Mustard Seed Pillow for Prevention of Deformational Plagiocephaly in ≤ 32 Weeks' Gestational Age Infants: An Open Label Randomized Controlled Trial.

OBJECTIVES: To assess the effectiveness of using mustard seed filled pillows in preventing deformational plagiocephaly (DP) in premature infants.

METHODS: A prospective open label randomized trial was conducted in a tertiary care hospital in south India. Eligible preterm infants born at ≤32 weeks and <1500 g admitted in the neonatal intensive care unit (NICU) were randomly allocated to the intervention and control groups. In addition to standard nesting, the intervention group was positioned using a mustard pillow, while the control group was positioned using nesting alone. Plagiocephaly was assessed using the Cranial Index (CI), Cranial Vault Asymmetry Index (CVAI) and Argenta classification within the first week and at 4 weeks postnatal age.

RESULTS: Twenty-eight infants, each in the control and intervention groups, were included for analysis. At 4 weeks postnatal age, the intervention group had lower mean (SD) CVAI scores when compared to the control group [3.16 (1.89 vs 7.85 (2.63)] with adjusted odds ratio, aOR (95% CI) of 28.2 (3.8, 210.01), P < 0.01. More number of infants in the control group had plagiocephaly measured using Argenta classification [aOR (95% CI) 25.70 (2.80, 235.67), P < 0.01]. There were no differences in the Cranial Index scores in the intervention and control groups [aOR (95% CI) 0.41 (0.11, 1.52), P = 0.184].

CONCLUSION: A mustard seed pillow is an easily available and a cost-effective intervention for preventing plagiocephaly in hospitalized preterm infants.