The Effect of Watching Infant Video With or Without Smelling an Infant-Scented Hat With Infant Scent on Anxiety, Milk Volume, Stress, and Attachment in Mothers of Hospitalized Infants in the Neonatal Intensive Care Unit: A Randomized Controlled Trial

Shahla Shafaati Laleh; Sevil İnal; Mohammadbagher Hosseini; Shirin Hasanpoor; Hamideh Nikzad; Mojgan Mirghafourvand

doi:10.1002/hsr2.72468

The Effect of Watching Infant Video With or Without Smelling an Infant-Scented Hat With Infant Scent on Anxiety, Milk Volume, Stress, and Attachment in Mothers of Hospitalized Infants in the Neonatal Intensive Care Unit: A Randomized Controlled Trial

Health Sci Rep. 2026 May 3:9:e72468. doi: 10.1002/hsr2.72468. eCollection 2026 May.

Authors

Shahla Shafaati Laleh¹, Sevil İnal², Mohammadbagher Hosseini³, Shirin Hasanpoor⁴, Hamideh Nikzad⁵, Mojgan Mirghafourvand⁶

Affiliations

¹ Faculty of Medicine, Department of Midwifery Urmia Islamic Azad University Urmia Iran.
² Faculty of Health Science, Midwifery Department Istanbul University- Cerrahpasa Istanbul Türkiye.
³ Neonatologist, Pediatric Health Research Center Tabriz University of Medical Sciences Tabriz Iran.
⁴ Physical Medicine and Rehabilitation Research Center Tabriz University of Medical Sciences Tabriz Iran.
⁵ Clinical Research Center of Al-Zahra Hospital Tabriz University of Medical Sciences Tabriz Iran.
⁶ Social Determinants of Health Research Center Tabriz University of Medical Sciences Tabriz Iran.

Abstract

Background and aims: An infant's unique scent can significantly foster a deep emotional connection between mother and baby. This study aimed to determine the effect of watching infant video with or without smelling an infant-scented hat on anxiety and breast milk volume (primary outcomes), stress and mother-infant attachment (secondary outcomes) in mothers with hospitalized infants in the neonatal intensive care unit (NICU).

Methods: In this randomized controlled trial, 78 mothers were allocated to three groups using block randomization: intervention group 1 (infant-scented hat plus video), intervention group 2 (video only), and a control group (plain hat). The intervention lasted 5 days. All mothers received training on breast pumping and recording their milk volume. Data were analyzed using analysis of covariance.

Results: Compared with the control group, both interventions led to significant improvements in state anxiety (Group 1: adjusted mean difference [AMD] = -16.40, 95%CI: -24.56 to -8.24, p < 0.001; Group 2: AMD = -13.83, 95%CI: -21.26 to -6.40, p < 0.001), trait anxiety (Group 1: AMD = -11.54, 95%CI: -16.29 to -6.80, p < 0.001; Group 2: AMD = -11.57, 95%CI: -15.87 to -7.26, p < 0.001), and perceived stress (Group 1: AMD = -2.11, 95%CI: -3.67 to -0.56, p = 0.004; Group 2: AMD = -1.86, 95%CI: -3.39 to -0.33, p = 0.001). Milk volume (mL) in Group 1 was significantly higher than in the control group (Day 3: MD = 37.85, 95%CI: 4.13 to 71.56, p = 0.023; Day 4: MD = 49.13, 95%CI: 9.73 to 88.53, p = 0.010; Day 5: MD = 80.55, 95%CI: 34.85 to 126.26, p = 0.001). On Day 5, milk volume in Group 2 was significantly higher than in the control group (MD = 51.05, 95%CI: 5.17 to 96.93, p = 0.024). Mother-infant attachment scores were significantly higher in Group 1 compared with the control group (MD = 3.56, 95%CI: 0.93 to 6.19, p = 0.004).

Conclusion: Scent-infused materials and infant video exposure during NICU hospitalization may reduce maternal anxiety and stress, enhance milk production, and improve attachment, supporting development of targeted NICU interventions.

Keywords: anxiety; attachment; breast milk; neonatal intensive care unit; olfactory stimuli; perceived stress.