Effect of a postural support nappy on 'flattened posture' of the lower extremeties in very preterm infants

To determine whether the use of a postural support nappy (PSN) would reduce the features of 'flattened posture' in the lower extremities of infants < 31 weeks gestation who are nursed prone.

Randomized, observer blind, controlled trial conducted at King Edward Memorial Hospital for Women, Perth, Western Australia. Infants were randomly assigned and stratified by gestational age to be nursed in a conventional nappy (n = 29) or a PSN (n = 31) when in the prone position. The features of 'flattened posture' were measured as angles and assessed by blinded observers prior to commencement of the intervention, 4 weeks post intervention, then bi-weekly until discharge.

A significant reduction in the features of 'flattened posture' occurred in the PSN group after 4-6 weeks of intervention and stabilized by 8 weeks until discharge. No changes were detected in the control group. No significant difference was observed between infants < 29 weeks gestation compared to infants of 29-30 weeks gestation in either treatment group.

Use of the PSN in infants < 31 weeks gestation who are nursed in the prone position significantly reduces the features of 'flattened posture' in the lower extremities. This is of benefit in the short term, and follow up of these infants into childhood will demonstrate whether the long-term effects of 'flattened posture' can be prevented.