Association Between Maternal Mood and Oxytocin Response to Breastfeeding

1 Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina School of Medicine , Chapel Hill, North Carolina.
Journal of Women's Health (Impact Factor: 2.05). 04/2013; 22(4):352-61. DOI: 10.1089/jwh.2012.3768
Source: PubMed


Postpartum depression is associated with reduced breastfeeding duration. We previously hypothesized that shared neuroendocrine mechanisms underlie this association. We sought to measure the association between maternal mood and neuroendocrine response to breastfeeding.

We conducted a longitudinal cohort study of women recruited during pregnancy who intended to breastfeed. Baseline depression and anxiety history were assessed with a structured clinical interview. We measured mood symptoms using validated psychometric instruments, and we quantified affect and neuroendocrine responses to breastfeeding during laboratory visits at 2 and 8 weeks postpartum.

We recruited 52 women who intended to breastfeed, among whom 47 completed 8-week follow-up. Duration and intensity of breastfeeding through 8 weeks were similar among mothers with lower versus higher anxiety and depression scores. In the third trimester, oxytocin was inversely correlated with Edinburgh Postnatal Depression Scale (EPDS) score (p=0.03). We did not find differences in neuroendocrine profile during breastfeeding at 2 weeks postpartum. Among the 39 women who breastfed at 8 weeks postpartum, oxytocin area under the curve during breastfeeding was inversely correlated with maternal EPDS and STAI-State and STAI-Trait anxiety scores (all p≤0.01). Higher anxiety and depression scores was further associated with lower oxytocin (group p<0.05) during feeding. During feeding at both visits, higher anxiety and depression scores were also associated with more negative affect: mothers reported feeling less happy and more depressed, overwhelmed, and stressed during feeding than women with lower scores.

Symptoms of depression and anxiety were associated with differences in oxytocin response and affect during breastfeeding.

