Developmental Care
Additional Information
|
Reviewed by Charge Nurse -
Newborn |
| December 2004 |
Sensory Pathway Development
Positioning
- Neuromuscular
immaturity, weak muscle tone and the effects of gravity on
the preterm infant can lead to positioning disorders such as widely
abducted hips (frog-leg position),retracted and abducted shoulders,
increased trunk extension with arching of back and ankle and foot
eversion. 26
- These
complications may lead to difficulties with normal development of
body movement and control in childhood.
- Persistent
or favoured positions can lead to a flattened posture and right head
preference and occipital plagiocephaly (flattened head).
20
- Postural
support should therefore be considered to reduce postural complications
as well as for promoting physiologic / autonomic stability.
- Research
promotes the use of a variety of positions for preterm infants.
- Prone
positioning in some infants may enhance oxygenation and promote
quiet sleep.
- Side-lying
positioning, with the back well supported in a nest, provides
opportunities for limb and trunk flexion and hand to mouth contact.
- The
less favoured position is the supine position that requires
‘nesting’ with close but flexible boundaries around the
infant’s body.
- A
soft blanket rolled into a nest encourages flexion of lower limbs,
brings shoulders forward and offers containment boundaries.
6
Noise Levels
in NICU
The
American Academy of Pediatrics recommends that noise levels not exceed 40-45
dB in NICU. <35 dB is desired for sleep.
Examples
of Recorded Noise Levels in NICU
| Event |
Loudness |
| Telephone
ringing |
80
db |
| Dash
Alarms (set at 70%) |
70
dB at 1 metre distance |
| Closing
incubators doors |
100-135
dB |
| Bubbling
in ventilator circuit |
62-87dB |
| Tapping
incubator with fingers |
80
dB |
| Talking
around the bedside (normal level) |
60
dB |
(
From M. Darin Cass Medical, and Kenner & Lott, 2003 )
Music
Therapy
- The
value of music therapy for the preterm infant is yet to be clearly
determined with research methods and findings contradictory.
- Concern
is voiced around offering sound stimulation without evaluating the
appropriate levels of music or the developmental stage of the preterm
infant receiving the stimulation.
- Also
from a behavioural perspective, where preterm infant states vary,
continuous playing of music therapy may offer stimulation when the
infant requires sleep. 12
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