The Challenge of Positional Car Seat Testing in Healthy Near-term Neonates

The American Academy of Pediatrics Committee on Injury and Poison Prevention recommends that hospitals develop policies that include a period of observation for any infant less than 37 weeks' gestation in an infant car safety seat before hospital discharge to monitor for apnea, bradycardia, or oxygen desaturation. Development of policy guidelines presents a challenge to health care providers on many levels. What evidence is the basis for this recommendation of the American Academy of Pediatrics? Does this recommendation include healthy near-term infants in level I nurseries? How should such policies be produced and implemented? What training and education will be necessary? How much will this cost? This article reviews the evidence for clinical practice and shares clinical experiences in policy development, education, and cost containment.