AbstractThe purpose of this study was to determine whether maternal perceptions of infant health and behavior made a unique contribution in understanding maternal self‐esteem beyond what could be achieved from objective measures. The Perception of Infant Health (POIH) questionnaire and the Bates ICQ captured the perception of infant health and temperament. Standard medical variables including the Hobel Medical Risk Summary measured the objective aspect of infant health. The Brazelton Neonatal Behavioral Assessment (NBAS) measured objective infant behavior. The Maternal Self‐Report Inventory measured self‐esteem. Eighty mother‐infant dyads, which included healthy, middle socioeconomic class mothers of both full‐term, neurologically normal and preterm infants with a range of medical problems were studied. Negative maternal perceptions of infant health and behavior as well as poorer objective health status were associated with decreased maternal self‐esteem. Perceptual variables of temperament and health made a unique contribution to maternal self‐esteem scores. Regression analysis indicated fussy/difficult, POIH, and NBAS autonomic scores explained a significant amount of variance in materna