Reciprocal Mother-Infant Voice Exposure in the Neonatal Intensive Care Unit

Hearing Each Other: Effects of Reciprocal Maternal-Infant Voice Exposure on Maternal Attachment and Breastfeeding in the NICU: A Randomized Controlled Trial

This randomized controlled trial evaluates the effect of reciprocal maternal-infant voice exposure on maternal attachment and breastfeeding outcomes in a neonatal intensive care unit (NICU). Infants in the intervention group are exposed to recordings of their mothers' voices, while mothers simultaneously listen to recordings of their infants' sounds between the 6th and 12th postpartum hours. The intervention is administered every 2 hours for 30 minutes. Outcomes include maternal attachment, breastfeeding effectiveness, breastfeeding self-efficacy, infant feeding intention, perceived insufficient milk, and expressed breast milk volume. Neonatal physiological parameters and blood gas values are also assessed. The findings aim to support family-centered NICU care through non-invasive auditory interventions.

Study Overview

• Status: Completed
• Conditions: Breastfeeding; Transient Tachypnea of the Newborn; Neonatal Intensive Care Unit; Maternal Attachment
• Intervention / Treatment: Behavioral: Reciprocal Voice Exposure Group

• Study Type: Interventional
• Enrollment (Actual): 60
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Istanbul, Turkey (Türkiye)
    • Nilgün Avcı

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Mothers aged ≥18 years
• Infants ≥37 weeks gestation
• Diagnosis of transient tachypnea of the newborn (TTN)
• Infant admitted to NICU ≥6 hours
• Ability to communicate in Turkish

Exclusion Criteria:

• Infant clinical deterioration requiring transfer
• Maternal psychiatric disorder
• Hearing impairment

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Reciprocal Voice Exposure Group; Reciprocal auditory stimulation consisting of maternal voice recordings played to infants and infant sound recordings played to mothers every 2 hours for 30 minutes between the 6th and 12th postpartum hours.	Behavioral: Reciprocal Voice Exposure Group; Reciprocal auditory stimulation consisting of maternal voice recordings played to infants and infant sound recordings played to mothers every 2 hours for 30 minutes between the 6th and 12th postpartum hours.
No Intervention: Routine Care Group; Standard NICU care without auditory stimulation.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Maternal Attachment	Measured using the Maternal Attachment Inventory (26 items; scores range from 26 to 104; higher scores indicate stronger attachment).	12th postpartum hour
Breastfeeding Effectiveness	Measured using the Bristol Breastfeeding Assessment Tool (scores range from 0 to 8; higher scores indicate more effective breastfeeding).	12th postpartum hour

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Breastfeeding Self-Efficacy	Measured using the Breastfeeding Self-Efficacy Scale-Short Form (14 items; scores range from 14 to 70; higher scores indicate greater self-efficacy).	12th postpartum hour
Infant Feeding Intention	Measured using the Infant Feeding Intention Scale. Scores range from 0 to 16; higher scores indicate stronger intention to breastfeed.	12th postpartum hour
Perceived Insufficient Milk	Measured using the Perceived Insufficient Milk Scale. Higher scores indicate greater perceived milk insufficiency.	12th postpartum hour
Expressed Breast Milk Volume	Volume of breast milk expressed using an electric pump, measured in milliliters (mL).	Between 6th and 12th postpartum hours
Neonatal Physiological Parameters	Respiratory Rate: Measured in breaths per minute.	6th, 8th, 10th, and 12th postpartum hours
Oxygen Saturation	Peripheral oxygen saturation measured as percentage (%).	6th, 8th, 10th, and 12th postpartum hours.
Heart Rate	Heart rate measured in beats per minute (bpm).	6th, 8th, 10th, and 12th postpartum hours.
Partial Pressure of Oxygen (pO₂)	Partial pressure of oxygen measured in mmHg.	Between 6th and 12th postpartum hours.
Partial Pressure of Carbon Dioxide (pCO₂)	Partial pressure of carbon dioxide measured in mmHg.	Between 6th and 12th postpartum hours.
Blood pH	Blood pH measured as a unitless value.	Between 6th and 12th postpartum hours.
Blood Lactate Level	Blood lactate level measured in mmol/L.	Between 6th and 12th postpartum hours.

Collaborators and Investigators

• Sponsor: Biruni University

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2022
• Primary Completion (Actual): September 30, 2023
• Study Completion (Actual): September 30, 2023

Study Registration Dates

• First Submitted: May 6, 2026
• First Submitted That Met QC Criteria: May 14, 2026
• First Posted (Actual): May 20, 2026

Study Record Updates

• Last Update Posted (Actual): May 20, 2026
• Last Update Submitted That Met QC Criteria: May 14, 2026
• Last Verified: October 1, 2022

More Information

Terms related to this study

• Keywords: Randomized controlled trial; NICU; Auditory stimulation; Maternal voice; Maternal attachment; Breastfeeding outcomes
• Additional Relevant MeSH Terms: Respiratory Tract Diseases; Lung Diseases; Respiration Disorders; Infant, Premature, Diseases; Infant, Newborn, Diseases; Signs and Symptoms, Respiratory; Respiratory Distress Syndrome, Newborn; Respiratory Distress Syndrome; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Pathological Conditions, Signs and Symptoms; Behavior; Signs and Symptoms; Feeding Behavior; Tachypnea; Transient Tachypnea of the Newborn; Breast Feeding
• Other Study ID Numbers: Reciprocal Mother-Infant Voice

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No