Patent Publication Number: US-7716764-B2

Title: Infant positioner

Description:
BACKGROUND OF THE INVENTION 
   The invention relates generally to devices for supporting and positioning infants and, more particularly, to infants such as prematurely-born babies, in an appropriate position. 
   It is well known that certain infants have developmental requirements which are improved through proper support and positioning. A number of infant supports and positioners are known. 
   SUMMARY OF THE INVENTION 
   In one aspect, an infant positioner for supporting and positioning an infant in a tucked prone position is provided. The infant positioner is made of a resilient foam material having a density for supporting the infant. The infant positioner includes an elongated base layer extending lengthwise from a head end to a feet end. The elongated base layer in turn includes, in order, a head support portion having a width at least sufficient to fully support the head of the infant, a torso support portion having a width sized to correspond to the width of the torso of the infant, and a pelvis support portion. Arm recesses are formed in the torso support portion extending through the entire thickness of said torso support portion. The arm recesses are configured and located in a position generally corresponding to the shoulders of the infant such that the arms of the infant are allowed to be rounded and tucked into a position of flexion. The pelvis support portion ranges in width from the width of the torso support portion to a narrower width corresponding to the distance between the legs of the infant. The pelvis support portion terminates in an upwardly extending rear support for the buttocks of the infant. The upwardly extending rear support has a width corresponding to the distance between the legs of the infant and is configured so as to allow the infant to maintain the tucked prone position without sliding towards the feet end of the infant positioner. A pair of upwardly and rearwardly extending lateral supports are connected to the torso support portion. The upwardly extending lateral supports are spaced a distance apart corresponding to the width of the torso of the infant, and extend lengthwise from the arm recesses to the feet end of the infant positioner. A pair of leg recesses are provided. Each of the leg recesses is defined between one of the upwardly extending lateral supports and the pelvis support portion and the upwardly extending rear support which terminates the pelvis support portion. 

   
     BRIEF DESCRIPTION OF THE DRAWINGS 
       FIG. 1  is a three-dimensional view of an infant positioner embodying the invention, with a portion cut away to show a fabric cover over resilient foam material; 
       FIG. 2  is a somewhat diagrammatic plan view of the main body of the infant positioner of  FIG. 1 , with various dimensions designated; 
       FIG. 3  is a somewhat diagrammatic side elevational view taken on line  3 - 3  of  FIG. 2 , with further dimensions designated; 
       FIG. 4  is a bottom view of the infant positioner; 
       FIG. 5  is a cross section taken on line  5 - 5  of  FIG. 4 ; 
       FIG. 6  is a cross section taken on line  6 - 6  of  FIG. 1 ; 
       FIG. 7  is a three-dimensional view of the infant positioner of  FIG. 1  in the same orientation as  FIG. 1 , and with an infant in a tucked prone position, prior to securing the infant with upper back and hip area containment straps; and 
       FIG. 8  is a three-dimensional view comparable to that of  FIG. 7 , but with the upper back and hip area containment straps in their in-use position. 
   

