The RES-Q Wedge is a new option for positioning an infant with Gastroesophageal Reflux Disease. While there are several wedges and slings on the market to position an infant with reflux in an upright position for sleep and play, the RES-Q Wedge is unique in several important ways. First, the wedge is designed to offer back and shoulder support to provide developmentally appropriate positioning and decrease head flattening that may occur from prolonged lying in a standard carrier or wedge. Further, the manufacturer offers a consultation from an occupational therapist with each purchase to assist caretakers with proper positioning and use of the RES-Q Wedge. Recently, I had an opportunity to chat with Rozlyn Troop, one of the inventors of the wedge to learn more.
**Question: Why did you develop this wedge? **
Answer: Robynne Elkin, an occupational therapist, had seen many cases of reflux while working with premature babies in the NICU (Neonatal Intensive Care Unit). Also, the simple triangular shaped wedges on the market caused more problems than they were actually addressing, namely: shoulder retraction, plagiocephaly (head flattening) and torticollis (shortening of the neck muscles). Consequently, many physicians stopped using reflux wedges. Robynne also had personal experience in her home when her second child was diagnosed with reflux. She was convinced that there must be a better way to address these issues. One day while working in the hospital, she came across a positioning device called the "Troop Elevation Pillow" which was designed by Dr. Troop (an anesthesiologist) to improve airway management for the morbidly obese. Robynne contacted Dr. Troop to see if they could work together on an infant reflux wedge. Dr. Troop enlisted his wife Rozlyn, a dietitian, to help out with the design. The three professionals all put their heads together and came up with the RES-Q Infant Wedge (which stands for R= reflux symptoms, E= Ear infections, S=Sleep disturbance, Q=Quick relief).
Question: What is unique about the design of the RES-Q Wedge?
Answer: It is the first reversible, orthopedically designed reflux wedge on the market. Infants can rest in a tummy lying position on the top side of the wedge and in a back lying position (recommended by the American Academy of Pediatrics and SIDS alliance) when the wedge is turned over to the ‘nest’ side.
Question: Why is back support important on a wedge for a baby?
Answer: Back support is essential for an infant to develop proper musculoskeletal alignment. Poor positioning can cause tightness of neck extensors, shoulder/scapular retraction, low back extension, hip abduction and external rotation. The orthopedic design of the RES-Q Wedge addresses all of these issues and allows a shoulders forward posture and relaxed neck on both sides of the wedge. The top side of the wedge has a curvilinear cut to allow the shoulders to come gently forward, and the cut out ‘nest’ also encourages this position when the infant is on its back. The ‘nest’ design also addresses head flattening problems associated with other wedges and hard (stiff) carriers as well as car seats. The baby’s bottom rests gently on the lower portion of the scooped out ‘nest’ thereby allowing the weight to come off of the back of the infant’s skull (the infant is basically in a sitting position). The nest is rounded to disperse pressure around the skull and to help assist with proper head molding. The ‘nest’ side also provides containment or boundaries to discourage muscle fatigue.
Question: Have you seen problems from other forms of positioning wedges, car seats, carriers etc.?
Answer: This natural support in the design of the RES-Q Wedge addressed a problem associated with other wedges which was that babies were hanging on the wedges without support which led to shoulder retraction, neck extension, upper and lower extremity extension and trunk arching.
Question: Should other baby equipment designers think about this too?
Answer: All baby equipment designs would benefit from these developmental design strategies to encourage optimum growth and muscle alignment, not to mention overall comfort.
Question: Can the wedge be used after the baby becomes mobile and is not in a sling?
Answer: The RES-Q Wedge is designed to be used with our slings only. There are three sling sizes ranging from 3-25 lbs. There is a variance of up to 2 lbs with each sling size to accommodate growth. Most infants have outgrown the RES-Q Wedge by one year of age. Many infants prefer to sleep on it especially at night even if they are mobile. Our company also makes a reflux/apnea adult positioner for home use called the ARA Pillow. We will also have a child ARA pillow available within the next few weeks online that our RES-Q Wedge infants can transition to once they out grow the RES-Q Slings. The child ARA pillow can be used in a crib or infant bed and comes with a machine washable cover.
Question: Is there any research underway on the wedge?
Answer: We presently have case studies being performed and documented in a hospital NICU in Spokane, Washington. Currently, observations for premature infants using the RES-Q Wedge are: improved reflux symptoms, increased oxygenation, decreased episodes of apnea, decreased incidence of bradycardia (slow heart rates), deeper sleep states, improved musculoskeletal alignment and shorter hospital stays. We are hopeful that these documented case studies will lead to a double blind research study in the near future. Hospitals in Arkansas and Washington have expressed an interest in conducting a long term study.
For more information about the RES-Q Wedge including a video go to the website.
Note: Please consult your child’s physician about positioning and other treatments for gastroesophageal reflux.