Maternal Plasma and Milk Free Cortisol during the First 3 Days of Breast-Feeding following Spontaneous Delivery or Elective Cesarean Section

Abstract

In a view of the increased clinical interest in the presence of hormones in human milk, the objective of this study was to evaluate maternal plasma and milk cortisol levels in early puerperium and their relationship in breast-feeding in women who underwent elective cesarean section or who delivered vaginally. During the first 3 days of breast-feeding, plasma and milk cortisol levels declined significantly both in women who underwent elective cesarean section and in women who had spontaneous deliveries. Moreover, the breast-feeding procedure did not affect maternal plasma and milk hormonal levels, since no differences between the cortisol levels measured immediately before and after morning daily breast-feeding were detected. Furthermore, a very high positive correlation (p < 0.001) was found between plasma and milk cortisol concentrations. Therefore, maternal plasma cortisol levels can be considered a very reliable measure to predict the hormonal concentration in breast milk.

Breastfeeding after cesarean delivery: a systematic review and meta-analysis of world literature

“…The full text was unobtainable for 3 studies (68)(69)(70). Of the remaining 100 studies, 47 were excluded for the following reasons: multiple reports of the same study population (32,(71)(72)(73)(74), selective study population (including studies in which all women intended to breastfeed) (32,40,58,64,(75)(76)(77)(78)(79), only qualitative data reported (43,80,81), or no suitable data on breastfeeding reported . The remaining 53 studies were included in the systematic review ( Table 1).…”

Correlation between maternal and infant cortisol varies by breastfeeding status

“…Previous studies have hypothesized a direct transfer of cortisol from mother to baby via human milk (Bright et al, 2011; Patacchioli et al, 1992; Stenius et al, 2008), however the literature examining the transfer or mechanisms of hormonal action via human milk is relatively sparse and inconclusive (Bernt & Walker, 1999; Nemsadze & Silagava, 2010; Tharner et al, 2012; Tu, Lupien, & Walker, 2005; Zanardo et al, 2001). In our study, mothers were instructed to wait until after the first saliva collection before feeding their infants.…”

“…One potential mechanism is the transfer of biologically active elements, such as cortisol, through human milk. Infants who are breastfed in their first year of life have higher cortisol levels than formula-fed infants (Cao et al, 2009) and studies suggest that cortisol present in human milk may be transmitted via breastfeeding from mother to baby (Bright, Granger, & Frick, 2011; Patacchioli et al, 1992; Stenius et al, 2008). In addition, breastfeeding may influence infant cortisol levels through the physical interactions that occur between mother and infant, leading to greater synchrony in cortisol levels.…”

Risk of early breastfeeding cessation among symmetrical, small for gestational age infants

“…Antenatal corticosteroids, given to enhance foetal maturation, have an adverse effect on the success of subsequent lactation (Henderson et al 2008). During the first 3 days of breast-feeding, plasma and milk cortisol levels decline significantly (Patacchioli et al 1992). Lactating women expressing transitional (post-partum days 4 -14) and mature milk (post-partum days 15 -180) have significantly lower serum cortisol concentrations than lactating women expressing colostrum (post-partum days 1 -3) (Ilcol et al 2006).…”