title: Safe Sleep Infant Care Practices Reported by Mothers of Twins.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  The study describes infant care practices reported by mothers of twins in the first 6 months postpartum.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Opportunities exist for development of an educational program geared specifically for postpartum parents of twins.
  
  
  CONCLUSIONS
  Barriers affecting adherence to AAP recommendations and effectiveness of educational programs addressing needs of this unique population need further exploration.
authors.affiliation: 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).
authors.forename: Elizabeth G
authors.initials: EG
authors.lastname: Damato
authors.forename: Madeline C
authors.initials: MC
authors.lastname: Haas
authors.forename: Pamela
authors.initials: P
authors.lastname: Czeck
authors.forename: Donna A
authors.initials: DA
authors.lastname: Dowling
authors.forename: Sarah Gutin
authors.initials: SG
authors.lastname: Barsman
mesh_terms: D001512:Bedding and Linens; D001942:Breast Feeding; D003430:Cross-Sectional Studies; D005260:Female; D019983:Guideline Adherence; D015438:Health Behavior; D006801:Humans; D007223:Infant; D007224:Infant Care / Q000706:statistics & numerical data*; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D008895:Milk, Human; D009035:Mothers / Q000706:statistics & numerical data*; D011446:Prospective Studies; D040242:Risk Reduction Behavior; D012890:Sleep; D013398:Sudden Infant Death / Q000517:prevention & control*; D016683:Supine Position; D011795:Surveys and Questionnaires; D013696:Temperature; D014028:Tobacco Smoke Pollution; D014427:Twins
chemical_list: D014028:Tobacco Smoke Pollution