Member May 2026: Positioning of Preterm Infants: Evidence Based Strategies for Neurodevelopmental Protection and Prevention of Musculoskeletal Deformities (On-Demand)-Session Recording

Video Transcription

Video Summary

This Pediatric Rehabilitation Community session focused on positioning preterm infants in the NICU to support neurodevelopment and prevent musculoskeletal deformities. The speakers reviewed neonatal bone, joint, and muscle development, explaining how fetal movement and intrauterine loading are crucial for healthy growth. Preterm infants, especially those born very early, have limited ability to flex against gravity and are at risk for “pro-gravity” postures such as neck hyperextension, frog-leg positioning, and foot eversion, which can contribute to plagiocephaly, asymmetry, delayed milestones, and feeding difficulties.<br /><br />The talk summarized evidence showing that supportive positioning devices—such as boundaries, nests, and structured supports—can reduce abnormal postures, improve midline movement, sleep, pain, respiration, and feeding responses. The presenters described their NICU’s process for replacing inconsistent cloth rolls with standardized positioners and noted that therapy and nursing buy-in were essential for implementation.<br /><br />They are also launching a clinical trial comparing head/shoulder positioners to determine which best prevents head shape deformities. The session highlighted pediatric physiatry’s role in guiding NICU positioning protocols and research.

Keywords

preterm infants

NICU positioning

neurodevelopment

musculoskeletal deformities

supportive positioners

plagiocephaly

pediatric rehabilitation

neonatal development

clinical trial