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

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.