A case presentation of early intervention with dolichocephaly in the NICU: collaboration between the primary nursing team and the developmental care specialist.
Dolichocephaly, narrow width and long anterior-posterior cranial distance, is more commonly seen in preterm than in term infants. It seems to persist after NJCU discharge and may be a marker for adverse neurodevelopment. This article reports a case of cranial molding in one extremely low birth weight infant. He was placed on a viscoelastic mattress and a twice weekly developmental care program. Cranial molding was measured using the cranial index (CI), a ratio of width to length. Initially, the patient presented with dolichocephaly (CI=72 percent). y week 2, CI measurements approached normal limits (CI=75 percent). When placed on continuous positive airway pressure, the infant presented with substantial dolichocephaly (CI=66.7 percent). Following position changes to midline, CI measurements continued to improve and remained within normal limits until discharge. This dual-element program was feasible, acceptable to parents and staff and may be effective for identifying and managing dolichocephaly.
McManus
Beth M
BM
NICU, Brigham and Women's Hospital, Boston, MA, USA. bmcmanus@hsph.harvard.edu
Capistran
Philip S
PS
D001513:Beds; D002508:Cephalometry; D002658:Developmental Disabilities / Q000517:prevention & control*; D005240:Feasibility Studies; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D016487:Parenting; D049068:Plagiocephaly, Nonsynostotic / Q000175:diagnosis / Q000451:nursing / Q000628:therapy*; D011187:Posture; D011596:Psychomotor Disorders / Q000517:prevention & control