Date of Completion


Embargo Period



Skin-to-Skin, Oxytocin, Prematurity, Kangaroo care

Major Advisor

Jacqueline McGrath

Associate Advisor

JoAnn Robinson

Associate Advisor

Xiaomei Cong

Field of Study



Doctor of Philosophy

Open Access

Open Access


Over 15 million premature infants are born annually around the world. It has been optimistically yet incorrectly proposed that healthy preterm infants without major complications eventually catch-up developmentally to full-term infants. Maternal touch, especially during skin to-skin contact (SSC) has the potential to reduce adverse consequences of prematurity. The aim of this dissertation is to increase understanding of mechanisms that link parent infant contact to bio-behavioral responses for parents and their healthy preterm infants. This study is an important step in exploring oxytocin as a potential moderator to improve infant developmental outcomes and the effects of SSC on the mother, father, infant and their developing relationships. SSC activates oxytocin release in mothers, fathers and healthy preterm infants. Infant oxytocin responses were similar whether the infant was held by the mother or father. SSC decreases salivary cortisol levels for infants held by their mother and father. SSC also decreases parental stress and anxiety. Parents and infants who have higher oxytocin levels have more synchronous and responsive interactions. Nurses can use SSC as a strategy to decrease stress in the Neonatal Intensive Care Unit for parents as well as premature infants to provide an opportunity to enhance developing relationships and support parental engagement. Another important concept to consider is utilizing these findings to influence policy change at a systemic level in regards to education for health care professionals, and the integration of skin-to-skin contact into clinical practice of the NICU along with community awareness and the influence of using SSC to improve health outcomes.