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Special Topic Course: Fluid Matters: Integrating Manual Edema Mobilization within the NICU for Optimal Neuromotor Development.

Speaker: Holly Schifsky, OTR/L, CNT, NTMTC, CBIS

Topic: Fluid Matters: Integrating Manual Edema Mobilization within the NICU for Optimal Neuromotor Development.

Course Description: Edema management for infants in the NICU is a critical skill for the developmental specialist to facilitate infant level of arousal, proper positioning, and proper movement pattern development. Infants born prematurely have a high incidence of chronic lung disease and gastro esophageal reflux disease. These co-morbidities can lead to significant lower trunk and lower extremity dependent edema secondary to elevated positioning or poor fluid mobilization because of inefficient respiratory patterns. This presentation provides you with the initial anatomical/physiological understanding of the development of the lymphatic and integumentary systems. There are patient case examples and video learning of the techniques with a variety of infant populations. A discussion on contraindications and family training for home program is included. Finally, advanced skills for the medically fragile older infant in the NICU are discussed.

Speaker Bio: Holly Schifsky, OTR/L, CNT, NTMTC, CBIS is an Occupational Therapist who has worked in pediatrics for the past 22 years with the past 15 years in a level IV NICU. She is a Certified Neonatal Therapist, Certified Neonatal Touch and Massage Therapist, Certified Brain Injury therapist, an active member of National Association of Neonatal Therapists, and has completed 6-month mentorship in infant/child NDT. She completed her Manual Edema Mobilization training from Sandra Artzberger in 2002. She has integrated lymphatic management into the NICU with positioning, handling, and manual therapy techniques. She consults with clinicians across the country on edema management within the NICU. She has worked within the NICU and NICU follow-up clinic to maximize patient and family outcomes for the most complex premature and medically-fragile term infants. Holly received her bachelors degree in Occupational therapy from the University of North Dakota in 1997. She has dedicated her career to clinical care and advancing developmental care practice patterns for all multidisciplinary team members.
She has presented at many regional and national conferences including NANT, Audrey Harris Vision NICU conference, and the University of Minnesota NICU conference. She provides frequent Developmental Care, Feeding Intervention, and NICU education throughout the country. She is a faculty member for Education Resources and the Neonatal Touch and Massage certification. She is the recipient of the National Association of Neonatal Therapists Clinical Excellence award in 2018, due to her clinical expertise and dedication to advancing the therapeutic interventions for NICU infants with cardiopulmonary conditions.

0-5 min: Introduction to effects of edema on premature infant
5-20 min: Role of the lymphatic system
20-40 min: Use of manual edema mobilization, treatment interventions, and rationale
40-49 min: Video presentation with case examples of techniques

Holly Schifsky, OTR/L, CNT, NTMTC, CBIS
Financial Disclosures: No relevant disclosures.
Nonfinancial disclosures: No relevant disclosures.

Conflict of Interest: There is no conflict of interest for anyone with the ability to control content for this activity.

Target Audience: OT, SLP, PT, RN, and Neonatal professionals

Level: Intermediate


  1. Verbalize the anatomical/gestational development of the lymphatic and integumentary systems in the premature infant; and its effects on neonatal movement pattern development.
  2. Demonstrate fluid mobilization techniques to utilize with infants for the trunk, upper and lower extremities; to reduce positional and chronic edema.
  3. Identify additional positioning strategies for edema management for infants with Congenital Diaphragmatic Hernia, Congenital Chylothorax, Spinal Muscle Atrophy, and limb anomalies.

Instructional Method: Recorded webinar with case studies and handouts. Learning assessment and course evaluation follow course.

Course Completion Requirements: The learner must view the entire webinar, complete the course evaluation and complete the post webinar learning assessment with at least 80% to receive education credit. Login and logout times will be recorded and documented.
Following completion of this course physical therapists, nurses and other disciplines will receive a certificate of completion and a zip file containing information necessary to submit to their individual state for education credit. Zip file will include course bibliography. Physical therapists are responsible for knowing and adhering to their state’s deadlines, rules and regulations.

Registration information:

In order to obtain access to the course, click the “Register now” button at the bottom of the screen. You are required to be a NANT member in good standing to have access to this course. You may also purchase this courses as a non-member by clicking the “Buy Now” button at the bottom of the screen.

For ADA accommodations, please call NANT Customer Service for more information at (866) 999-5524.

Cancellation Policy: Click HERE to review NANT’s Course Cancellation Policy.


Continuing Education Information


AOTA CEUs: National Association of Neonatal Therapists® (NANT) is an AOTA Approved Provider of professional development. This Distance-Learning Independent Course is offered at 0.05 CEUs (Intermediate level, Occupational Therapy Service Delivery). AOTA does not endorse specific course content, products, or clinical procedures.

ASHA CEUs: Learners must complete the entire course in order to receive ASHA CEUs. No partial credit awarded. ASHA CE Provider approval and use of the Brand Block does not imply endorsement of course content, specific products or clinical procedures.
ASHA CE Registry users: NANT will submit your ASHA CEU credit to ASHA on your behalf. ASHA CEUs may take up to 100 days to appear on your ASHA Transcript.

Non-ASHA CE Registry users: Maintain your course records and please keep your registry status current in your NANT account. Update your NANT account with your ASHA number if your registry status changes. NANT is not responsible for tracking your registry usage.

PT CE Credit: This course is approved for 1.0 contact hour from the Ohio Physical Therapy Association (OPTA) for continuing education in Ohio.

NANT is recognized by the New York State Education Department’s State Board for Physical Therapy as an approved provider of physical therapy and physical therapist assistant continuing education.

Questions regarding CE credit should be directed to the National Association of Neonatal Therapists at or (866) 999-5524.

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