developmental care, neurobehavior, orthopedic, positioning nursing, preterm neonate



  1. Vaivre-Douret, Laurence PhD, OTR
  2. Golse, Bernard MD, PhD


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.