The answer to this question is unique to each child. The supine position (lying on our back) is often the easiest way to achieve a supported, symmetrical position.

However, not everyone will tolerate the supine position due to other health issues such as reflux or risk of aspiration. A big change to a habitual posture can also easily cause sleep disturbance – we cannot assume that supine lying is a position that the child will find comfortable or sleep inducing straight away (again, think about the postures you find comfortable when going to sleep).

If this is the case, we recommend choosing a time of day when there is a higher level of supervision to spend times in a more symmetrical position, and gradually build up introducing the system and its supports over time.

A multi-disciplinary approach with advice and involvement from multiple healthcare professionals such as the child’s physiotherapist/occupational therapist/speech and language therapist/paediatrician etc, can help with achieving optimal positioning and sleep.

Most children will eventually sleep all night in a supported sleeping system. However, it may take several months to acclimatise them to their new sleeping position and get the best of it. Some users may only tolerate the system for a few hours at a time, but it's important to remember that two hours per night is equal to 730 hours of night time postural management.

There are no strict guidelines on the type of mattress required for a supported sleeping system. Sometimes, the system itself incorporates its own mattress.

However, we recommend a mattress that is of good quality, and meets the appropriate standards.

It is difficult to provide a definitive answer to this, as the answer will be unique to each user. The Helping Hand company who manufacture the Symmetrisleep recommend that around five years would be a good lifespan for the fabric components.

Recent studies have showed that both dynamic pressure mattresses and turning beds can be used in conjunction with some supported sleeping systems.

When combining your supported sleep system with a dynamic pressure mattress, it is important to make frequent inspections of the skin to ensure that there is no skin breakdown. We advise speaking to the child’s medical team to determine the appropriate sleep system and appropriate mattress.

Technically some sleep positioning systems can be used from birth due to their sizing. The earlier in a child’s life a sleep system is applied, the better chance of establishing healthier postures, good sleep routines for both child and carers and better outcomes overall.

However, application of these systems in children under the age of 2 needs careful consideration. It is especially important that is guided by your child’s healthcare professionals. The risk of Sudden Infant Death Syndrome (SIDS) needs to be taken into account, especially in babies under 6 months of age. Impairments associated with neurodisability, such as reflux, increased choking risk and breathing difficulties, also need careful consideration on how to minimise their risks when positioning a child in a sleep system. Due to these risks, some international clinical guidelines do not recommend sleep systems for children with Cerebral Palsy under the age of 2, whereas other guidelines advise they can be appropriate if clinical presentation, assessment and clear clinical reasoning demonstrate a clinical need.

Again, it is important to remember that sleep systems do not need to be used exclusively at night. They can be used for short periods during the day when more careful monitoring of the child can place.