Do gentle movements to stimulate the inner ear and brain (vestibular stimulation), improve the health of babies born before nine months of pregnancy?

Key messages

• We are unsure about the effects of rocking premature babies to stimulate their inner ear and brain (vestibular stimulation) on death compared to no stimulation; there may be little to no difference in weight gain.

• We identified too few studies to report on the effects of vestibular stimulation on physical or mental development, such as learning difficulties, cerebral palsy, or blindness. No studies compared one type of vestibular stimulation with another, so it is unclear which types of vestibular stimulation are most effective.

• Future studies should be bigger, use more robust methods, and define and report their research more clearly.

What is the vestibular system?

The vestibular system is a sensory system within the inner ear and the brain. It controls balance and physical coordination. It helps us maintain our posture when standing, sitting or walking; it helps our brains to process what we see and hear. It is vital to navigate the day-to-day world. Like other organs and sensory systems, the vestibular system develops while we are in the womb.

What is vestibular stimulation?

Vestibular stimulation involves body movements such as rocking, swinging, rolling, turning and bouncing. In the womb, babies receive this type of stimulation through the mother's movements. After birth, babies receive this type of stimulation when they are held and fed, washed and changed, played with, and moved around onto their tummies or sides. Premature babies, born before nine months of pregnancy, may not receive as much of this type of stimulation as babies born at nine months because they may be quite small and fragile, or ill and in an incubator. This may affect their physical and mental development. For example, they may develop breathing problems, not gain weight, or be deaf or blind.

What did we want to find out?

We wanted to find out if stimulating the vestibular systems of hospitalized, premature babies by gently rocking, repositioning, swinging in a hammock, or laying on a waterbed or on an air mattress could be helpful and safe for their short-term and long-term well-being. Specifically, we wanted to find out if vestibular stimulation might:

• decrease the number of babies who develop physical or mental delays at 18 to 24 months of age;

• increase infants' weight gain;

• reduce death in babies during hospitalization after birth.

What did we do?

We searched for studies set in neonatal intensive care units that compared:

• any type of vestibular stimulation to no vestibular stimulation;

• one type of vestibular stimulation to another. For example, hammock swinging compared to waterbed rocking.

We compared and summarized the results of the studies and rated our confidence in the evidence based on factors such as the size of the study (number of babies) and the methods of the study.

What did we find?

We found 4 studies with 196 premature infants. Three studies took place in the USA and 1 in Canada. Healthcare professionals carried out vestibular stimulation in all studies. The studies investigated different types of vestibular stimulation.

• One study evaluated vestibular stimulation with an air mattress swinging back and forth in a regular rhythm.

• One study evaluated vestibular stimulation with a waterbed swinging back and forth in a regular rhythm.

• One study evaluated rocking.

• One study evaluated stimulation with a rocking chair (VestibuGlide).

No studies provided evidence about disabilities such as cerebral palsy, delayed physical or mental development, blindness or deafness. We did not find any studies that directly compared different types of vestibular stimulation.

Main results

Vestibular stimulation compared to no intervention

It is very uncertain whether vestibular stimulation, compared to no stimulation, has any effect on death (1 study, 122 babies).

Three studies (169 babies) investigated weight gain, but they all defined it differently and measured it over different periods, so we could not combine their results. We don't know whether vestibular stimulation makes any difference to weight gain compared to no stimulation.

What are the limitations of the evidence?

We have little confidence in these results, as the few studies we found were not well-designed and included few babies. Several studies did not report on outcomes or lacked data that we were interested in.

How up-to-date is this evidence?

The evidence is current up to 26 October 2025.