Understanding the impact of newborn touch upon mothers of hospitalized preterm neonates.


  • Christopher Barnes PhD, School of Psychology, College of Health, Psychology and Social Care, University of Derby, Derby, U.K.
  • Elvidina N. Adamson-Macedo bPhD, University of Wolverhampton, Retired Prof. Emeritus formerly with School of Health [CHSCI], Wolverhampton, U.K.




Touch, Preterm, Newborn, Self-efficacy, Self-esteem, Attachment


Introduction: Many interventions have been designed to support the development of the preterm baby and minimise the complications of prematurity. However, there is limited evidence of the possible psychological benefits of touch to the mother when she is the one performing the support programme during the hospitalisation of her newborn.

Objective: This study explored whether the type of touch provided to preterm neonates had an impact on maternal self-efficacy, self-esteem and maternal-to-infant attachment, as-well-as newborn weight gain.

Methods: Using a randomised cluster trial, forty babies and their mothers were allocated to one of two groups receiving either a touch-based intervention (TAC-TIC; Touching And Caressing; Tender In Caring) or spontaneous touch.

Results: Mothers who provided the touch-based intervention demonstrated greater increases in self-efficacy, self-esteem and attachment, and babies gained more weight than those using spontaneous touch.

Conclusion: The results indicate that systematic touch interventions may be used to facilitate the mother-baby relationship as well as to promote newborn weight gain.


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Leung C. Born too soon. in E.N. Adamson-Macedo (Ed.), Expanding Frontiers of Neonatology. Special Issue of Neuroendocrinology Letters, 2004 25(1).

Manns SV. Life after the NNU: the long term effects on mothers’ lives, managing a child at home with broncho-pulmonary dysplasia and on home oxygen. Neuro Endocrinology Letters. 2004 Dec 1; 25: 127-32.

Knepfer, G. and Johns, C. (1989) Nursing for Life. Pan Books, Australia.

Pederson DR, Bento S, Chance GW, Evans B, Fox AM. Maternal emotional responses to preterm birth. American Journal of Orthopsychiatry. 1987 Jan; 57(1): 15-21.

Padden T, Glenn S. Maternal experiences of preterm birth and neonatal intensive care. Journal of reproductive and infant psychology. 1997 May 1; 15(2): 121-39.

Adamson-Macedo EN, de Roiste A, Wilson A, Hayes JA, Eaton B, de Carvalho F. systematic gentle/light stroking and maternal random touching of ventilated preterms: A preliminary study. International Journal of Prenatal and Perinatal Psychology and Medicine. 1997; 9(1): 17-31.

Field T. Massage therapy research review. Complementary therapies in clinical practice. 2014 Nov 1; 20(4): 224-9.

Field T, Hernandez-Reif M, Diego M, Schanberg S, Kuhn C. Cortisol decreases and serotonin and dopamine increase following massage therapy. International Journal of neuroscience. 2005 Jan 1; 115(10): 1397-413.

McIlduff A. Parental touch of the neonate: Encourage or condemn?. Australian College of Midwives Incorporated Journal. 1998 Mar 1; 11(1): 18-22.

White-Traut R, Wink T, Minehart T, Holditch-Davis D. Frequency of premature infant engagement and disengagement behaviors during two maternally administered interventions. Newborn and Infant Nursing Reviews. 2012 Sep 1; 12(3): 124-31.

Barabach L, Sedlock J, Salmon K. Making kangaroo care the norm: Implementation of a new model of care. Journal of Obstetric, Gynecologic & Neonatal Nursing. 2012 Jun 1; 41: S53-4.

Adamson-Macedo EN. Effects of tactile stimulation on low and very low birthweight infants during the first week of life. Current psychological research & reviews. 1985 Dec; 4(4): 305-8.

Field T. Interventions in early infancy. Infant Mental Health Journal. 1992 Dec; 13(4): 329-36.

Field T, Diego M, Hernandez-Reif M. Preterm infant massage therapy research: a review. Infant behavior and development. 2010 Apr 1; 33(2): 115-24.

Oehler JM. Research utilization: The NICU environment. Neonatal network: NN. 1996 Apr; 15(3): 85-6.

