DEVELOPMENTAL CARE IN THE NICU
Tami Van Aswegen - Physiotherapist
31 January 2018
AIM
SUPPORT & EMPOWER PARENTS
AIM
DEVELOPMENTAL STIMULATION
POSITIONING
Why is it important?
How should we do it?
When should we do it?
- Third trimester: crowding in the uterus = physiological flexion & midline orientation
- Post term: gravity causes open, extended posture
- Babies job: to reach midline, develop active flexion and active extension
- Why: promotes self soothing, self feeding, sensorimotor experiences
- Every milestone in a babies life has a very particular reason
- I.e hands to mouth teach them about their hands/fingers, teaches them they have 2 sides to their bodies;
- feet to hand/mouth play lets them discover their feet and prepares their abs for sitting and lengthens their hamstrings
HOW
HOW?
NB – COMBINATION OF THE FOLLOWING ALLOWS FOR OVERALL DEVELOPMENT
Nesting/boundries – purpose = to give baby feeling of security, for feedback and body orientation and to promote midline orientation
Nesting/boundries – purpose = to give ba...
Minimise supine positioning
Minimise supine positioning
Position side lying – promotes midli...
Position side lying – promotes midline orientation
Swaddeling – proven to improve sleep, decrea...
Swaddeling – proven to improve sleep, decrease stress & improve self regulation
Prone – NB for active head control and shoulder gird...
Prone – NB for active head control and shoulder girdle strengthening = fine motor development
As soon as baby is stable
As soon as baby is stable
KMC -position with principles
KMC -position with principles
Position baby in flexion with midline when transferi...
Position baby in flexion with midline when transfering baby to mom or scale
PLAGIO-CEPHALY
Deformational Plagiocephaly
'flat head'
Plagiocephaly
Due to the babies soft skull the shape of the skull changes due to prolonged positioning.
OTHER MALFORMATIONS
Supine with slight rotation
Prevention
- Change position regularly
- Change orientation in incubator - beware of the babies head preference and where the light comes from
Consequences
Cosmetic abnormalites
Visual defects
Otitis Media
Developmental delays
What's next
REFERRALS
Timeline