Differential Maternal Physiological Stress Responses During Rooming-In: High Stress in Newborn Sleeping versus Relief...

Postpartum stress (PPS) significantly risks maternal-infant health, yet how specific newborn behavioral states are dynamically associated with maternal physiological stress during rooming-in remains unknown.

This study examined the associations among maternal stress, rooming-in levels, and newborn states during early postpartum hospitalization.

A prospective repeated-measures observational study with consecutive sampling was conducted at a hospital in Taiwan. Eligible participants were healthy, full-term, primiparous women after vaginal birth accompanied by a partner; those with clinical complications or cardiac arrhythmias were excluded. A total of 43 women completed the overall longitudinal assessments. Maternal normalized low frequency (nLF) was monitored via portable ECG across four newborn states (crying, breastfeeding, being held, sleeping). Among them, a subgroup of 30 mothers provided complete newborn state diaries and continuous ECG data for synchronized analysis. Data were analyzed with descriptive statistics, paired samples t-tests, and correlation tests.

Overall maternal nLF increased significantly from Day 1 (T1) to Day 3 (T2) (p=0.022, N=43). No significant associations were observed between nLF and rooming-in levels (p>0.05, n=30). Contrary to our hypothesis, 73% of participants experienced the highest level of maternal physiological stress while the infant slept (nLF=65.4%), suggesting a state of situational alertness. Conversely, breastfeeding demonstrated a distinct stress-relieving potential, with 40% of participants exhibiting their lowest stress levels (nLF=60.2%).

Infant sleep is linked to maternal situational alertness rather than rest, while breastfeeding offers stress-relief potential. This study provides preliminary exploratory evidence that maternal autonomic activity varies across caregiving contexts.