Damato Elizabeth G, Haas Madeline C, Czeck Pamela, Dowling Donna A, Barsman Sarah Gutin
Case Western Reserve University, Cleveland, Ohio (Drs Damato and Dowling and Mss Haas and Barsman); and University Hospitals Case Medical Center, Southwest General Hospital, Middleburg Heights, Ohio (Ms Czeck).
Adv Neonatal Care. 2016 Dec;16(6):E3-E14. doi: 10.1097/ANC.0000000000000332.
The high prevalence of prematurity and low birth-weight places twin infants at increased risk for sudden unexpected infant death (SUID) and/or sudden infant death syndrome (SIDS). Risk for these SUID and SIDS is affected by a combination of nonmodifiable intrinsic risk factors and modifiable extrinsic stressors including infant care practices related to sleep. Although adherence to the full scope of American Academy of Pediatrics (AAP) 2011 recommendations is intended to decrease risk, these recommendations are aimed at singleton infants and may require tailoring for families with multiple infants.
The study describes infant care practices reported by mothers of twins in the first 6 months postpartum.
Mothers caring for twin infants (N = 35) were surveyed online both longitudinally (at 2, 8, 16, and 24 weeks after infant hospital discharge) and cross-sectionally. AAP recommendations (2011) guided survey content.
The degree of adherence to AAP recommendations varied over time. For example, mothers of twins reported 100% adherence to placing twins supine for sleep initially, but many reported putting babies on their stomachs for naps as twins became older. Sharing a parent's bedroom decreased over time as did frequency of crib sharing. Fewer than half of mothers offered a pacifier most or all of the time for sleep.
Opportunities exist for development of an educational program geared specifically for postpartum parents of twins.
Barriers affecting adherence to AAP recommendations and effectiveness of educational programs addressing needs of this unique population need further exploration.
早产和低出生体重的高发生率使双胞胎婴儿面临意外婴儿猝死（SUID）和/或婴儿猝死综合征（SIDS）的风险增加。这些SUID和SIDS的风险受到不可改变的内在风险因素和可改变的外在压力源的综合影响，包括与睡眠相关的婴儿护理习惯。尽管遵循美国儿科学会（AAP）2011年的全部建议旨在降低风险，但这些建议是针对单胎婴儿的，可能需要为多胞胎家庭量身定制。
本研究描述了产后头6个月双胞胎母亲报告的婴儿护理习惯。
对照顾双胞胎婴儿的母亲（N = 35）进行了纵向（婴儿出院后2、8、16和24周）和横断面的在线调查。AAP的建议（2011年）指导了调查内容。
对AAP建议的遵循程度随时间而变化。例如，双胞胎母亲报告最初100%遵循让双胞胎仰卧睡眠，但随着双胞胎长大，许多母亲报告让婴儿趴着小睡。与父母同室睡眠的情况随着时间减少，共用婴儿床的频率也降低了。不到一半的母亲在大多数或所有睡眠时间提供安抚奶嘴。
有机会开发专门针对双胞胎产后父母的教育项目。
影响遵循AAP建议的障碍以及满足这一独特人群需求的教育项目的有效性需要进一步探索。