   DETAILED DESCRIPTION 
   With reference to the three-dimensional views of  FIGS. 1 ,  7 , and  8 , shown is an infant positioner  10  embodying the invention for supporting and positioning an infant  12  ( FIGS. 7 and 8 ) in a tucked prone position, and which is also referred to herein as an infant positioner  10 . The infant positioner  10  is intended to be placed within a suitable bed (not shown) for the infant  12 , and typically is employed in combination with bedding (not shown) . More particularly, the infant positioner  10  can be used within an isolette, radiant warmer, or crib in a neonatal intensive care unit (NICU) or nursery in a hospital. To provide additional containment, the infant positioner  10  can be used in combination with other positioning supports. 
   Outside of the in-utero environment, premature infants may be unable to maintain an optimal tucked prone position. While in the in-utero sac with the enclosed boundaries and the buoyancy of the amniotic fluid, the infant can maintain a comfortable tucked position for a long period of time. However, while positioned in prone outside of the in-utero environment the infant, especially a premature infant, may not be able to maintain the optimal tucked position for a long period of time with the forces of gravity on his or her under-developed muscles. While in the infant positioner  10 , the infant  12  is able to maintain this position due to the supportive elements described hereinbelow in detail, with less stress on the joints and decreased weight bearing impact on the extremities of the infant  12 . At the same time, there is enough flexibility so that the infant  12  can generally move as desired. 
   The infant positioner  10  thus promotes the ability of the infant  12  to assume a position of flexion while in prone, to better replicate the position the infant  12  would have been in-utero, and accordingly to at least somewhat simulate the experience of the infant  12  in-utero. The infant positioner  10  accordingly can be employed for positioning and supporting prematurely-born babies in a developmentally appropriate tucked prone position, as well as for post-surgical babies requiring prolonged prone positioning. One example is an infant with Spina Bifida who needs to be in the prone position for an extended period of time after myelomeningocele repair. There are other surgical procedures with similar requirements. 
   The infant positioner  10  is generally made of a resilient foam material having a density for supporting the infant  12 , with a thickness that can vary depending on the size of the infant  12 . In the illustrated embodiment, a form-fitting, removable washable fabric cover  14  is provided over a resilient foam material core  16 , visible in the cut away portion of  FIG. 1 . The cover  14  can be made of a wipeable bi-directional stretch fabric. With reference to the underside view of  FIG. 4  and the cross-section of  FIG. 5 , a zippered aperture  18  is provided so that the cover  14  can be removed and washed. Accordingly, a sanitary environment for the infant  12  is facilitated. 
   Referring to the dimensioned diagrammatic views of  FIGS. 2 and 3 , as well as to the three-dimensional views of  FIGS. 1 ,  7  and  8 , the infant positioner  10  has a head end  20  and a foot end  22  defining a length l between the two ends  20  and  22 , as well as a width w. The infant positioner  10  includes an elongated base layer  30  extending lengthwise from the head end  20  to the feet end  22 . The elongated base layer  30  includes, in order, a head support portion  32  having a width at least sufficient to fully support the head of the infant  12 , a torso support portion  34  having a width a sized to correspond to the width of the torso of the infant  12 , and a pelvis support portion  36 . In the illustrated embodiment, the width of the head support portion  32  corresponds to the width w of the infant positioner  10 . The pelvis support portion  36  ranges in width from the width a of the torso support portion  34  to a narrower width b corresponding to the distance between the legs of the infant  12 . 
   Along a transition zone  38 , the base layer  30  decreases in thickness from the torso support portion  34  (thickness c) to a cavity  40  in the head support portion  32  (thickness d) of the base layer  30 . The transition zone  38  and cavity  40  allow the upper back of the infant  12  to assume a more rounded position. The cavity  40  has a “U” shape in plan view, and a shallow curvature in cross-section. One function of the cavity  40  is to assist in maintaining the head of the infant  12  in a centered position widthwise and lengthwise. In addition, the decrease in thickness d of the cavity  40  in the head support portion  32  compared to the thickness c of torso support portion  34  effectively discourages the infant  12  from extending his or her head back and possibly extubating in the event the infant  12  has an endotracheal tube, or disconnecting from a nasal continuous positive airway pressure prong. The cavity  40  also limits the infant  12  from scooting too far up in the infant positioner  10 . 
   Referring also to the cross-sectional view of  FIG. 6 , a shallow longitudinal trough  42  is formed in the torso and pelvis support portions  34  and  36 . This shallow longitudinal trough  42  maximizes support area for the torso of the infant  12 , and promotes ease of breathing. 
   Arm recesses  44  and  46  are provided in the torso support portion  34 , extending all the way through the elongated base layer  30 , and located in a position generally corresponding to the shoulders of the infant  12 . The edges of the arm recesses  44  and  46  immediately adjacent the transition zone  38  also correspond to the position of the neck of the infant  12 . The arm recesses  44  and  46  allow the arms of the infant to be rounded and tucked into a position of flexion. Further, this promotes the scapula to rest in a relaxed protracted position. This position encourages the infant to bring his or her hands toward the mouth to assist with self soothing. The arm recesses  44  and  46  generally have a “U” configuration and are large enough to accommodate the arms of the infant. The widthwise distance between the arm recesses  44  and  46  is referenced as e, and the lengthwise height of the arm recesses  44  and  46  is referenced as f. The longitudinal distance from the neck of the infant  12  to the feet end  22  of the infant positioner is referenced as g. In order to provide a smoother surface for the shoulders of the infant to rest upon, there is a gradual slope from the top of the arm recesses  44  and  46  towards the bottom. 
