In most cases, infants are placed to sleep in standard cots four-sided, standalone, bassinettes.
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This allows mother-infant dyads easier access to each other, whilst still providing separate surfaces for sleep. In recent years researchers have evaluated the benefits of using side-car cribs on postnatal wards, however similar research is yet to be done to investigate the use of similar cribs in the home environment. Breastfeeding Several research studies have investigated the impact of infant sleep location on the postnatal ward standard cot versus side-car crib on breastfeeding outcomes.
To date, research has found that following an unassisted, unmedicated vaginal delivery, infants assigned a side-car crib breastfed significantly more frequently whilst on the postnatal ward, and breastfed for longer after leaving hospital, compared to infants who were assigned a standard cot Ball et al. These results have not, however, been replicated following deliveries where mothers received opioid labour analgesia or obstetric intervention i.
This is supported by Tully et al.
Infant safety No studies have found any evidence that side-car cots pose any risk to babies. The observed risks associated with the standard cot after caesarean section delivery included mothers lifting the infant without supporting their head, tipping the cot whist attempting to place the infant within it, dropping the infant into the cot and prone infant sleep.
A recent American Academy of Pediatrics report on Safe Sleep and Skin to Skin Contact in the Neonatal Period highlighted the potential of side-car cribs for enhancing infant safety on the partnatal unit Feldman-Winter et al Thompson and Moon investigated the dangers and injuries obtained by infants using at-home co-sleepers.
Staff contact In two studies, demands on staff time have been assessed according to cot type. In the first Ball et al. There was no difference in the duration of visits to mothers made by staff. In contrast, caesarean section mothers Tully and Ball stated that they felt the side-car crib minimised calls to postnatal ward staff.
Tully and Ball reported that staff spent significantly less time with mother-infant dyads allocated a side-car crib compared to the standard cot. Maternal perceptions Regardless of mode of delivery, mothers have expressed an overwhelming enthusiasm and preference for side-car cribs whilst on the postnatal ward Tully and Ball ; Tully et al.
Mothers stated that side-car cribs, unlike standard cots, permitted visual and physical access to their infants; enabled emotional closeness; facilitated breastfeeding; allowed them to settle their infant quickly; and minimised calls to postnatal ward staff.
Following a caesarean section, mothers commented unfavourably about standard cots compared to side-car crib use Tully and Ball ; Tully et al. Furthermore, side-car cribs can play an important role in promoting mother-infant contact and successful breastfeeding initiation amongst these dyads Tully et al. This is significant, as this method of non-labour induced delivery tends to result in lower rates of breastfeeding overall due to inhibited lactation and physical pain.
Similar findings were reported following an audit of different cot-types trialled on Belgian postnatal wards which led to some hospitals adopting a practice of exclusively using side-car cribs on the post-natal ward wooden variety, see picture below right, which are different in design to those commonly used in UK. Martine van Haver, Midwife, Lueven, pers comm
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