Does the type of sleep surface influence infant wellbeing in the NICU?

To evaluate whether different mattress surfaces (standard vinyl-covered foam mattress [SFM] versus viscoelastic polyurethane mattress [VPM]) are associated with differences in nurses' perceptions of infant sleep/restfulness, nurses' assessment of infant pain, parents' perceptions of infant comfort/crying, infant weight, and vital signs among babies with birthweights <1,700 grams or gestational ages <35 weeks in a NICU.

A quasi-experiment was conducted in which a control group of 40 babies admitted to the NICU over a 7-month period were placed on SFMs and an experimental group of 40 babies admitted in the next 7 months were placed on VPMs. Data were collected in 72 hours immediately following infant placement on the mattresses.

There were no differences between groups based on gender, gestational age, and birthweight. Babies in the SFM group were an average of 15 hours older when placed on the mattress and had lower Day 1 acuity. There were no differences between groups on nurses' perceptions of infant sleep/restfulness, nurses' assessment of infant pain, parents' perceptions of comfort/crying, and infant vital signs. Weight loss for babies in the VPM group was more than twice that of infants on the SFM; however, the loss was clinically within normal limits. Vital signs of babies in both groups were largely within normal ranges and perceptions of sleep/restfulness and comfort/crying levels were positive.

Both mattresses seem to be effective for babies in the NICU. More data are needed on the potential relationships between the VPM mattress and neonatal weight loss.