Co-Bedding

  1. 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?

    Thanks for your responce!
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  2. Visit kitty29 profile page

    About kitty29

    Joined: Sep '03; Posts: 1,658; Likes: 117
    RN; from AZ , US

    14 Comments

  3. by   prmenrs
    There are some discussions about this topic. Try "searching"--see tabs above forums.
  4. by   kitty29
    Quote from prmenrs
    There are some discussions about this topic. Try "searching"--see tabs above forums.
    I did go back and what has already been posted does not completely answer my questions...I would appreciate any new replies/information anyone might want to contribute. Thank you!
  5. by   Mimi2RN
    We do co-bed twins in isolettes. Sometimes this is for a few hours at a time, keeping an isolette available for both babies. We also have isolettes made for two, with doors on both sides. They are a bit wider than a regular one. Usually we only keep stable growing premies together.

    When we had a set of quads, we sometimes tucked two of them in together for a few hours. They were going home to share cribs, anyway.

    Sometimes the babes love to snuggle together, sometimes they want to fight! It can get messy when one spits up.

    We don't have a specific policy covering this.
  6. by   prmenrs
  7. by   kitty29
    Quote from Mimi2RN
    We do co-bed twins in isolettes. Sometimes this is for a few hours at a time, keeping an isolette available for both babies. We also have isolettes made for two, with doors on both sides. They are a bit wider than a regular one. Usually we only keep stable growing premies together.

    When we had a set of quads, we sometimes tucked two of them in together for a few hours. They were going home to share cribs, anyway.

    Sometimes the babes love to snuggle together, sometimes they want to fight! It can get messy when one spits up.

    We don't have a specific policy covering this.
    Thanks for your reply. It sounds like you do not keep the babe's in the same iso 24/7. We do have the isolettes you speak of, and I still thought it was too crowded to position them correctly. Do you use the heat probes, or use air temp control?

    The issue I had was one was having a & b episodes with desats requirering 02 intervention...so basically both baby's were recieving the 02 (since in an isolette), the one shouldn't have been getting any 02.

    I also had a problem when one had emsis...one was frequently doing so, not tolerating feedings yet. So she would barf in the other's face...and it was busy not easy to get help to change the beds. But the 02 thing was my biggest concern.
  8. by   kitty29

    Thanks, as I said above I did see that information...although it was over 3 years ago and not as specific as I'd like...and no name as to who to contact for further questions.
  9. by   BittyBabyGrower
    The only time we co-bed in isolettes is when our census is so high we need bedspaces. And they have to be close to being put in a crib. We have the ones that can hold two, but IMHO, it is still crowded...can't do something to one and not wake the other. And then if one gets sick, we have to scramble around for a bed and spot for the other one.
  10. by   nekhismom
    nope, we don't cobed at all. ever.
  11. by   sparkyRN
    Never have. Never will.
  12. by   KRVRN
    We never have and never will cobed. Our infection control nurse and ID doc will never allow it. The benefits aren't convincing enough to warrant the infection risk. (they don't take into account the "cute" factor do they?!)
  13. by   Mimi2RN
    Quote from KRVRN
    We never have and never will cobed. Our infection control nurse and ID doc will never allow it. The benefits aren't convincing enough to warrant the infection risk. (they don't take into account the "cute" factor do they?!)

    I realise that all it takes is one occurence, but has anyone working in a hospital that does co-bed have any problems with infection?

    I don't remember ever having any problems in our nursery. We don't let the fragile little ones socialize, they have to be stable and just growing premies.

    :zzzzz :zzzzz
  14. by   TiffyRN
    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.

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