Iranian Journal of Neonatology

Iranian Journal of Neonatology

Effect of Horizontal Rocking on Maternal-Neonatal Attachment Behaviors in Mothers with Premature Neonates Hospitalized in NICU: A Randomized Clinical Trial Study

Document Type : Original Article

Authors
Zahra Nikbakhti 1
Zahra Pourmovahed 2
Mitra Soltanian 3
1 Department of Nursing, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2 Department of Nursing Education, Research Center for Nursing and Midwifery Care, Comprehensive Research Institute for Maternal and Child Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
3 Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
10.22038/ijn.2025.81106.2565
Abstract
Background: Mother-neonate attachment is impaired when a premature neonate is hospitalized, affecting the neonate’s growth and development and the mother’s ability to care for the infant. This study aimed to determine the effect of horizontal neonate rocking on the attachment behaviors of mothers with premature neonates admitted to the neonatal intensive care unit (NICU).
Methods: This clinical trial was conducted on 64 mothers with premature neonates hospitalized in the NICU of Hafezieh Hospital and Hazrat Zeinab Hospital in Shiraz in 2023. Participants were selected using convenience sampling and randomly assigned to control and intervention groups. In the intervention group, mothers performed horizontal rocking for two weeks, five days a week, four times a day for three minutes each time, half an hour before feeding their neonates. The Avant attachment questionnaire was completed by all participants. Data were analyzed using SPSS 24 with independent t-tests, paired t-tests, and chi-square tests.
Results: After the intervention, the mother-neonate attachment score was significantly higher in the intervention group (18.58±3.85) compared to the control group (12.91±2.70) (P<0.001). In the intervention group, the mean scores for emotional behaviors increased from 4.64±1.43 to 6.84±1.93, and proximity behaviors increased from 2.61±1.45 to 7.10±1.51 (P<0.001). However, the mean score for caring behavior showed no significant difference between before (5.55±1.06) and after (4.65±1.14) the intervention (P>0.05).
Conclusion: Horizontal rocking of neonates increased attachment behaviors, specifically emotional and proximity behaviors, in mothers with premature neonates. It is recommended that nurses in the NICU teach mothers the correct method of rocking premature neonates horizontally to enhance mother-neonate attachment.
 
Keywords
Horizontal rocking
Maternal-infant attachment
Neonatal intensive care unit
Premature neonate 
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Iranian Journal of Neonatology
Volume 17, Issue 1
Winter 2026
Pages 34-40