Evaluating the effectiveness of gel pillows for reducing bilateral head flattening in preterm infants: a randomized controlled pilot study

Schultz, Alyce A.; Goodwin, Patricia A.; Jesseman, Cynthia; Toews, Heidi G.; Lane, Megan; Smith, Christine

doi:10.1016/j.apnr.2006.11.003

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Volume 21, Issue 4 , Pages 191-198, November 2008

Evaluating the effectiveness of gel pillows for reducing bilateral head flattening in preterm infants: a randomized controlled pilot study☆

Alyce A. Schultz, RN, PhD, FAAN
- Center for the Advancement of Evidence-Based Practice, Arizona State University, Tempe, AZ, USA
- Corresponding author.
Patricia A. Goodwin, RNC
- Neonatal Intensive Care Unit, Barbara Bush Children's Hospital at Maine Medical Center, Portland, ME 04102, USA
Cynthia Jesseman, RN, NNP
- Neonatal Intensive Care Unit, Barbara Bush Children's Hospital at Maine Medical Center, Portland, ME 04102, USA
Heidi G. Toews, RN, BSN
- Neonatal Intensive Care Unit, Barbara Bush Children's Hospital at Maine Medical Center, Portland, ME 04102, USA
Megan Lane, RN, FNP-C
- Maine Centers for HealthCare, Scarborough, ME 04074, USA
Christine Smith, RN, BSN
- Visiting Nurse Association of Brooklyn, Inc., Brooklyn, NY 11201, USA

Received 2 August 2006; received in revised form 21 November 2006; accepted 28 November 2006.

Abstract

This study evaluated the effectiveness of gel pillows for reducing bilateral head molding (plagiocephaly) in preterm infants, as determined by the cephalic index (CI). Eighty-one infants weighing <1,500 g were randomly assigned at birth to usual care on a standard mattress (n = 40) or to placement on a gel pillow (n = 41). The CI was measured with a digimatic caliper upon entry and weekly thereafter, until infants had been transferred or discharged. Repeated measures analysis of variance revealed no statistically significant differences in the CI between subjects upon entry, at 5 weeks postintervention, or at 10 weeks postintervention. The trend was toward less molding over time for smaller infants on gel pillows who were hospitalized longer; however, the sample size was too small to detect statistical significance.