Association Between Maternal Mood and Oxytocin Response to Breastfeeding

ArticleinJournal of Women's Health 22(4):352-61 · April 2013with36 Reads
DOI: 10.1089/jwh.2012.3768 · Source: PubMed
Abstract
Background: 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. Methods: 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. Results: 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. Conclusion: Symptoms of depression and anxiety were associated with differences in oxytocin response and affect during breastfeeding.
    • "Mother's depressive symptoms have been associated with diminished maternal physical contact and touch (Feldman & Eidelman, 2003, 2007 Feldman, Keren, GrossRozval, & Tyano, 2004; Murray, Halligan, Goodyer, & Herbert, 2010; Righetti-Veltema, Conne-Perréard, Bousquet, & Manzano, 2002). Furthermore, maternal touch is linked with peripheral and genetic biomarkers of the oxytocinergic system ( Feldman et al., 2012), which are disrupted in cases of depression (Apter-Levy, Feldman, Vakart, Ebstein, & Feldman, 2013; Mah, Van Ijzendoorn, Smith, & Bakermans-Kranenburg, 2013; Stuebe, Grewen, & Meltzer-Brody, 2013), suggesting that PPD may be associated with dysfunction in the biological substrate that supports affectionate touch. In contrast to maternal touch, which appears immediately after birth in all mammals, the coordination of social gaze between mother and child is exclusively human and emerges in the third month of life (Feldman, 2007b). "
    [Show abstract] [Hide abstract] ABSTRACT: Maternal postpartum depression (PPD) exerts long-term negative effects on infants; yet the mechanisms by which PPD disrupts emotional development are not fully clear. Utilizing an extreme-case design, 971 women reported symptoms of depression and anxiety following childbirth and 215 high and low on depressive symptomatology reported again at 6 months. Of these, mothers diagnosed with major depressive disorder (n = 22), anxiety disorders (n = 19), and controls (n = 59) were visited at 9 months. Mother-infant interaction was microcoded for maternal and infant's social behavior and synchrony. Infant negative and positive emotional expression and self-regulation were tested in 4 emotion-eliciting paradigms: anger with mother, anger with stranger, joy with mother, and joy with stranger. Infants of depressed mothers displayed less social gaze and more gaze aversion. Gaze and touch synchrony were lowest for depressed mothers, highest for anxious mothers, and midlevel among controls. Infants of control and anxious mothers expressed less negative affect with mother compared with stranger; however, maternal presence failed to buffer negative affect in the depressed group. Maternal depression chronicity predicted increased self-regulatory behavior during joy episodes, and touch synchrony moderated the effects of PPD on infant self-regulation. Findings describe subtle microlevel processes by which maternal depression across the postpartum year disrupts the development of infant emotion regulation and suggest that diminished social synchrony, low differentiation of attachment and nonattachment contexts, and increased self-regulation during positive moments may chart pathways for the cross-generational transfer of emotional maladjustment from depressed mothers to their infants. (PsycINFO Database Record
    Full-text · Article · Jul 2016
    • "However, correlational research specific to mothers with depression is sparse. Lower plasma OT level during midpregnancy predicts a risk for the subsequent development of PND [32, 33]. Outcomes for children have also been measured when considering the link between OT and PND. "
    [Show abstract] [Hide abstract] ABSTRACT: Postnatal depression (PND) is common and negatively affects the mother-infant relationship; oxytocin (OT) has been found to have positive effects on parenting, although psychiatric disorders may reduce these effects. Thus, we explored the role of OT in mothers diagnosed with PND. A within-subject, randomized controlled double-blind design was used to test the effects of nasal administration of OT or placebo on sensitive caregiving. The outcome measures were perceptual and caregiving responses to prerecorded cry sounds, as well as observed maternal sensitivity. We found that in the OT condition mothers with PND were more likely to rate an infant cry as more urgent and they were more likely to indicate they would chose a harsh caregiving strategy in response. There was no effect of OT on maternal sensitive interaction with their own baby. Further research is required prior to consideration of OT administration in depressed mothers of infants.
    Full-text · Article · Apr 2016
    • "Our conceptual framework further proposes that future research capture the impact of lifetime stress and trauma as well as the proximity of these stressors to pregnancy and childbirth to determine how chronic cultural and contextual stressors are associated with dysregulation of neuroendocrine function and the subsequent development of PPD in Latina women in the United States. For instance, as cited here, studies of prenatal and postpartum women have shown an association between culturally and contextually relevant stressors and PPD, as well as hormone levels (e.g., Hernandez et al., 2011; Stuebe et al., 2013). On the basis of the cited literature, we propose a framework for future research that integrates psychosocial and physiological factors that will improve our understanding of the role biopsychosocial determinants have on the development of PPD in immigrant and U.S.-born Latinas in the United States. "
    [Show abstract] [Hide abstract] ABSTRACT: Objective: In this review, we offer a conceptual framework that identifies risk factors of postpartum depression (PPD) in immigrant and U.S.-born Latinas in the United States by focusing on psychosocial and neuroendocrine factors. Although the evidence of the impact psychosocial stressors have on the development of PPD has been well-documented, less is known about the biological etiology of PPD or how these complex stressors jointly increase the risk of PPD in immigrant and U.S.-born Latinas in the United States. Methods: Using PubMed, CINAHL, and Embase, we reviewed the literature from 2000 to 2015 regarding psychosocial and physiological risk factors associated with PPD to develop a conceptual model for Latinas. Results: Our search yielded 16 relevant studies. Based on our review of the literature, we developed a biopsychosocial conceptual model of PPD for Latinas in the United States. We make arguments for an integrated model designed to assess psychosocial and physiological risk factors and PPD in a high-risk population. Our framework describes the hypothesized associations between culturally and contextually relevant psychosocial stressors, neurobiological factors (e.g., hypothalamic-pituitary-adrenal [HPA] axis response system and oxytocin signaling), and PPD in Latinas in the United States. Conclusions: Future studies should evaluate prospectively the impact psychosocial stressors identified here have on the development of PPD in both immigrant and U.S-born Latinas while examining neuroendocrine function, such as the HPA axis and oxytocin signaling. Our conceptual framework will allow for the reporting of main and indirect effects of psychosocial risk factors and biomarkers (e.g., HPA axis and oxytocin function) on PPD in foreign- and U.S.-born postpartum Latinas.
    Full-text · Article · Apr 2016
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