Twin Sleep in the Early Weeks

Why safer sleep advice carries more weight with twins

Twins Trust explains the reason without dressing it up: safer sleep guidance exists to reduce the risk of sudden infant death syndrome, SIDS is very rare, but "babies who are born prematurely or have a low birth weight are at higher risk. This means many twins, triplets or more fall into a higher risk category, so following simple steps for every sleep really matters."

That is the twin-specific point on this page. Everything else is standard safer sleep advice, and the NHS and the Lullaby Trust both set out the core version: back to sleep for every sleep, a clear, firm, flat sleep space, room-sharing with an adult for around the first six months, and a smoke-free environment.

Can twins share a cot?

Yes, in the early months, with conditions. The Lullaby Trust describes co-bedding as siblings sharing the same sleep space, and says you might co-bed in the early weeks and months or prefer separate Moses baskets or cots from birth. Whichever you choose, it says to follow the safer sleep advice "for each baby, for every sleep".

The positioning is specific. The Lullaby Trust says that if you choose to co-bed, "your babies should be placed on their backs with the tops of their heads facing one another, with their feet at opposite ends of the cot. Or side-by-side on their backs, with their feet at the foot (bottom) of the cot."

Twins Trust adds the size requirement and explains it. Co-bedding is safest in a full-sized cot, and the shared space must be large enough for each baby to have their own area with room around them — not only for comfort, but because it "helps air to circulate around their faces and bodies and reduces the chance of overheating". Bedding should be tucked in no higher than shoulder height and kept well away from their faces.

What is too small to share

Twins Trust is explicit: a single Moses basket, a single next-to-me style crib or a pram bassinette "aren't recommended for more than one baby". There is less room to move, less airflow, and a greater risk of overheating or of a baby covering their face. This is the rule that most often collides with a small bedroom, and it is not one to bend.

When to give them separate spaces

The trigger is rolling. The Lullaby Trust says that once your babies can roll and move about the cot, they will need separate sleep spaces, "because there is a risk they could roll into each other, which means they could accidentally block each others' airways, or risk overheating". Twins Trust gives the same rule and suggests placing the two cots close together if you have space, so the babies can still sense each other while each has their own safe space.

Planning for this in advance is sensible, because it usually arrives before parents expect it, and because a second cot is an expense worth anticipating rather than discovering.

Room-sharing when there is no room

The six-month room-sharing recommendation is harder with two, and Twins Trust addresses the practicalities head on. It suggests rearranging furniture or moving non-essential items out of your bedroom for a while, and using travel cots, smaller cribs or compact cots for daytime naps until around six months, with a mix of these upstairs and downstairs.

Where a downstairs sleep space genuinely is not possible, its advice is to leave doors open and check your babies regularly, and it adds a caution about monitors: a baby monitor "may give some peace of mind, but it shouldn't replace your presence in the room whilst they're napping."

It also offers a solution people rarely think of: taking it in turns with a partner to sleep in the nursery with the babies, rather than trying to fit two cots into one bedroom.

Co-sleeping in an adult bed: the twin rules are different

This is where twin guidance diverges most sharply from general advice, and it is worth reading carefully.

Twins Trust says that if you choose to share your bed with a baby, "only ever share the bed with one baby at a time". It then adds a restriction that applies to a great many twins: "Never co-sleep if your baby was born before 37 weeks or weighed under 2.5 kilograms at birth. For these babies, the safest place to sleep is in their own cot or crib right next to your bed."

Given that NICE says about 60 in 100 twin pregnancies end in spontaneous birth before 37 weeks, and that UK guidance plans birth at 37 weeks or earlier for uncomplicated twins, that rule will apply to most twins. It is the single most important sentence on this page.

Both Twins Trust and the Lullaby Trust also repeat the absolute rule that applies to every baby: it is never safe to sleep with your babies on a sofa or armchair, and even a brief doze in that position greatly increases the risk.

Temperature, and the clear cot

Twins Trust suggests a comfortable room temperature of around 16 to 20 degrees, and says to avoid placing cots right next to a window or radiator — or, if that is unavoidable, to keep the window closed or the radiator off. It adds a detail that catches people out: when you come in from somewhere colder, unwrap your babies and take off their hats so they do not overheat.

The sleep space itself should be clear. Twins Trust lists a firm, flat, waterproof mattress in good condition that fits the cot, and a space free of pillows, cot bumpers, nests, toys and loose bedding. Sleeping bags, or blankets tucked in well to the foot and sides, are the alternative to loose covers.

One more twin-specific warning. Twins Trust says not to use rolled up towels or blankets to prop babies up, and explains why parents try: you may have seen it in neonatal care. In hospital your babies were under constant monitoring. At home, standard safe sleep advice applies unless a healthcare professional has told you otherwise.

If you use a next-to-me crib

Twins Trust sets out the specific checks: the crib must be big enough for each baby to have their own space with airflow around their faces, it must be securely attached to your bed so there is no gap a baby could slip into, the mattress must be the firm one designed for that crib, and the babies must be separated into their own spaces once one starts rolling.

Do twins wake each other?

Less than people fear. Twins Trust says research suggests that sharing a large cot does not always make babies wake more often and may help them settle into similar sleep patterns, and that many multiples who co-bed do not disturb each other — while adding, correctly, that every baby is different.

When you are unsure, Twins Trust's own summary is the right thing to come back to: back to sleep, a clear, flat, firm sleep space, the same room as you, smoke-free, and not too hot.