The purpose of this investigation was to study the effects of nonoscillating waterbeds on three indices of energy expenditure: activity level, heart rate, and behavioral state. Subjects were 22 healthy preterm infants in a neonatal intensive care unit who had reached 31 to 35 weeks postconceptional age, and whose average weight was 1,482 grams at the onset of the study. Infants were placed on a waterbed for 3 consecutive days and on a standard incubator mattress for 3 consecutive days. Infants served as their own controls on and off the waterbed. Treatment order was randomly counterbalanced. One-hour observations of activity and state occurring in conjunction with heartbeat counts were the repeated measures on each day over both treatment and control conditions. Infants experienced longer durations of quiet sleep, less active awake and fuss states, and fewer state changes and awakenings while on the waterbed. Heart rates were higher after infants were taken off the waterbed. The findings suggest that nonoscillating waterbed flotation is a simple, cost-effective intervention that reduces energy expenditure.

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