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 NICU 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). By 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.