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What Are the Effects of the Maternal Voice on Preterm Infants in the NICU?

Williamson, Selena BSN, RN; McGrath, Jacqueline M. PhD, RN, FNAP, FAAN

Section Editor(s): Gephart, Sheila

doi: 10.1097/ANC.0000000000000578
Evidence Based Practice Brief

Background/Significance: Premature infants often experience extended stays in the neonatal intensive care unit (NICU) as opposed to home with parents. This prolonged separation creates a strain for both parents and infants, decreasing attachment and parental caregiving. One strategy to combat this shared stress is increasing parental participation, particularly through the use of their voices whether parents are present or not.

Purpose: This Evidence-Based Practice Brief column explores the connection between mother and child, specifically the effects of maternal voice on infant autonomic stability, weight gain, and behavioral states.

Methods: A systematic search of CINAHL, PubMed, and PsycInfo was used to identify studies involving the use of maternal voice intervention with preterm infants in the NICU.

Results: Fifteen studies were identified. Three intervention categories emerged: (1) live maternal speech, (2) recorded maternal speech (subcategories included whether intervention content was prescribed or not), and (3) recorded maternal speech that was combined with biological maternal sounds (heart rate). Within each category, studies were organized chronologically to reflect how knowledge has changed overtime.

Implications for Practice: Maternal voice has physiological as well as behavioral and emotional effect on preterm infants. Several studies found that maternal voice increased autonomic stability improving (heart rate and respirations) as well as weight gain. No negative effects were identified. Given these findings, incorporating different types of maternal voice into routine care by the bedside nurse can assist the mother in feeling more involved in her infant's care without seemingly being a distraction or obstacle to providers.

Implications for Research: A major limitation for generalizability was sample size; more research is needed with larger sample sizes replicating interventions types to discern best outcomes.

Video Abstract available at

School of Nursing, University of Connecticut, Storrs (Ms Williamson); and School of Nursing, University of Texas Health Science Center San Antonio (Dr McGrath). Ms Williamson is a BS undergraduate nursing student.

Correspondence: Selena Williamson, BSN, RN, 118 A. Baltic Hanover Rd, Baltic, CT 06330 (

No competing interests exist.

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© 2019 by The National Association of Neonatal Nurses