When placing a shunt at birth for hydrocephalus secondary to IVH, how do you decide between a programmable and non-programmable shunt?

In infants, I exclusively use programmable shunts. My feeling is that shunt requirements change as the child grows and the fontanelle ultimately closes. Over the first year of life, I titrate the resistance of the shunt to the maximal setting tolerated by the child. I use developmental milestones, p...

I rarely use a programmable shunt, especially for an infant. The only circumstance would be an infant with extreme hydrocephalus for whom I’m worried about ventricular collapse and the development of subdural collections or hematomas.