Maternal and Neonatal Hair Cortisol Levels and Psychological Stress Are Associated With Onset of Secretory Activation of Human Milk Production

Abstract

Background: Several factors can influence the production of human milk. Purpose: To assess the influence of maternal psychological stress, maternal cortisol levels, and neonatal hair cortisol levels on the production of human milk. Methods: A prospective study was conducted at 2 public health centers in Andalusia, Spain. Participants were 60 pregnant women and their 60 neonates. Hair cortisol levels and psychological stress (pregnancy-specific stress [PDQ], perceived stress [PSS]), was evaluated during the third trimester and the postpartum period. Results: Higher PDQ scores during the third trimester were associated with later human milk production (P < 0.05). Higher PSS scores in the third trimester were associated with later human milk production (P < 0.05). Higher postpartum maternal hair cortisol levels were associated with a delayed secretory activation of human milk (P < 0.05). Implications for Research: Future studies should study the influence of psychological stress and cortisol levels on the variety of hormones involved in human milk production. Implications for Practice: Neonatal nurses and other health care providers are encouraged to should be familiar with the level of maternal prenatal stress and how much stress neonates were exposed to before birth.