open crib....but lately hae tried in an isolette also (something in which I have issues). If your NICU does do co-bedding, do you do this in the isolettes also?
We co-bed all the time, in fact it is assumed that all twins/multiples will co-bed as long as they meet criterion (no active infection, most O2 support needed nasal cannula, IV's ok). We co-isolette sometimes but it's really hard to keep both the babies thermoregulated, generally one baby is always hot. I don't care for the co-isolette thing due to that and because it's just too crowded even in our larger isolettes.
What I was going to comment on though was that we've never had a problem with infections transmitting between twins, even in the isolettes. I would assume this is because we wait to put them together until they are stable and bigger. They generally benefit each other when open cribbed because they keep each other warm even when one twin is technically too small to come out of an isolette. I even had one twin come down with very bad NEC while "co-isoletted" and the other twin never got sick with it. This even though some of the theories say the unaffected twin is more likely to catch it even if not in close contact. We always separate the multiples at any sign of infection or if one needs increased resp support.
Now I know that's all anecdotal, however I haven't seen the studies so it's all I have to base my opinions on. I would love to see any studies on this subject as I desire to promote evidence based practice where I work.
We have never had a problem with infection either. The kids are usually about 1400-1500g when they are ready to be out of the box, so their chances of getting sick are less. Our ID is fine with it, but it did take some convincing of them and our head doc.
TiffyRN, BSN, PhD
2,316 Posts
We co-bed all the time, in fact it is assumed that all twins/multiples will co-bed as long as they meet criterion (no active infection, most O2 support needed nasal cannula, IV's ok). We co-isolette sometimes but it's really hard to keep both the babies thermoregulated, generally one baby is always hot. I don't care for the co-isolette thing due to that and because it's just too crowded even in our larger isolettes.
What I was going to comment on though was that we've never had a problem with infections transmitting between twins, even in the isolettes. I would assume this is because we wait to put them together until they are stable and bigger. They generally benefit each other when open cribbed because they keep each other warm even when one twin is technically too small to come out of an isolette. I even had one twin come down with very bad NEC while "co-isoletted" and the other twin never got sick with it. This even though some of the theories say the unaffected twin is more likely to catch it even if not in close contact. We always separate the multiples at any sign of infection or if one needs increased resp support.
Now I know that's all anecdotal, however I haven't seen the studies so it's all I have to base my opinions on. I would love to see any studies on this subject as I desire to promote evidence based practice where I work.