Consistency Is Key: Neonatal Positioning For Neurodevelopmental Support

During gestation, babies receive consistent, predictable positioning and sensory input from the womb. Positioning and sensory interventions in the NICU should ideally promote consistency in practice across caregivers, such as using dedicated tools that decrease variability in positioning technique. Having consistent, evidence-based positioning support tools can be viewed as an important step toward improving developmental care.

Our social media series Consistency Is Key covered three main areas of neonatal positioning that benefit greatly from consistent neurodevelopmental support. Find all of the slideshows in one place with additional information about Swaddling, Nesting, and Prone Support below:


Swaddling has been used for centuries to provide babies with warmth and calming containment. Hospitalized babies— especially those born preterm— need consistent, neurodevelopmentally-supportive positioning that aims to bridge the gap between the experience of the womb and the experience of the NICU.

Traditional swaddling with blankets may not provide the right type of support to optimize growth and development. High levels of variation can exist in blanket swaddling techniques, resulting in a variable experience and position for the baby.

Babies also need dynamic boundaries that allow for free movement and periods of active extension, followed by passive recoil to flexion at rest. Traditional blankets may be stiff, preventing free movement and failing to promote recoil to flexion.

An ideal swaddling aid should make it easy to provide the right position and sensations for each baby, without the influence of caregiver preference or technique on the outcome.

Learn more about the Dandle® WRAP Stretch.


Positioning nests crafted, folded, or molded by hand are a long-standing tradition in NICU environments.

While these types of support can be effective with the right technique, the potential exists for high variability in positioning across caregivers, babies, and even shifts.

Nesting with products that provide close-fitting, easy-to-replicate positioning support will give the babies the redundancy and dynamic interplay characteristic of the womb. Womb-like positioning can promote deeper sleep, which benefits babies, their parents, and caregivers alike!

Learn more about the Dandle® ROO2.

Prone Support

Developmentally supportive prone positioning should facilitate a flexed posture, with the shoulders rounded, hips and knees flexed, and hands toward the face.

Prone supports that are built from blankets, burp cloths, pillowcases, or other flaccid materials may not be firm enough to promote and maintain proper prone positioning.

Learn more about the Dandy Prone Pad™.

To learn more about the 5 Tenets of Neurodevelopmentally Supportive Positioning™ check out the 5 Tenets Deep-Dive and/or download the Dandle•LION® Positioning Competency Toolkit.