Harrison L, Olivet L, Cunningham K, Bodin MB, Hicks C. Effects of gentle human touch on preterm infants: pilot study results. Neonatal Network: NN. 1996 Mar 1; 15(2): 35-42.

Harrison L, Sherrod RA, Dunn L, Olivet L. Effects of hospital-based instruction on interactions between parents and preterm infants. Neonatal network: NN. 1991 Apr; 9(7): 27-33.

De Roiste EA. Aspects of tactile stimulation with infants in intensive and special care baby units. University of Glasgow (United Kingdom); 1991.

Ohgi S, Fukuda M, Moriuchi H, Kusumoto T, Akiyama T, Nugent JK, Brazelton TB, Arisawa K, Takahashi T, Saitoh H. Comparison of kangaroo care and standard care: behavioral organization, development, and temperament in healthy, low-birth-weight infants through 1 year. Journal of Perinatology. 2002 Jul; 22(5): 374-9.

Roiste AD, Bushnell IW. Tactile stimulation and pre-term infant performance on an instrumental conditioning task. Journal of Reproductive and Infant Psychology. 1993 Jul 1; 11(3): 155-63.

Róiste ÁD, Bushnell IW. The immediate gastric effects of a tactile stimulation programme on premature infants. Journal of reproductive and infant psychology. 1995 Jan 1; 13(1): 57-62.

de Rόiste A, Bushnell IW. Tactile stimulation: Short-and long-term benefits for pre-term infants. British Journal of Developmental Psychology. 1996 Mar; 14(1): 41-53.

Ruiz-Peláez JG, Charpak N, Cuervo LG. Kangaroo Mother Care, an example to follow from developing countries. Bmj. 2004 Nov 11; 329(7475): 1179-81.

Moore ER, Bergman N, Anderson GC, Medley N. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane database of systematic Reviews. 2016 (11).

Anderzén-Carlsson A, Lamy ZC, Eriksson M. Parental experiences of providing skin-to-skin care to their newborn infant—Part 1: A qualitative systematic review. International journal of qualitative studies on health and well-being. 2014 Jan 1; 9(1): 24906.

Fujita M, Endoh Y, Saimon N, Yamaguchi S. Effect of massaging babies on mothers: pilot study on the changes in mood states and salivary cortisol level. Complementary Therapies in Clinical Practice. 2006 Aug 1; 12(3): 181-5.

Onozawa K, Glover V, Adams D, Modi N, Kumar RC. Infant massage improves mother–infant interaction for mothers with postnatal depression. Journal of affective disorders. 2001 Mar 1; 63(1-3): 201-7.

Gürol A, Polat S. The effects of baby massage on attachment between mother and their infants. Asian nursing research. 2012 Mar 1; 6(1): 35-41.

Benzies KM, Magill-Evans JE, Hayden KA, Ballantyne M. Key components of early intervention programs for preterm infants and their parents: a systematic review and meta-analysis. BMC pregnancy and childbirth. 2013 Jan; 13(1): 1-5.

Adamson-Macedo EN. Neonatal Psychology: Theories and Practice. Journal of Human Growth and Development 2016; 26: 129–32. DOI: https://doi.org/10.7322/jhgd.119236

Prilleltensky I. Cultural assumptions, social justice and mental health: Challenging the status quo. Cultural cognition and psychopathology. 2001: 251-66.

Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychological review. 1977 Mar; 84(2): 191.

Bandura A. Self-efficacy: The exercise of control). New York. 1997.

Koul R. An analysis of the reliability and validity of personal internet teaching efficacy beliefs scale. The Electronic Journal for Research in Science & Mathematics Education. 1999 Jan 1.

Teti DM, Gelfand DM. Behavioral competence among mothers of infants in the first year: The mediational role of maternal self-efficacy. Child development. 1991 Oct; 62(5): 918-29.

Leerkes EM, Crockenberg SC. The development of maternal self-efficacy and its impact on maternal behavior. Infancy. 2002 May 1; 3(2): 227-47.

Pajares, F. Overview of social cognitive theory and of self-efficacy. Retrieved 03/06/2013, from http://www.uky.edu/~eushe2/Pajares/eff.html.

