There are 48 in total (8 of them secret) and an additional Platinum Trophy on the PS3 version when all others are awarded. In Dead Space (mobile), the song can be heard during the beginning cutscene if one listens closely.These are all of the achievements (Xbox 360) and trophies (PS3) that can be earned from Dead Space. It can best be heard by standing on or near the elevator platform. It also appears on the Bridge of the USG Ishimura, in the room with the escape pods outside the Captain's Nest two voices can be heard faintly singing it. In the first chapter of Dead Space 2, the ghostly hallucination of Nicole Brennan sings the song quietly while Isaac is in an elevator, before ending by shouting ' MAKE US WHOLE!'.

In Dead Space 2, a print of Isaac's medical examination mentions his repetition of the phrase 'Twinkle twinkle little star'. Kuttner himself can be heard singing along when he hallucinates being with her when he dies after she tricks him into sucking himself (alongside several Marines) into space. In Aftermath, the melody is played often when Nickolas Kuttner's deceased daughter, Vivian Kuttner, is seen, and she can be heard singing along to it. He at first thinks Lexine Murdoch is singing the song, and it is assumed that Nathan is experiencing a hallucination. In Extraction, the song can be heard near the end of the game, while Nathan McNeill is climbing through the vents. In Downfall, after Alissa Vincent's death, the song is heard as her lifeless body floats into the darkness of space.

In Dead Space (2023), the song once again plays during an elevator ride in Chapter 6 as well as in a loop in the Crew Lounge in Chapter 10, although the latter instance now has it being sung by a noticeably deeper female voice. The song can be fully heard at the beginning of Chapter 10 while Isaac investigates the Crew's Quarters Lounge, where the song will be in a loop.

Next time is in Chapter 6 while Isaac Clarke rides the elevator up to the West Grow Chamber. In the original Dead Space, the song can first be heard if the game is not started immediately after game boot-up when the Lullaby trailer starts playing. The song first appeared in the 'Lullaby' trailer for the original Dead Space.

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