Psychosocial stress and cortisol stress reactivity predict breast milk composition

Abstract

We studied a sample of 146 Polish, exclusively breastfeeding mothers and their healthy born on time infants to explore the effect of perinatal psychosocial stress on breast milk composition. Maternal perinatal stress was assessed using Recent Life Changes Questionnaire summarizing stressful events from the previous six months. Stress reactivity was determined by administering the cold pressor test and measuring cortisol in saliva samples taken during the test. Breast milk sample was taken to measure energy, protein, fat, lactose, and fatty acid content. Analyses revealed that stress reactivity was positively associated with milk fat and long-chain unsaturated fatty acids and negatively associated with milk lactose. Perinatal psychosocial stress negatively affected energy density, fat as well as medium-chain and long-chain saturated fatty acids in milk. These results, together with previous studies, advocate monitoring maternal psychological status during the peripartum to promote breastfeeding and healthy infant nutrition.

Environmental determinants of human milk composition in relation to health outcomes

“…In a recent study, perinatal psychosocial stress (the intensity and number of maternal stressor) was negatively associated with FAs concentration and energy density of HM, while stress reactivity (cortisol measured in saliva taken during the cold pressor test) associated positively with fat and FAs and negatively with lactose. 47 The HM immune factors though were not affected by natural variations in maternal distress (questionnaires for stress, anxiety and depressive symptoms). 49 The level of cortisol in the amniotic fluid has been shown to be inversely correlated with infant cognitive development.…”

“…A short period of anxiety (acute stress), such as during infant hospitalisation, does not seem to affect HM macronutrient content, 48 whereas long‐term (chronic) stress results in the cumulative glucocorticoid burden and is associated with maternal diet and BC changes, thus may lead to HM composition changes. In a recent study, perinatal psychosocial stress (the intensity and number of maternal stressor) was negatively associated with FAs concentration and energy density of HM, while stress reactivity (cortisol measured in saliva taken during the cold pressor test) associated positively with fat and FAs and negatively with lactose 47 . The HM immune factors though were not affected by natural variations in maternal distress (questionnaires for stress, anxiety and depressive symptoms) 49 …”

“…Maternal psychological stress (acute and chronic) that accompanies birth and childcare has multiple origins and may impact HM composition, milk production and potentially infant outcomes; however, the effects of stress on lactation are poorly understood and only few studies have investigated effect on HM composition with mixed results. 47 The measures of maternal stress are usually maternal questionnaires for long-term stress, and glucocorticoids (cortisol, measured in plasma or saliva) for both long-and shortterm stress. A short period of anxiety (acute stress), such as during infant hospitalisation, does not seem to affect HM macronutrient content, 48 whereas long-term (chronic) stress results in the cumulative glucocorticoid burden and is associated with maternal diet and BC changes, thus may lead to HM composition changes.…”

“…Maternal psychological stress (acute and chronic) that accompanies birth and childcare has multiple origins and may impact HM composition, milk production and potentially infant outcomes; however, the effects of stress on lactation are poorly understood and only few studies have investigated effect on HM composition with mixed results 47 . The measures of maternal stress are usually maternal questionnaires for long‐term stress, and glucocorticoids (cortisol, measured in plasma or saliva) for both long‐ and short‐term stress.…”

Milking it for all it’s worth: The effects of environmental enrichment on maternal nurturance, lactation quality, and offspring social behavior

“…This is in addition to reducing milk vitamin and mineral content (Smit et al, 2000;Spring et al, 1985;Sauerwald et al, 2001). However, even non-disastrous contexts such as psychosocial stress negatively correlates with maternal milk fat and energy content (Ziomkiewicz et al, 2021) and mothers who reported higher levels of perceived stress exhibited significantly lower levels of milk immunoglobulin A (Moirasgenti et al, 2019;Groer et al, 2004). Stress arising from perinatal anxiety and depression can also be associated with significant differences in milk composition, including a reduction in DHA, increased sodium, and increased transforming growth factor β-2 (reviewed in Di Benedetto et al, 2021).…”