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DEVELOPMENTAL CARE IN THE NICU

Tami Van Aswegen - Physiotherapist

31 January 2018

AIM

SUPPORT & EMPOWER PARENTS

AIM

EARLY INTERVENTION

DEVELOPMENTAL STIMULATION

Positioning

POSITIONING

Why is it important?

How should we do it?

When should we do it?

WHY?

  • 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

WHEN?

WHEN?

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.

What is it?

Pics

DEFORMATION OF THE SKULL

SHAPE OF THE SKULL

OTHER MALFORMATIONS

Side Lying

Supine with slight rotation

Supine

Prevention

Prevention

  • Change position regularly
  • Change orientation in incubator - beware of the babies head preference and where the light comes from

Consequences

Consequences

Cosmetic abnormalites

Visual defects

Otitis Media

Developmental delays

What's next

REFERRALS

Timeline

January

March

February

Keep in mind

Keep in mind

Changes

Changes

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