References

Als H Towards a synactive theory of development: promise for the assessment of infant individuality. Infant Mental Health Journal. 1982; 3:(4)229-43

Ammari A, Schulze KF, Ohira-Kist K Effects of body position on thermal, cardiorespiratory and metabolic activity in low birth weight infants. Early Hum Dev. 2009; 85:(8)497-501 https://doi.org/https://doi.org/10.1016/j.earlhumdev.2009.04.005

Blencowe H, Cousens S Addressing the challenge of neonatal mortality. Trop Med Int Health. 2013; 18:(3)303-12

Brazelton TB, Nugent JK The Neonatal Behavioral Assessment Scale.Cambridge: Mac Keith Press; 2011

Bueno EA, Castro AAM, Chiquetti EMS Influence of home environment on the motor development of infants born preterm. Revista de Neurociências. 2014; 22:(1)45-52 https://doi.org/https://doi.org/10.4181/RNC.2014.22.914.8p

Cândia MF, Osaku EF, Leite MA Influence of prone positioning on premature newborn infant stress assessed by means of salivary cortisol measurement: pilot study. Rev Bras Ter Intensiva. 2014; 26:(2)169-75

Procedimento Operacional Padrão. Posicionamento Terapêutico no Paciente Neonatal e Pediátrico.Uberaba: EBSERH; 2015

Gomella TL, Cunningham MD, Eyal FG, Zenk KE Neonatology: Management, Procedures, On-Call Problems, Diseases, and Drugs, 5th edn. New York, NY: Lange Medical Textooks/McGraw-Hill; 2004

Gouna G, Rakza T, Kuissi E, Pennaforte T, Mur S, Storme L Positioning effects on lung function and breathing pattern in premature newborns. J Pediatr. 2013; 162:(6)1133-7 https://doi.org/https://doi.org/10.1016/j.jpeds.2012.11.036

Hough JL, Johnston L, Brauer S, Woodgate P, Schibler A Effect of body position on ventilation distribution in ventilated preterm infants. Pediatr Crit Care Med. 2013; 14:(2)171-7 https://doi.org/https://doi.org/10.1097/PCC.0b013e31826e708a

Positioning of preterm infants for optimal physiological development. Best Practice: evidence-based information sheets for health professionals. 2010; 14:(18)1-4

Liaw JJ, Yang L, Lo C Caregiving and positioning effects on preterm infant states over 24 hours in a neonatal unit in Taiwan. Res Nurs Health. 2012; 35:(2)132-45 https://doi.org/https://doi.org/10.1002/nur.21458

Madlinger-Lewis L, Reynolds L, Zarem C, Crapnell T, Inder T, Pineda R The effects of alternative positioning on preterm infants in the neonatal intensive care unit: A randomized clinical trial. Res Dev Disabil. 2014; 35:(2)490-7 https://doi.org/https://doi.org/10.1016/j.ridd.2013.11.019

Atenção humanizada ao recém-nascido de baixo peso: Método Canguru, 2nd edn. Brasília: Editora do Ministério da Saúde;; 2011a

Atenção à Saúde do recém-nascido: guia para os profissionais de saúde.Brasília: Ministério da Saúde; 2011b

Olmedo MD, Gabas GS, Merey LSF Physical responses of pre-term newborn babies submitted to the Kangaroo-Mother Care method in prone position. Fisioter Pesq. 2012; 19:(2)115-121 https://doi.org/https://doi.org/10.1590/S1809-29502012000200005

Peixe AAF, Carvalho FA, Sarmento GJV Avaliação de fisioterapia respiratória pediátrica e neonatal, 2nd edn. In: Sarmento GJV (ed). Barueri: Manole; 2011

Rodrigues OMPR, Bolsoni-Silva AT Effects of prematurity on infant development. Revista Brasileira de Crescimento e Desenvolvimento Humano. 2011; 21:(1)111-21

Sweeney JK, Gutierrez T Musculoskeletal implications of preterm infant positioning in the NICU. J Perinat Neonatal Nurs. 2002; 16:(1)58-70 https://doi.org/https://doi.org/10.1097/00005237-200206000-00007

Toso BRGO, Viera CS, Valter JM, Delatore S, Barreto GMS Validation of newborn positioning protocol in Intensive Care Unit. Rev Bras Enferm. 2015; 68:(6)1147-53 https://doi.org/https://doi.org/10.1590/0034-7167.2015680621i

Agenda pela infância 2015–2018: desafios e propostas eleições 2014.Brasília: UNICEF; 2014

Vignochi C, Teixeira PP, Nader SS Effects of aquatic physical therapy on pain and sleep and wakefulness of stable preterm newborns admitted to a neonatal intensive care unit. Rev. Bras Fisioter. 2010; 14:(3)214-20 https://doi.org/https://doi.org/10.1590/S1413-35552010000300013

Watt JE, Strongman KT The organization and stability of sleep states in in fullterm, preterm, and small-for-gestational-age infants: a comparative study. Dev Psychobiol. 1985; 18:151-62 https://doi.org/https://doi.org/10.1002/dev.420180207

Born too Soon: The Global Action Report On Preterm Birth.Geneva: WHO; 2012

Xavier SO, Nascimento MAL, Badolati MEM, Paiva MB, Camargo FCM Positioning Strategies of the Premature Newborn: Reflections for Neonatal Nursing Care. Rev Enferm (Lisbon). 2012; 20:(2)814-18

Physiological and behavioural effects of preterm infant positioning in a neonatal intensive care unit

02 October 2017
Volume 25 · Issue 10

Abstract

Aim

To compare the effect of sleeping position on physiological and behvioural responses in preterm infants.

Methods

A quasi-experimental study was conducted in a neonatal intensive care unit in the south of Brazil. The sample was 24 preterm newborns with gestational age ≤32 weeks, who were randomly separated into four groups: right side position, supine position, left side position and prone position. The physiological and behavioral variables were evaluated before, during and after positioning.

Findings

During the intervention, heart rate decreased in right side position, supine position, and prone position. The respiratory rate reduced in all positions and peripheral oxygen saturation remained stable in most positions. Behavioural scores were reduced in supine, left side and prone positions.

Conclusions

Positioning according to a standard operating procedure was able to produce more positive responses in prone and supine position groups during the intervention.

Premature births account for 11.1% of the total number of births worldwide. In Brazil, the percentage is slightly higher, at 11.9% (World Health Organization (WHO), 2012; Blencowe and Cousens, 2013; UNICEF, 2014). As a result of the demands often associated with prematurity, the preterm infant generally requires hospitalisation, in many cases for prolonged periods. In addition, the preterm infant's system and organ immaturity can lead to difficulty in adapting to life in its neuropsychomotor development, which may cause delays and extrauterine alterations in the long term (Ministério da Saúde, 2011a).

According to the synactive theory of newborn behavioural organisation and development (Als, 1982), the adaptation of the preterm infant to the neonatal intensive care unit (NICU) environment varies according to his or her ability to change their behaviour in response to a stimulus; to achieve a well-regulated balance; and to maintain the energy required to sustain life. This theory is divided into five subsystems: physiological, motor, behavioural state, attention, and interaction and regulatory (Ministério da Saúde, 2011a). Neuropsychomotor development is the result of a number of factors inherent to the preterm infant and his or her environment, which influence behaviour (Rodrigues and Bolsoni-Silva, 2011).

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month