Effect of sleep and play positions on infant development: Reconciling developmental concerns with SIDS prevention

Preterm infants have traditionally been considered at risk for positional deformities and delayed or atypical development. During the last decade, however, similar problems have increasingly been documented in normal infants born at term gestation, with recommendations of supine sleeping for prevention of sudden infant death syndrome often implicated as a causal factor. This article seeks to inform and educate neonatal and pediatric nurses on positional and postural influences in normal and delayed infant development, including the relationship of sleep and play positions to developmental issues. An observant nurse who understands normal development, can recognize atypical postures, and is knowledgeable about potential developmental consequences is in a position to intervene at the earliest interaction with the family. The American Academy of Pediatrics (AAP) sleep position guidelines, however, must not be compromised in the process. Current AAP rationale and guidelines for prevention of sudden infant death syndrome are summarized to facilitate nursing efforts to correctly model and teach infant caregivers. Common-sense suggestions for hospital and community-based nurses to help parents avoid preventable developmental delay while reinforcing current sleep position guidelines are presented.