Effects of maternal voice on pain and mother–Infant bonding in premature infants in Taiwan: A randomized controlled trial

Wan Chen Yu, Ming Chou Chiang, Kuan Chia Lin, Chun Chu Chang, Kai Hui Lin, Chi-Wen Chen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Purpose: This study aimed to examine the effectiveness of maternal voice in alleviating premature infants' pain during the heel sticks and facilitating mother–infant bonding during hospitalization. Design and methods: A randomized controlled trial with a parallel group design was conducted in which 64 premature infant–mother dyads were randomly assigned to an intervention group or a control group. Voice recordings of the mother reading a children's book were created and subsequently played for the infant during a heel stick procedure once daily for 3 consecutive days. The primary outcomes were heart rate, respiratory rate, oxygen saturation, and pain response assessed using the Neonatal Infants Pain Scale before, during, and after the procedure. The secondary outcome was mother–infant bonding evaluated using the Mother–Infant Bonding Inventory on the seventh postnatal day. Data were analyzed using generalized estimation equations. Results: The two groups did not significantly differ in length of gestation, sex, weight, or other demographic characteristics. At 1 min after the procedure, the intervention group had a lower heart rate (p < 0.001) and Neonatal Infants Pain Scale score (p < 0.001) than the control group did. Conclusions: The maternal voice intervention slowed the heart rate and alleviated the pain response of the hospitalized premature infants. Practice implications: This intervention has clinical potential to provide mothers with an opportunity to care for their infants and infants with an opportunity to be soothed during health care, thus enhancing the infant–mother connection. The clinical trial registration number is NCT04158206.

Original languageEnglish
Pages (from-to)e136-e142
Number of pages7
JournalJournal of Pediatric Nursing
StateAccepted/In press - 30 Sep 2021


  • Bonding
  • Maternal voice
  • Pain
  • Premature infant
  • Randomized controlled trial


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