Sleep position for preemies questioned
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The lung volumes of premature infants is higher when they are place on their stomachs (i.e., prone) rather than their backs, a UK study indicates, but this doesn’t seem to improve the concentration of oxygen in their circulation much, at least when they are not in respiratory distress.
“Prematurely born infants are often nursed prone in the initial stage of illness, because such positioning is associated with superior oxygenation and lung function,” Dr. Anne Greenough and colleagues from King’s College Hospital, London, write in the Archives of Disease in Childhood. “However, there has been little research on the effect of sleeping position on convalescent infants.”
The researchers looked into the issue in a study of 41 infants born prematurely at an average gestational age of 28 weeks and with an average birth weight of 1120 grams. Twenty-one of the babies had to have oxygen to survive.
The team measured the babies’ lung volume and concentration of oxygen in their bloodstream at 2 weekly intervals, from the equivalent of 32 weeks’ gestational age until they were sent home. The infants were studied supine and prone on each occasion, with the positions being maintained for one hour.
The investigators report that lung volumes were higher in the prone position throughout the study. Oxygen concentration was also higher in the prone position, but the effect was small and significant only in the oxygen-dependent infants.
The team recommends that “infants who are not dependent on oxygen ... should be nursed supine on the neonatal unit.”
That said, Greenough and colleagues add, “we recommend continuing monitoring oxygen saturation ... to be certain that longer periods of supine sleeping are not associated with loss of lung volume” and a drop in oxygen levels.
SOURCE: Archives of Disease in Childhood—Fetal and Neonatal Edition, September 2007.
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