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Mustard Seed Pillow for Prevention of Deformational Plagiocephaly in ≤ 32 Weeks' Gestational Age Infants: An Open
Christina Felcy Saji1, Hima B John2, Reethajanetsureka Stephen1
1Department of Occupational Therapy, Christian Medical College, Vellore, Tamil Nadu, India.
Insights
Mustard seed pillows effectively prevent deformational plagiocephaly in hospitalized preterm infants. This simple intervention significantly reduced plagiocephaly measurements compared to standard care alone.
Area of Science:
- Neonatal care
- Pediatric neurology
- Medical device innovation
Background:
- Deformational plagiocephaly (DP) is a common condition in preterm infants.
- Positional molding can lead to DP, requiring effective preventive strategies.
- Current interventions may have limitations in accessibility or cost-effectiveness.
Purpose of the Study:
- To evaluate the efficacy of mustard seed filled pillows in preventing DP in premature infants.
- To compare outcomes between infants using mustard pillows and those receiving standard nesting.
Main Methods:
- A prospective, open-label, randomized trial was conducted in South India.
- Preterm infants (≤32 weeks, <1500 g) in the NICU were randomized into intervention (mustard pillow) and control (nesting only) groups.
- Plagiocephaly was assessed using Cranial Index, Cranial Vault Asymmetry Index, and Argenta classification at 1 and 4 weeks postnatal age.
Main Results:
- The intervention group showed significantly lower Cranial Vault Asymmetry Index scores at 4 weeks (3.16 vs. 7.85).
- A higher incidence of plagiocephaly was observed in the control group based on Argenta classification.
- No significant difference was found in Cranial Index scores between the groups.
Conclusions:
- Mustard seed pillows serve as an accessible and cost-effective method for preventing plagiocephaly in hospitalized preterm infants.
- This intervention demonstrates potential for widespread adoption in neonatal intensive care units.
- Further research could explore long-term outcomes and optimal usage protocols.
Objectives:
To assess the effectiveness of using mustard seed filled pillows in preventing deformational plagiocephaly (DP) in premature infants.
Methods:
A prospective open label randomized trial was conducted in a tertiary care hospital in South India. Eligible preterm infants born at ≤32 weeks and <1500 g admitted in the neonatal intensive care unit (NICU) were randomly allocated to the intervention and control groups. In addition to standard nesting, the intervention group was positioned using a mustard pillow, while the control group was positioned using nesting alone. Plagiocephaly was assessed using the Cranial Index (CI), Cranial Vault Asymmetry Index (CVAI) and Argenta classification within the first week and at 4 weeks postnatal age.
Results:
Twenty-eight infants, each in the control and intervention groups, were included for analysis. At 4 weeks postnatal age, the intervention group had lower mean (SD) CVAI scores when compared to the control group [3.16 (1.89 vs 7.85 (2.63)] with adjusted odds ratio, aOR (95% CI) of 28.2 (3.8, 210.01), P < 0.01. More number of infants in the control group had plagiocephaly measured using Argenta classification [aOR (95% CI) 25.70 (2.80, 235.67), P < 0.01]. There were no differences in the Cranial Index scores in the intervention and control groups [aOR (95% CI) 0.41 (0.11, 1.52), P = 0.184].
Conclusion:
A mustard seed pillow is an easily available and a cost-effective intervention for preventing plagiocephaly in hospitalized preterm infants.
