Effects of hammock positioning in behavioral status, vital signs, and pain in preterms: a case series study

Background: The hammock positioning within the incubators simulates the intrauterine environment, however, there is little evidence of its benefits and possible risks. Objectives: The aim of this study was to assess the effects of hammock positioning on behavioral status, vital signs, and pain in very low birth weight preterm newborns. Methods: This is a quasi-experimental/case series study in which premature infants (<1500 g) were positioned in supine for one hour in a hammock. The preterm newborns were assessed 10 min before, during (2, 20, 40, and 60 min), and 10 min after hammock positioning with the Brazelton Neonatal Behavioral Assessment Scale, vital signs and pain by the Neonatal Facial Coding System. Results: 28 preterm infants between 28 and 36 weeks of gestational age were evaluated. Regarding the behavioral state, the preterm newborns progressively evolved to light or deep sleep during hammock positioning. There was a statistically significant reduction of the heart and respiratory rate from 2 to 60th minute in a hammock, which was maintained after the positioning. The oxygen saturation remained within normal values. No changes in pain scores were observed. Conclusion: The hammock positioning can be considered a safe method of positioning that can be used to reduce the stress levels in very low birth weight preterm newborns. We did not observe worsening in either pain or vital signs. (C) 2018 Associacao Brasileira de Pesquisa e Pos-Graduacao em Fisioterapia. Published by Elsevier Editora Ltda. All rights reserved.