Related Experiment Video
Updated: Aug 2, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Relationship between infant sleep position and motor development in preterm infants
K Ratliff-Schaub1, C E Hunt, D Crowell
1National Center on Sleep Disorders Research, National Heart, Lung, and Blood Institute, Two Rockledge Centre, Bethesda, MD 20892-7920, USA.
Insights
Premature infants sleeping on their backs (supine) showed delayed head control development. However, this sleep position did not impact overall psychomotor or mental development indices.
Area of Science:
- Neonatal development
- Pediatric motor control
Background:
- The "Back to Sleep" campaign has reduced Sudden Infant Death Syndrome (SIDS) risk.
- Understanding the impact of sleep position on premature infant motor development is crucial.
Purpose of the Study:
- To investigate the relationship between infant sleep position and motor development in premature infants.
- To assess if different sleep positions affect head control and overall development.
Main Methods:
- Evaluated 213 premature infants (<1750 g birth weight) from the Collaborative Home Infant Monitoring Evaluation (CHIME) study.
- Assessed sleep position at 56 weeks postconceptional age (PCA) via maternal report.
- Administered the Bayley Scales of Infant Development 2nd Edition (BSID-II) at 56 and 92 weeks PCA.
Main Results:
- Infants sleeping supine were less likely to achieve head elevation milestones (45 and 90 degrees) compared to prone sleepers.
- No significant differences were found in Psychomotor or Mental Development Indices at 56 and 92 weeks PCA based on sleep position.
- Supine sleeping was associated with reduced ability to lift and control the head during prone activity.
Conclusions:
- While supine sleep is vital for SIDS prevention, it may be linked to temporary delays in head control acquisition in premature infants.
- Compensatory awake activities may be necessary to promote head control development in infants sleeping supine.
- Global developmental outcomes remain unaffected by sleep position in this cohort.
Abstract:
To determine whether motor development in premature infants varies according to sleep position, we evaluated 213 infants <1750 g birth weight enrolled in the Collaborative Home Infant Monitoring Evaluation (CHIME). At 56 weeks postconceptional age (PCA), sleep position was determined by maternal report, and the Bayley Scales of Infant Development 2nd Edition (BSID-II) were performed. Infants who slept supine were less likely than infants who slept prone to receive credit for maintaining the head elevated to 45 degrees (p = .021), and infants who slept nonprone were less likely than prone sleepers to receive credit for maintaining the head elevated to 90 degrees and lowering with control (p = .001). The Psychomotor and Mental Development Indices at 56 and 92 weeks PCA were not altered by usual sleep position at 56 weeks PCA. In summary, infants sleeping supine are less able to lift the head and lower with control at 56 weeks PCA, but global developmental status was unaffected. Supine sleeping has been associated with decreased risk for sudden infant death syndrome, but compensatory strategies while awake may be needed to avoid delayed acquisition of head control.
Related Concept Videos
01:11Anatomical Positions
The body is upright, facing forward, and standing erect.
The feet are parallel and flat on the floor.
The arms are hanging by the...
01:14Piaget's Stage 1 of Cognitive Development
Exploration...
01:21The Nativist Approach