Award Date

August 2023

Degree Type


Degree Name

Doctor of Philosophy (PhD)



First Committee Member

Hyunhwa Lee

Second Committee Member

Du Feng

Third Committee Member

Rebecca Benfield

Fourth Committee Member

Lela Rankin Williams

Fifth Committee Member

Peter Gray

Number of Pages



Babywearing is the practice of carrying an infant in a baby carrier close to the body. It provides an environment that allows the bodies of the parent and infant to be close together. The closeness of parent and infant improves the well-being and coregulation of the parent and infant, which could be estimated with heart rate (HR). Few studies have examined mother-infant dyads, but even fewer have examined father-infant dyads. This study examined mother-infant and father-infant dyads, especially for infants with neonatal abstinence syndrome (NAS). The significance of studying babywearing in this vulnerable population is that if babywearing is associated with a decrease in HR, it would indicate a possible decrease in distress among infants with NAS. Babywearing would benefit the infant and possibly the parent through autonomic coregulation, improving their well-being.Autonomic coregulation occurs when the parent and infant coregulate through their behaviors (e.g., emotional communication), influencing the autonomic nervous system. Per the Calming Cycle Theory, autonomic coregulation and emotional connection are influenced by emotional communication between the parent and infant (e.g., eye contact, listening, vocalization, or facial expressiveness). Babywearing facilitates emotional communication by providing an environment where the parent's and infant's bodies are near each other. This nearness allows the infant and parent to respond readily to each other's emotional cues. Insight into autonomic coregulation can be seen through heart rate, as the autonomic nervous system controls the heartbeats from the sinoatrial node. Therefore, babywearing may improve autonomic coregulation and emotional connection simultaneously because it provides a condition that facilitates the behaviors found in emotional communication. This study examined the influence of babywearing on the heart rate (HR) of infants with NAS and their parents, using the Calming Cycle Theory as the framework, where autonomic coregulation was examined through HR. The research question explored was: Does babywearing influence parents' and infant's HRs (PHR and IHR)? The aims of this proposal examined the influence of babywearing on PHR and IHR, the correlation between PHR and IHR, and the association between parents' gender on PHR and IHR. Secondary data analysis was completed using the Newborn Wellness and Attachment Study data (PI: Rankin). Statistical analysis was conducted using HLM 8 and SPSS. Mixed model analyses and Pearson correlation coefficient analyses were conducted to examine these hypotheses. Although the results of the analyses did not support any of the hypotheses in the expected direction, there were two statistically significant findings. PHR increased during babywearing when examining parents with their infant who was not medicated, and mother's HR and IHR had the strongest correlation during babywearing. The significant finding in the mother-infant dyad during babywearing indicates that autonomic coregulation may be at work, supporting the Calming Cycle Theory. A significant correlation was found between PHR and IHR during babywearing for the mother-infant dyad. Based on this study, babywearing may be a remarkable nonpharmacological intervention for infants with NAS and their parents to improve the autonomic coregulation between the dyads. However, further research is needed to examine the effects of babywearing on autonomic coregulation.


Babywearing; NAS; NICU



Degree Grantor

University of Nevada, Las Vegas




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