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.

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    • "Youths' OT levels in both CSF and plasma were significantly negatively associated with the parents' ratings. Other investigative groups have also found significant negative correlations between anxiety symptoms and plasmaOT levels in different segments of the adult population including women with fibromyalgia(Anderberg and Uvnas-Moberg, 2000),clinically depressed men and women(Scantamburlo et al., 2007),and nursing mothers(Stuebe et al., 2013). Weisman et al. (2013) examined plasma OT levels in 473 non-clinical adults (41.5% males), and found that males showed a significant negative correlation between plasma OT levels and trait anxiety. "
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    ABSTRACT: Clinical anxiety disorders in youth are common and associated with interpersonal behaviors including reliance on parents for family accommodation, or changes that parents make to their own behaviors to help the youth avoid anxiety related distress. The neuropeptide oxytocin is associated with the regulation of anxiety and of close interpersonal behavior leading to the hypothesis that oxytocinergic functioning plays a role in youth anxiety and its disorders, and the resulting family accommodation. To test this hypothesis salivary oxytocin from 50 youth with primary DSM-5 anxiety disorders was assayed. A multi-source/multi-method anxiety assessment including semistructured interviews with youth and mothers, rating scales, and behavioral observations was used to assess anxiety disorders and symptoms, and family accommodation.Youth with separation anxiety disorder had significantly lower salivary oxytocin levels than clinically anxious youth not diagnosed with separation anxiety disorder. Salivary oxytocin levels were significantly negatively correlated with separation anxiety symptoms based on both youth- and mother-ratings.Anxious behavior displayed by youth during interactions with their mothers was associated with lower salivary oxytocin levels in youth. Maternal ratings of family accommodation were negatively associated with salivary oxytocin levels in youth. Results support the role of the oxytocinergic system in youth anxiety and its disordersand in parental involvement in youth anxiety through family accommodation. Oxytocin may be particularly important for diagnoses and symptoms of separation anxiety, which is inherently interpersonal in nature. Findings have potentially important implications for assessment and treatment ofanxiety in youth.
    Full-text · Article · Dec 2015 · Psychoneuroendocrinology
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    • "In our study, maternal psychological well-being at enrollment was not associated with feeding at the breast during hospitalization or breastfeeding duration. Previous research found that high maternal anxiety, depressive symptoms, and distress after late preterm childbirth were associated with less at-breast feeding at hospital discharge (Zanardo et al., 2011); greater postpartum anxiety was associated with reduced breastfeeding duration (Paul, Downs, Schaefer, Beiler, & Weisman, 2013); and high maternal anxiety and depressive symptoms correlated with low oxytocin during breastfeeding and expressing sessions (Stuebe, Grewen, &Brody, 2013). Findings for mothers in this study may have differed because of the indirect effects of receiving confirmation of the infants' stability from the hospital staff before each occasion of KC or ATVV. "
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    ABSTRACT: Objective: To test the effects of kangaroo care (KC) on breastfeeding outcomes in preterm infants compared with two control groups and to explore whether maternal-infant characteristics and the mother's choice to use KC were related to breastfeeding measures. Design: Secondary analysis of a multisite, stratified, randomized three-arm trial. The treatment groups used KC, auditory-tactile-visual-vestibular (ATVV) intervention, or received preterm infant care information. Setting: Neonatal intensive care units from 4 hospitals in the United States from 2006 to 2011. Participants: Racially diverse mothers (N = 231) and their preterm infants born weighing less than 1,750 g. Methods: Mothers and their infants were enrolled once the infants were no longer critically ill, weighed at least 1,000 g, and could be safely held outside the incubator by parents. Participants were instructed by study nurses; those allocated to the KC or ATVV groups were asked to engage in these interactions with their infants for a minimum of 3 times a week in the hospital and at home until their infants reached age 2 months adjusted for prematurity. Results: Feeding at the breast during hospitalization, the duration of postdischarge breastfeeding, and breastfeeding exclusivity after hospital discharge did not differ statistically among the treatment groups. Regardless of group assignment, married, older, and more educated women were more likely to feed at the breast during hospitalization. Mothers who practiced KC, regardless of randomly allocated group, were more likely to provide their milk than those who did not practice KC. Breastfeeding duration was greatest among more educated women. Conclusion: As implemented in this study, assignment to the KC group did not appear to influence the measured breastfeeding outcomes.
    Full-text · Article · Nov 2015 · Journal of Obstetric Gynecologic & Neonatal Nursing
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    • "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). "
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    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.
    Full-text · Article · Aug 2015 · Hormones and Behavior
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