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Developmental Positions
1 Prone
1.1 Facilitates head control
1.1.1 Helps develop muscles of shoulders, arms, back, hips
1.1.2 Helps develop flexor tone in premature infants
1.1.3 Improves oxygenation and ventilation in premature
1.1.4 Reduces reflux, esp at 30 deg elevation
1.1.5 Reduces hip flexion contractures
1.2 Increased risk of SIDS
1.2.1 Can cause flattened, frog leg positioning
1.2.2 Infants with weak/low tone may not have enough strength to clear airway
1.2.3 Visual exploration more difficult
1.2.3.1 Less face-to-face contact with caregivers
2 Sidelying
2.1 Right side lying can improve gastric emptying
2.1.1 Encourages midline orientation of head and extremities
2.1.1.1 Allows gravity eliminated positioning of UE so can increase use in weak/low tone patients
2.1.1.1.1 Facilitates hand-to-mouth; hand-to-hand activity
2.1.1.1.1.1 Can help decrease patient's extensor patterning because requires less effort to move
2.2 May be difficult to maintain with increased extensor patterning
2.2.1 Left side lying can decrease gastric emptying time
3 Sitting
3.1 Facilitates balance
3.1.1 Good alerting posture
3.1.2 Good visual exploration
3.1.3 Encourages social interaction
3.2 May be too difficult for patients with abnormal tone and/or weakness; too much difficulty working against gravity
3.2.1 Can cause increased neck flexion and difficulty breathing in patients with poor head control
4 Standing
4.1 Frees UE for prehension and manipulation
4.1.1 Facilitates higher level neurological integration
4.2 Need good trunk stability or much outside support to facilitate position
5 Supine
5.1 Advantages
5.1.1 Recommended position to reduce SIDS
5.1.2 Easy visual exploration
5.1.3 Helps facilitate abdominal muscles in older infants
5.2 Disadvantages
5.2.1 Encourages extensor posturing
5.2.2 Too much support, not enough challenge
5.2.3 Low tone, weak patients, encourages external rotation positional deformities of arms/legs
5.2.4 Greater risk of aspiration than in prone or side lying