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Below you will find a link to an example clinical protocol, clinical tools and videos for learning and FAQs. The case study article can be found at the link at the top of the page.
Align the Spine, Align the Band
Please reach us at ginny@neophysicaltherapy.com if you cannot find an answer to your question.
The earliest I have used abdominal support is right around 25 weeks. This is often on babies born younger than 25 weeks as the safety criteria in place in my setting includes waiting 7 days after birth for skin maturation and feeding advancements to ensure GI function, rule out underlying pathology and ensure skin integrity.
It has been used in humidity in my center without issues. Level and duration of humidity differ center to center as do standards for cleaning beds, etc. Consult with your bedside team to decide what is right for your setting.
The band is opened at each diaper change. Therefore, abdominal assessments and skin checks are done with the same frequency as when not on the band, if you are swaddling, positioning prone or covering incubators between cares as part of typical care. If there is a concern which necessitates constant visualization of the abdomen, this would contraindicate using a band.
No, due to concern for disrupting the integrity of the line and/or the dressing. Add an answer to this item.
In my center, the provider team had a comfort level that GI function is established at "full feeds" which we started out defining as 140ml/kg and now define as 120ml/kg. We may move to after umbilical lines are discontinued but have not yet. Consult with your team to determine definition of full feeds, and if you start sooner, please let me know and publish the case study or share your results!
It has not been used under phototherapy due to the amount of surface area of skin covered.
Yes, it has been used with NIPPV and has been used in a limited way prior to extubating.
Inguinal hernias have decreased since using it in my center. Umbilical hernias have not gone away but have decreased in severity and number. To optimize the effect on umbilical hernias be sure the diaper is fastened high (not folded down below the umbilicus) and the belly band is applied over it/overlapping the diaper with lower border at the line between the ASIS.
This is a bedside team decision as to the presentation of the infant. In my experience, a lite foam dressing has been applied over for a still moist umbilicus or around the base of the umbilicus to protect the surrounding skin from a sharp or long stump that has not yet fallen off yet.
Studies being done include:
Focus on Rectus Abdominis Thickness and Time to Oral Feeding: University of Minnesota Children’s
Focus on GERD: University of Chicago Doctoral Project
Focus on Feeding Tolerance: Albany Med
Focus on Length of Stay and CLD: Multicare Deaconness and Valley Hospitals
Focus on QI: Multi-site with Providence St. Vincent and Helen De Vos
More in the initial stages as well!
For more on my retrospective case series, see the webinar on the DandleLion Website.
In my experience, it has come clean best with dish soap. Therefore, using the soap you have available to wash bottles rather than the soap you use to bathe the baby is more effective. Hand wash with tap water and hang/lay flat to dry. Can stretch in all directions to reshape as needed. Consult with your center, some centers toss soiled bands rather than washing them. I have not had issues with washing and reusing.
This is a complex issue of skin integrity, i.e. not putting anything under it due to pressure, and temperature regulation. Please consult with your bedside experts and incubator company to further explore the best options.
Yes.
Yes, I started by using to rehabilitate after CPAP. This is still the way many units have gotten started. Units using with older babies and getting comfortable can then allow to work younger if your unit decides to pursue using while on CPAP. Other units are also finding good success with their older CLD population.
I cannot share the smart phrase itself but if you know how to build them, it ends up in a table which has asterisks and drop downs to fill in the following information: Date and provider entering the order, on 120ml/kg?, Xray with continuous/normal bowel gas pattern?, stooling regularly?, AC/HC, Ratio and Percentile, Parent education and agreement complete?
When using the AC/HC ratio is not possible due to an anomaly, there are weight-based norms, see the Meldere article in the references.
It has been used to support a “functional” pectus which resolved with use, meaning the pectus was present due to flexibility of the rib cage and work of breathing. I do not have experience using it with an anatomical pectus.
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