Redistributes pressure
A shallow concave surface increases contact area instead of concentrating load at a cutout edge.
Thoughtful support for the smallest patients
Soft where it touches. Structured where it matters. PediPillow is a single-use infant occipital positioner designed to redistribute pressure across a continuous, supportive surface during procedures and monitored clinical care.
Designed by Scott J. Rapp, MD, FACS, a practising paediatric craniofacial surgeon.
Why PediPillow
Infants with poor tone or torticollis may spend prolonged periods loading the same part of the occiput. PediPillow replaces improvised blocks and collapse-prone foam with one continuous support surface engineered for monitored care.
A shallow concave surface increases contact area instead of concentrating load at a cutout edge.
The open-cell silicone core retains its structure under sustained load and in wet conditions.
Consistent geometry, adhesive striping and single-patient use make positioning less improvised.
Seven padding materials in clinical use at Cincinnati Children's and Dayton Children's were tested on a universal testing machine across four conditions, with scanning electron microscopy on each substrate. These are the results for the silicone foam used in PediPillow™ against the polyurethane foams it would replace.
| Measure | Open-cell silicone | Polyurethane foams | Significance |
|---|---|---|---|
| Structure retained at 100 lb load | 20% retained | Near-complete collapse | P < 0.001 |
| Force to deform when saturated | No significant change | 13.2% ± 20.8 less force needed | P = 0.023 |
| Recovery after 2-hour compression | Full recovery, wet and dry | Delayed; donuts and eggcrate did not fully recover | P < 0.001 |
| Structure on electron microscopy | Weakened cells, lattice intact | Fractured fibres, breaks in continuity | — |
On every measure tested, the open-cell silicone used in PediPillow™ outperformed the polyurethane foams it is meant to replace: it held its structure under sustained load, it was unaffected by saturation, and it recovered fully after two hours of compression. The polyurethane foams did none of those things.
Rapp SJ, Pierzchajlo N, Gordon CB, Anderson SR. Prevention of pressure-induced soft tissue injuries in acute and chronic hospital settings: a biomechanical comparison of current methods and materials. Plast Reconstr Surg Glob Open 2025;13:e7291. Dr. Rapp holds equity in Fiomet Ventures, Inc.; the test fixture was purchased by the company. Both disclosures are published with the article. Testing was in vitro and does not establish a clinical outcome.
A baby’s skull is soft and the sutures are open. Sustained contact on one part of the back of the head flattens that part, and the rest of the skull shifts to compensate. Argenta’s classification describes how far that compensation has travelled.
of 440 healthy full-term infants had some degree of positional plagiocephaly when assessed at 7 to 12 weeks of age. Most of it was mild, and the right side was affected roughly twice as often as the left.
Mawji A, Vollman AR, Hatfield J, McNeil DA, Sauvé R. The incidence of positional plagiocephaly: a cohort study. Pediatrics 2013;132(2):298–304. Classification after Argenta L. Clinical classification of positional plagiocephaly. J Craniofac Surg 2004. Images are illustrations prepared to show the classification; they are not clinical photographs of patients. PediPillow™ is not indicated to prevent, treat, or correct plagiocephaly or any other change in head shape. This section is here because the mechanism — sustained load on one area of infant skin and skull — is the same mechanism the device addresses for pressure injury.
Cutting a hole under the pressure point is the intuitive fix. It is the wrong one, and the reason is not obvious from looking at the device.
A ring does not remove load. It moves all of it onto two narrow edges, a centimetre or two from the spot you were protecting.
The opening is the part that gets missed. Tissue suspended over a hole still has arterial inflow, but its venous and lymphatic outflow has to cross the compressed ring. Fluid collects. With dependent oedema the tissue swells down into the opening, the skin tents over the rim edge, and peak pressure ends up on that edge, over poorly perfused skin.
The international pressure injury guideline says not to use ring or donut-shaped devices for exactly this reason: the edges create areas of high pressure that damage tissue, impair circulation, and create oedema. It is a recommendation that is published but not widely applied.
European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline, 3rd ed., 2019.
Dimensions are nominal and uncompressed. The contact scalp surface is a continuous concave surface, so it has no measurable rim edge. The dish is shallow by design: the occiput settles close to the support surface rather than being raised above it.
Ordering
Cases of 10 are the standard order unit; single units are available for evaluation. PediPillow is a prescription device for monitored use in a healthcare facility.
Order total $749.90 — 10 units
Taxes and shipping are calculated at checkout. Tax-exempt facilities should use the invoice request.
For purchase orders, net terms, and tax-exempt accounts.
PediPillow was designed by a surgeon who positions these patients. The geometry came out of the operating room, not a catalogue.
Dr. Rapp is a pediatric cleft and craniofacial surgeon. He operates across three children’s hospitals — Cincinnati Children’s, Dayton Children’s, and Shriners Children’s Ohio — and holds an associate professorship at the University of Cincinnati College of Medicine. His caseload is the reconstructive end of the specialty: cleft lip and palate, craniosynostosis, and craniofacial reconstruction in infants and small children.
Long operations are where positioning stops being routine. In a case that runs eight or twelve hours, the padding under a small patient’s head is usually improvised at the table from cut foam blocks, and whether it holds depends on who assembled it. Dr. Rapp founded Fiomet Ventures to replace that improvisation with a manufactured part at a fixed geometry.
This was never about invention. It was about prevention.
The work behind PediPillow started with the material rather than the shape. A comparison of seven padding products in clinical use at Cincinnati Children’s and Dayton Children’s, published in Plastic and Reconstructive Surgery — Global Open, found that the polyurethane foams in common use lose structure under sustained load and degrade further when wet, while open-cell silicone retained its structure and recovered fully. PediPillow puts that material into a form specific to the infant occiput.
The mission behind the company is narrower than it sounds: eliminate the harm that was preventable, so that a hospital stay does not follow a patient for the rest of their life.
Pressure injury is a complication of position, and position is something the surgical team controls. In long procedures the padding under a patient’s head is often assembled at the table from cut foam blocks. It is quick, it is what is on the shelf, and it leaves gaps.
Prolonged operations carry a documented pressure injury risk, and neonatal skin has very little margin. The design question was narrow: give the occiput one continuous surface at a fixed geometry, so the offload does not depend on who assembled the padding or how long the case ran.
The material came first. A published comparison of seven padding products in clinical use at Cincinnati Children’s and Dayton Children’s found that polyurethane foams lose structure under sustained load and degrade further when wet, while the open-cell silicone retained structure and recovered fully. PediPillow applies that material in a form specific to the infant occiput.
Rapp SJ, Pierzchajlo N, Gordon CB, Anderson SR. Plast Reconstr Surg Glob Open 2025;13:e7291.
Dr. Rapp is the founder and chief executive of Fiomet Ventures, Inc. and holds equity in the company. He is an author of the biomechanical study cited on this site; that study’s test fixture was purchased by Fiomet, and both facts were disclosed in the published article.
Clinical appointments are listed to describe professional background. They do not constitute an endorsement of this device by Cincinnati Children’s Hospital Medical Center, Dayton Children’s Hospital, Shriners Children’s Ohio, or the University of Cincinnati.
PediPillow™ is intended to reduce pressure on the skin over bony prominences, to reduce the likelihood of pressure injury, in infants under direct clinical observation in a healthcare facility.
Sleep or any unobserved period. Use in a car seat, carrier, rocker, swing, or other sitting device. Home use. Changing head shape or symmetry, or preventing or treating any medical condition, including positional plagiocephaly. Reuse between patients.
Prescription device. Federal law restricts this device to sale by or on the order of a physician.