Developmental Positions

Developmental Positions

1. Prone

   • Facilitates head control
     • Helps develop muscles of shoulders, arms, back, hips
     • Helps develop flexor tone in premature infants
     • Improves oxygenation and ventilation in premature
     • Reduces reflux, esp at 30 deg elevation
     • Reduces hip flexion contractures
   • Increased risk of SIDS
     • Can cause flattened, frog leg positioning
     • Infants with weak/low tone may not have enough strength to clear airway
     • Visual exploration more difficult
       • Less face-to-face contact with caregivers

2. Sidelying

   • Right side lying can improve gastric emptying
     • Encourages midline orientation of head and extremities
       • Allows gravity eliminated positioning of UE so can increase use in weak/low tone patients
         • Facilitates hand-to-mouth; hand-to-hand activity
           • Can help decrease patient's extensor patterning because requires less effort to move
   • May be difficult to maintain with increased extensor patterning
     • Left side lying can decrease gastric emptying time

3. Sitting

   • Facilitates balance
     • Good alerting posture
     • Good visual exploration
     • Encourages social interaction
   • May be too difficult for patients with abnormal tone and/or weakness; too much difficulty working against gravity
     • Can cause increased neck flexion and difficulty breathing in patients with poor head control

4. Standing

   • Frees UE for prehension and manipulation
     • Facilitates higher level neurological integration
   • Need good trunk stability or much outside support to facilitate position

5. Supine

   • Advantages
     • Recommended position to reduce SIDS
     • Easy visual exploration
     • Helps facilitate abdominal muscles in older infants
   • Disadvantages
     • Encourages extensor posturing
     • Too much support, not enough challenge
     • Low tone, weak patients, encourages external rotation positional deformities of arms/legs
     • Greater risk of aspiration than in prone or side lying