A case presentation of early intervention with dolichocephaly in the NICU: collaboration between the primary nursing team and the developmental care specialist

Dolichocephaly, narrow width and long anterior-posterior cranial distance, is more commonly seen in preterm than in term infants. It seems to persist after NJCU discharge and may be a marker for adverse neurodevelopment. This article reports a case of cranial molding in one extremely low birth weight infant. He was placed on a viscoelastic mattress and a twice weekly developmental care program. Cranial molding was measured using the cranial index (CI), a ratio of width to length. Initially, the patient presented with dolichocephaly (CI=72 percent). y week 2, CI measurements approached normal limits (CI=75 percent). When placed on continuous positive airway pressure, the infant presented with substantial dolichocephaly (CI=66.7 percent). Following position changes to midline, CI measurements continued to improve and remained within normal limits until discharge. This dual-element program was feasible, acceptable to parents and staff and may be effective for identifying and managing dolichocephaly.