Positioning of babies in the transitional nursery?

[pickledpepperRN]

I have nurse friends who disagree on the safety of keeping newborns on their side when in the transitional (step-down) nursery when they can be observed at all times.

Some say babies should always be on their back. This is both for immediate safety and because mothers model what the nurses did when they take the baby home.

Others feel there a lesser risk of aspiration if the position is changed. Some of these babies are monitored, some not. Some have pulse oximetry. The staffing is 4 or less per nurse. Most of the nurses in favor of changing position from side to side with an arm extended to prevent the infant from rolling into a prone position also work NICU.

What about the healthy newborn nursery? Is this different? staffing is 8 or less per nurse.

I am an adult nurse with many maternal-child nurse friends who do not surf the web like I do.

Any studies or the practice at your unit will be appreciated.

Thank you

[live4today, RN]

In 1991, when I worked Newborn Nursery, the side-lying position was what we used...snuggling the blankets tight around the babies. :)

I've heard the recent studies of placing the infants on their backs to prevent aspiration if the baby upchucked. I still prefer the side-lying position however.......for my own grandbabies on the homefront. My daughters use both positions with their babies. :)

[Hardknox]

Since the study linking Sids to sleeping on the stomach, we HAD to have the babies on their backs per pediatricians orders. All the cribs had "Back to Sleep" signs on them...so the mothers would model this. We also stressed this in our baby care classes. I still liked the baby on their side, especially when I was 1:12 as the newborn nursery nurse at night. I felt I could keep an eye on them and if they upchucked silently as some do, they would not aspirate. It's hard to keep an eye on that many babies while you are feeding or bathing someone else. However, the pedi's would have a fit if they saw that the baby was not on his/her back. One MD entered the nursery when my colleague was there, spotted a baby on his back and said "Look at the nurse trying to kill the baby!"

[dawngloves, BSN, RN]

I place them on their side if I had just fed them, belly if they are freaking out. I always stress to the parents that the baby is on a monitor here and is being watched at all times and at home the baby should sleep on her back.