Sitting position for lumbar puncture in an infant

The assistant grasps one of the infant's arms and one of the legs in each hand while supporting the head to prevent excessive flexion at the neck. Older children should be asked to sit with their legs hanging over the edge of the examining table. They can be flexed over a pillow with the elbows resting on the knees. An assistant may be helpful, even in a cooperative child, in maintaining alignment throughout the procedure.