   To allow sufficient depth for the infant  12  to tuck his or her arms into the arm recesses  44  and  46 , the thickness c of the torso support portion  34  of the base layer  30  in the vicinity of the arm recesses  44  and  46  is about three-fourths the length of the humerus of the infant. 
   The pelvis support portion  36  transitions in width and terminates in an upwardly-extending rear support  50  for the buttocks of the infant  12 , which support  50  has a width b corresponding to the distance between the legs of the infant  12 . Thus, and as noted above, the pelvis support portion  36  ranges in width from the width a of the torso support portion  34  to the narrower width b of the upwardly-extending rear support corresponding to the distance between the legs of the infant  12 . In the illustrated infant positioner  10 , the upwardly-extending rear support  50  extends to the feet end  22  of the infant positioner  10 , and has a length h. The upwardly-extending rear support  50  is laterally centered, wide enough to support the buttocks of the infant  12 , and has a height i which is approximately the height of the buttocks  12  of the infant while the infant is in the tucked prone position. The upwardly-extending rear support  50  is an important element of the infant positioner  10 , and allows the infant  12  to maintain the tucked prone position without sliding towards the feet end  22  of the infant positioner  10 . Sliding down can otherwise occur if the bedding is placed in a tilted position, or the infant  12  squirms down. 
   In order to provide boundaries and containment to the torso, pelvis and legs of the infant  12 , a pair of upwardly and rearwardly-extending lateral supports  52  and  54  are connected to the torso support portion  34 , and extend lengthwise from the arm recesses  44  and  46  to the feet end  22  of the infant positioner  10 . The lateral supports  52  and  54  are spaced a distance apart corresponding to the width a of the torso of the infant  12 . Viewed from the side, the lateral supports  52  and  54  are preferably approximately the height of the torso of the infant  12 , when the infant  12  is positioned within the infant positioner  10 . The height i of the upwardly-extending lateral supports  52  and  54  and of the upwardly-extending rear support  50  is determined by the size of the infant  12 . 
   A pair of leg recesses  60  and  62  is provided to receive the legs of the infant  12 , and to allow the infant  12  to tuck and extend his or her lower extremities as desired. More particularly, each of the leg recesses  60  and  62  is defined between one of, the upwardly-extending lateral supports  52  and  54 , and the pelvis support portion  36  and the upwardly-extending rear support  50  which terminates the pelvis support portion. The leg recesses  60  and  62  begin approximately where the torso support portion  34  and the pelvis support portion  36  interface with each other, and extend to the feet end  22  of the positioner  10 , and all the way through the thickness of the base layer  30 . The leg recesses  60  and  62  are shaped and are large enough so as to accommodate the lower extremity of the infant  12 , but still provide containment and boundaries for the infant  12 . In  FIG. 2 , the length of the leg recesses  60  and  62  is designated j, and the width is designated k. The longitudinal distance from the position of the neck of the infant  12  to the beginning of the leg recesses  60  and  62  is designated m. 
   As noted above, embodiments of the invention provide flexible containment for the infant  12 , to at least simulate the experience of the infant  12  in-utero, as an infant frequently braces his or her feet against the uterine walls. As part of that containment, a foot brace  70  is provided, in the form of webbing  70  extending across the feet end  22  of the positioner  10 , at least between the upwardly-extending lateral supports  52  and  54 . During use, the foot brace  70  is in contact with the soles of the infant&#39;s feet in the same manner as the feet had contact with the uterine walls while the infant wa in-utero. In the illustrated embodiment, the webbing of the foot brace  70  is sewn at one end  72  to the fabric cover  14  at the end of the upwardly-extending lateral support  52 . The webbing  70  has a free end  74  which is attached to the other upwardly-extending lateral support  54  in a manner which supports repeated attachment and detachment, such as by employing a hook and loop fastener  76 . 
   As further containment for the infant  12 , a pair of containment straps  80  and  82  are provided, the containment strap  80  generally extending over the upper back of the infant  12  when in use, and the containment strap  82  generally extending over the hip area of the infant when in use. As can be seen in the underside view of  FIG. 4 , the containment straps  80  and  82  have respective attached ends  84  and  86  which are sewn to the fabric cover  14 , and free distal ends  88  and  90 . In use, as illustrated in  FIG. 8 , the free ends  88  and  90  of the containment straps  80  and  82  are wrapped around and underneath the infant positioner  10 , and are held in place by frictional forces due to the weight of the infant  12  and positioner  10 . Optionally, hook and loop fasteners (not shown) may be employed to secure the distal ends  88  and  90  of the containment straps  80  and  82  to the underside of the positioner  10 . In use ( FIG. 8 ), the containment straps  80  and  82  provide containment and boundaries for the infant  12 , again simulating the contained in-utero environment. 
   An important aspect of the invention is appropriate sizing and dimensioning of the positioner  10 . Correct sizing and dimensioning is important for comfort of the infant  12 . Although an infant positioner  10  embodying the invention can be custom made based on the measurements of an individual infant, an aspect of the invention is providing infant positioners  10  in a plurality of standardized sizes. In the embodiment described herein, three sizes are provided: “Size A” generally for a 25-29 week premature infant, “Size B” generally for a 29-32 week premature infant, and “Size C” generally for a 32-36 week premature infant. With particular reference to  FIGS. 2 and 3 , the following table indicates certain dimensions of the infant positioner  10  for these three sizes. It should be noted that, due to variations in size versus age of individuals, these measurements and sizes are not absolute for every infant. 
   
