NICU positioning strategies to reduce stress in preterm infants: a scoping review

Appropriate positioning maintains preterm infants in symmetrical posture and is important for stress reduction and impacting neurological or musculoskeletal development. This review was performed to elucidate which positioning methods emerge as the most beneficial. Several databases were searched using search terms for neonatal intensive care, preterm, infant positioning, and stress. Three hundred and fifty-eight articles were initially retrieved and nine were retained after applying inclusion criteria. Included studies varied widely in their methods and outcome measures. Prone positioning was supported by three studies, sidelying was found to reduce stress more than supine positioning, and supine positioning emerged as the least effective for controlling stress behaviours. Limited evidence supports the efficacy of alternative positioning techniques that contain infants in supine positions. Future studies should continue to investigate the impact of positioning on stress in order to optimize developmental outcomes for preterm infants.