Lappin G. Infant massage: A strategy to promote self-efficacy in parents of blind infants. British Journal of Visual Impairment. 2006 Sep; 24(3): 145-9.

Clausen JM, Aguilar RM, Ludwig ME. Fostering healthy attachment between substance dependent parents and their infant children. Journal of Infant, Child, and Adolescent Psychotherapy. 2012 Oct 1; 11(4): 376-86.

Anzman-Frasca S, Stifter CA, Paul IM, Birch LL. Infant temperament and maternal parenting self-efficacy predict child weight outcomes. Infant Behavior and Development. 2013 Dec 1; 36(4) :494-7.

McGrath MM, Meyer EC. Maternal self-esteem: from theory to clinical practice in a special care nursery. Children’s Health Care. 1992 Sep 1; 21(4): 199-205.

Mercer RT. Parents at risk. Springer Publishing Co; 1990.

Farrow C, Blissett J. Maternal cognitions, psychopathologic symptoms, and infant temperament as predictors of early infant feeding problems: a longitudinal study. International Journal of Eating Disorders. 2006 Mar; 39(2): 128-34.

Chang Y, Fine MA, Ispa J, Thornburg KR, Sharp E, Wolfenstein M. Understanding parenting stress among young, low-income, African-American, first-time mothers. Early Education and Development. 2004 Jul 1; 15(3): 265-82.

Graham SM, Clark MS. Self-esteem and organization of valenced information about others: The” Jekyll and Hyde”-ing of relationship partners. Journal of Personality and Social Psychology. 2006 Apr; 90(4): 652.

Als H. A synactive model of neonatal behavioral organization: framework for the assessment of neurobehavioral development in the premature infant and for support of infants and parents in the neonatal intensive care environment. Physical & Occupational Therapy in Pediatrics. 1986 Jan 1; 6(3-4): 3-53.

Spielman V, Taubman-Ben-Ari O. Parental self-efficacy and stress-related growth in the transition to parenthood: A comparison between parents of pre-and full-term babies. Health & Social Work. 2009 Aug 1; 34(3): 201-12.

Cody AL. The effects of infant massage on the attitudes and perceptions of mothers who massage their hospitalized premature infants. The Wright Institute; 1995.

Müller ME. A questionnaire to measure mother-to-infant attachment. Journal of Nursing measurement. 1994 Jan 1; 2(2): 129-41.

Raval V, Goldberg S, Atkinson L, Benoit D, Myhal N, Poulton L, Zwiers M. Maternal attachment, maternal responsiveness and infant attachment. Infant Behavior and Development. 2001 Mar 1; 24(3): 281-304.

Roskam I, Meunier JC, Stievenart M. Parent attachment, childrearing behavior, and child attachment: Mediated effects predicting preschoolers’ externalizing behavior. Journal of Applied Developmental Psychology. 2011 Jul 1; 32(4): 170-9.

Egeland B, Hiester M. The long-term consequences of infant day-care and mother-infant attachment. Child development. 1995 Apr; 66(2): 474-85.

Feldman R, Weller A, Sirota L, Eidelman AI. Testing a family intervention hypothesis: the contribution of mother-infant skin-to-skin contact (kangaroo care) to family interaction, proximity, and touch. Journal of Family Psychology. 2003 Mar; 17(1): 94.

Barnes CR, Adamson-Macedo EN. Perceived maternal parenting self-efficacy (PMP SE) tool: Development and validation with mothers of hospitalized preterm neonates. Journal of advanced nursing. 2007 Dec; 60(5): 550-60.

Shea E. Tronick E (Belester M. Yongman eds). The Maternal Self-Report Inventory, a research and Clinical Instrument for Assessing Maternal Self-Esteem. Theory and research in behavioral pediatrics. New York: Plenun Press. 1988; 4: 109-40.

Condon JT, Corkindale CJ. The assessment of parent-to-infant attachment: development of a self-report questionnaire instrument. Journal of Reproductive and Infant Psychology. 1998 Feb 1; 16(1): 57-76.

Jefferies AL, Canadian Paediatric Society, Fetus and Newborn Committee. Kangaroo care for the preterm infant and family. Paediatrics & child health. 2012 Mar 1; 17(3): 141-3.