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Neuromotor development and the physiologic effects of positioning in very low birth weight infants
Leanne Monterosso1, Linda Kristjanson, Joan Cole
1School of Nursing and Public Health, Edith Cowan University, Churchlands, Western Australia. l.monterosso@ecu.edu.au
Insights
Positioning very low birth weight infants in the prone position offers physiological benefits but requires careful management to prevent developmental issues. Empirically tested interventions are recommended for optimal neuromotor development.
Area of Science:
- Neonatal Development
- Physiology
- Developmental Pediatrics
Background:
- Neuromotor development in preterm infants is influenced by various factors, including positioning.
- Understanding the physiological effects of different infant positions is crucial for optimizing development.
Purpose of the Study:
- To conduct a comprehensive literature review on neuromotor development and the physiological effects of positioning in very low birth weight infants.
- To identify optimal positioning strategies and interventions for this vulnerable population.
Main Methods:
- Extensive literature search of multiple databases (MEDLINE, CINHAL, etc.) from 1966-2000.
- Inclusion of theoretical writings, research studies, and clinical papers.
- Assessment of studies for scientific rigor, theoretical foundation, and clinical relevance.
Main Results:
- Optimal neuromotor development requires a balance of active and passive muscle tone.
- The prone position is physiologically more advantageous for preterm infants compared to supine or lateral positions.
- Potential for short- and long-term postural and developmental problems exists with the prone position.
Conclusions:
- The use of empirically tested postural interventions is recommended.
- Interventions should be tailored to the infant's gestational age, health status, and organizational capacity.
- Evidence-based positioning practices are essential for supporting healthy neuromotor development in very low birth weight infants.
Objective:
To provide a comprehensive literature review of neuromotor development and related physiologic effects of positioning in very low birth weight infants.
Data Sources:
MEDLINE, CINHAL, Health Star, Current Contents, and the Australian Medical Index (1966-2000) databases were searched. Unpublished studies (e.g., dissertations, conference proceedings) and all relevant references listed in articles also were examined.
Study Selection:
One hundred and eighty theoretical writings, research studies, and clinical papers related to neuromotor development, the physiologic effects of positioning, and interventions to minimize or prevent short- and long-term effects of positioning in very low birth weight infants were reviewed.
Data Extraction:
Studies were assessed for scientific rigor, evidence of theoretical foundation, and clinical relevance. Comparisons were made across data sources to determine the most reliable, valid, and consistent findings.
Data Synthesis:
Three compelling results emerged: (a) The development of posture and mobility in newborn infants requires an optimal balance between active and passive muscle tone, (b) the prone position is physiologically more beneficial for the preterm infant than supine and lateral positions, and (c) the prone position can lead to short- and long-term postural and associated developmental problems.
Conclusion:
Use of empirically tested postural interventions appropriate for an infant's gestational age, health status, and overall organizational capacity is recommended.