     
       
         
             
             
             
             
             
           
             
               TABLE 
             
             
                 
             
             
                 
               Reference 
               Size A 
               Size B 
               Size C 
             
             
                 
             
           
          
             
                 
             
          
         
         
             
             
             
             
             
             
             
             
          
             
               Length of infant 
               l 
               380 
               mm 
               400 
               mm 
               420 
               mm 
             
             
               positioner 12 
             
             
               Width of infant 
               w 
               160 
               mm 
               180 
               mm 
               200 
               mm 
             
             
               positioner 12 
             
             
               Width between supports 52 
               a 
               91 
               mm 
               104 
               mm 
               110 
               mm 
             
             
               and 54 for torso 
             
             
               Width of upwardly-extending 
               b 
               35 
               mm 
               40 
               mm 
               40 
               mm 
             
             
               rear support 50, between 
             
             
               legs of infant 
             
             
               Thickness of foam in the 
               c 
               25 
               mm 
               30 
               mm 
               35 
               mm 
             
             
               vicinity of arm recesses 44 
             
             
               and 46 
             
             
               Thickness of foam within 
               d 
               20 
               mm 
               25 
               mm 
               30 
               mm 
             
             
               cavity 40 in head support 
             
             
               portion 32 
             
             
               Distance between arm 
               e 
               70 
               mm 
               75 
               mm 
               80 
               mm 
             
             
               recesses 44 and 46 
             
             
               Longitudinal extent of arm 
               f 
               60 
               mm 
               65 
               mm 
               70 
               mm 
             
             
               recesses 44 and 46 
             
             
               Longitudinal distance - neck 
               g 
               210 
               mm 
               230 
               mm 
               240 
               mm 
             
             
               to feet end 22 
             
             
               Length of upwardly-extending 
               h 
               50 
               mm 
               55 
               mm 
               60 
               mm 
             
             
               rear support 50 
             
             
               Height of upwardly-extending 
               i 
               75 
               mm 
               80 
               mm 
               90 
               mm 
             
             
               supports 50, 52, 54 
             
             
               Length of leg recesses 60 
               j 
               110 
               mm 
               115 
               mm 
               115 
               mm 
             
             
               and 62 
             
             
               Width of leg recesses 60 and 
               k 
               28 
               mm 
               32 
               mm 
               35 
               mm 
             
             
               62 
             
             
               Longitudinal distance - neck 
               m 
               110 
               mm 
               120 
               mm 
               125 
               mm 
             
             
               to leg recesses 60 and 62 
             
             
                 
             
          
         
       
     
   
   Of the foregoing dimensions, the most important ones from the point of view of providing a plurality of standard sizes are the ones referenced as a, b, c, e, g, h, j and m. The resilient foam core  16  may be molded as one piece or may be cut from a piece of foam stock, using an electric knife. Another possible construction technique is to provide layers of pre-cut foam stacked on top of each other, and adhesively secured. 
   While particular embodiments of the invention have been illustrated and described herein, it is realized that numerous modifications and changes will occur to those skilled in the art. It is therefore to be understood that the appended claims are intended to cover all such modifications and changes as fall within the true spirit and scope of the invention.