20 Reads
  • Source
    • "In fact, human postmortem studies found increases in the number, size and mRNA expression of oxytocin neurons in the paraventricular nucleus (PVN) between patients with a past diagnosis of depression compared to healthy controls (Meynen et al., 2007; Purba et al., 1996). Studies of oxytocin in PPD women found that women at risk for PPD (EDPS scores N 10) had lower plasma oxytocin concentration in their last trimester (Skrundz et al., 2011; Stuebe et al., 2013). However, administering oxytocin to women suffering from PPD resulted in lowered mood, albeit in a small sample study (Mah et al., 2013). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Pregnancy and the postpartum is associated with dramatic alterations in steroid and peptide hormones which alter the mothers' hypothalamic pituitary adrenal (HPA) and hypothalamic pituitary gonadal (HPG) axes. Dysregulations in these endocrine axes are related to mood disorders and as such it should not come as a major surprise that pregnancy and the postpartum period can have profound effects on maternal mood. Indeed, pregnancy and the postpartum are associated with an increased risk for developing depressive symptoms in women. Postpartum depression affects approximately 10-15% of women and impairs mother-infant interactions that in turn are important for child development. Maternal attachment, sensitivity and parenting style are essential for a healthy maturation of an infant's social, cognitive and behavioral skills and depressed mothers often display less attachment, sensitivity and more harsh or disrupted parenting behaviors, which may contribute to reports of adverse child outcomes in children of depressed mothers. Here we review, in honor of the "father of motherhood", Jay Rosenblatt, the literature on postnatal depression in the mother and its effect on mother-infant interactions. We will cover clinical and pre-clinical findings highlighting putative neurobiological mechanisms underlying postpartum depression and how they relate to maternal behaviors and infant outcome. We also review animal models that investigate the neurobiology of maternal mood and disrupted maternal care. In particular, we discuss the implications of endogenous and exogenous manipulations of glucocorticoids on maternal care and mood. Lastly we discuss interventions during gestation and postpartum that may improve maternal symptoms and behavior and thus may alter developmental outcome of the offspring. Copyright © 2015. Published by Elsevier Inc.
    Hormones and Behavior 08/2015; DOI:10.1016/j.yhbeh.2015.08.008 · 4.63 Impact Factor
  • Source
    • "sorder . Oxytocin has a key role in regulating emotion , social interaction , and stress reactivity ( Carter , 1998 ; Neumann and Landgraf , 2012 ) . It is also central to normal birth , lactation , and mother – infant attachment ( Carter , 1998 ; Feldman , 2012 ) . In addition , reductions in oxytocin measured in plasma ( Skrundz et al . , 2011 ; Stuebe et al . , 2013 ) have been associated with PPD . Oxytocin exerts its effect on the cell through interaction with the oxytocin receptor gene ( OXTR ) , a G - protein coupled receptor that upon ligand binding transduces signal to the nucleus ( Gimpl and Fahrenholz , 2001 ) . Transcription of the OXTR is modulated by DNA methylation of a group of sites l"
    [Show abstract] [Hide abstract]
    ABSTRACT: Postpartum depression (PPD) affects up to 19% of women, negatively impacting maternal and infant health. Reductions in plasma oxytocin levels have been associated with PPD and heritability studies have established a genetic contribution. Epigenetic regulation of the oxytocin receptor gene (OXTR) has been demonstrated and we hypothesized that individual epigenetic variability at OXTR may impact the development of PPD and that such variability may be central to predicting risk. This case-control study is nested within the Avon Longitudinal Study of Parents and Children and included 269 cases with PPD and 276 controls matched on age group, parity, and presence or absence of depressive symptoms in pregnancy as assessed by the Edinburgh Postnatal Depression Scale. OXTR DNA methylation (CpG site -934) and genotype (rs53576 and rs2254298) were assayed from DNA extracted from blood collected during pregnancy. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association of elevated symptoms of PPD with genotype, methylation, and their interaction adjusted for psychosocial factors (n = 500). There was evidence of an interaction between rs53576 and methylation in the OXTR gene amongst women who did not have depression prenatally but developed PPD (p interaction = 0.026, adjusted for covariates, n = 257). Those women with GG genotype showed 2.63 greater odds of PPD for every 10% increase in methylation level (95% CI: 1.37, 5.03), whereas methylation was unrelated to PPD amongst "A" carriers (OR = 1.00, 95% CI: 0.58, 1.73). There was no such interaction among women with PPD and prenatal depression. These data indicate that epigenetic variation that decreases expression of OXTR in a susceptible genotype may play a contributory role in the etiology of PPD.
    Frontiers in Genetics 08/2015; 6:243. DOI:10.3389/fgene.2015.00243
    • "Methodological differences across studies may play a role in these conflicting results . The relationship between OT and depres - sion / anxiety in pregnant or postpartum women ( Eapen et al . , 2014 ; Skrundz et al . , 2011 ; Stuebe et al . , 2013 ) may be affected by the hormonal fluctuations that occur during the perinatal period . Some have examined the relationship between OT and degrees of self - reported symptomatology ( e . g . , Eapen et al . , 2014 ; Gordon et al . , 2008 ) , the results of which may not extend to comparisons of OT in those meeting diagnostic criteria fo"
    [Show abstract] [Hide abstract]
    ABSTRACT: Mothers with mood or anxiety disorders exhibit less optimal interactive behavior. The neuropeptide oxytocin (OT) has been linked to more optimal interactive behaviors in mothers without mental illness, and it may play a particularly beneficial role in mothers with mood or anxiety disorders given its antidepressant and anxiolytic functions. We compared the relationship between OT and interactive behavior in mothers with and without mental health problems. Participants included 20 women diagnosed with postpartum mood or anxiety disorders (clinical sample) and 90 women with low levels of depression and anxiety during pregnancy and postpartum (community sample). At 2 months' postpartum, blood was drawn to assess maternal OT levels, and mother-infant interaction was coded for maternal sensitivity, intrusiveness, remoteness, and depressiveness. Clinical mothers exhibited less sensitive, more intrusive, and more depressive interactive behaviors than did community mothers. The groups did not differ in OT levels. Mothers with higher OT levels were less intrusive with their infants. Higher OT levels were associated with less depressive interactive behavior only in clinical mothers. OT was associated with positive interactive behaviors in both groups. In clinical mothers, the calming and soothing effects of OT may promote more relaxed, energetic, and infant-focused interactive behaviors. © 2015 Michigan Association for Infant Mental Health.
    Infant Mental Health Journal 06/2015; 36(4). DOI:10.1002/imhj.21521 · 0.61 Impact Factor
Show more