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Comparative Effects of 2 Positional Supports on Neurobehavioral and Postural Development in Preterm Neonates

Vaivre-Douret, Laurence PhD, OTR; Golse, Bernard MD, PhD

The Journal of Perinatal & Neonatal Nursing: October-December 2007 - Volume 21 - Issue 4 - p 323–330
doi: 10.1097/01.JPN.0000299790.47161.5c
Feature Article

Preventing abnormal neurobehavioral and postural development requires careful nursing in preterm neonates. The purpose of this prospective study is to assess the effects of 2 different lying-position body supports for physiologic and functional positioning. Thirty preterm neonates were eligible, born between 28 and 35 weeks' gestation. A first sample experimented with a “Home-Cocoon” support made by nurses with rolled sheets, and a second sample provided a “Coconou” support, made with a specifically designed rolled pad. Assessments of body posture and of neurobehavior were administered pretest (on admission without support) and posttest (at discharge). In addition, nurses were asked to answer a questionnaire concerning motor behavior. All preterm neonates showed gains in postural development, but the “Coconou” group performed significantly better than the “Home-Cocoon” group, with fewer cranial deformities, with head positioning, arm relaxation, and better orthopedic leg position. The overall quality of behavior increased for the 2 groups, but visual pursuit was very significantly better for the “Coconou” group. Nurses' assessment was also better for the “Coconou” support. These results point to the benefits of positioning with a specifically designed support like “Coconou,” promoting optimal prophylactic neurobehavioral and postural developmental care for preterm neonates.

From the Univ Paris-Sud and Univ Paris Descartes (Drs Vaivre-Douret and Golse), Department of Obstetrics and Gynaecology, AP-HP Port Royal-Cohin Hospital (Dr Vaivre-Douret), and Department of Child Psychiatry, AP-HP, Necker-Enfants Malades Hospital (Dr Golse), Paris, France.

Corresponding Author: Laurence Vaivre-Douret, PhD, OTR, Department of Obstetrics and Gynaecology, AP-HP, Port-Royal-Cohin Hospital, Paris, France (

© 2007 Lippincott Williams & Wilkins, Inc.