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Published Online: 16 October 2009

Effects of Sucking and Skin-to-Skin Contact on Maternal ACTH and Cortisol Levels During the Second Day Postpartum—Influence of Epidural Analgesia and Oxytocin in the Perinatal Period

Publication: Breastfeeding Medicine
Volume 4, Issue Number 4

Abstract

Background and Aims: In this study we made a detailed analysis of the mothers' release pattern of adrenocorticotropic hormone (ACTH) and cortisol during a breastfeeding session during the second day postpartum and related these patterns to maternal oxytocin levels as well to the duration of sucking and the duration of skin-to-skin contact before sucking the breast. Furthermore, we investigated if epidural analgesia and oxytocin administration during and after labor influenced the release pattern of ACTH and cortisol.
Methods: Sixty-three primiparae were included in the study. Fourteen received oxytocin intramuscularly postpartum, nine received oxytocin infusion, 14 received epidural analgesia combined with oxytocin infusion, and six received epidural analgesia alone. Twenty mothers did not receive any of these medical interventions. Blood samples were analyzed for ACTH and cortisol by enzyme-linked immunoassay.
Results: Both ACTH and cortisol levels fell significantly during the breastfeeding session. A significant negative relationship was found between oxytocin and ACTH levels, but not between oxytocin and cortisol levels. A positive and significant relationship was found between ACTH and cortisol levels. The duration of skin-to-skin contact before onset of sucking was significantly and negatively associated with lower cortisol levels, but not with ACTH levels. Cortisol levels differed significantly between mothers having received epidural analgesia with and without oxytocin.
Conclusions: Breastfeeding is associated with a decrease of ACTH and cortisol levels. Skin-to-skin contact contributes to this effect. ACTH correlated negatively with the duration of sucking and with median oxytocin levels, whereas cortisol levels correlated inversely with the duration of skin-to-skin contact preceding sucking, suggesting a partial dissociation between the mechanisms regulating ACTH and cortisol release. In addition, medical interventions in connection with birth influence the activity of the hypothalamic-pituitary-adrenal axis 2 days after birth.

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Published In

cover image Breastfeeding Medicine
Breastfeeding Medicine
Volume 4Issue Number 4December 2009
Pages: 207 - 220
PubMed: 19731998

History

Published in print: December 2009
Published online: 16 October 2009
Published ahead of print: 4 September 2009

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Linda Handlin
School of Life Sciences, University of Skövde, Skövde, Sweden.
Department of Animal Environment and Health, Swedish University of Agriculture, Skara, Sweden.
Wibke Jonas
Department of Women and Child Health, Division of Reproductive and Perinatal Health Care, Karolinska Institute, Stockholm, Sweden.
Maria Petersson
Department of Molecular Medicine, Endocrine and Diabetes Unit, Karolinska University Hospital/Karolinska Institute, Stockholm, Sweden.
Mikael Ejdebäck
School of Life Sciences, University of Skövde, Skövde, Sweden.
Anna-Berit Ransjö-Arvidson
Department of Women and Child Health, Division of Reproductive and Perinatal Health Care, Karolinska Institute, Stockholm, Sweden.
Eva Nissen
School of Life Sciences, University of Skövde, Skövde, Sweden.
Department of Women and Child Health, Division of Reproductive and Perinatal Health Care, Karolinska Institute, Stockholm, Sweden.
Kerstin Uvnäs-Moberg
School of Life Sciences, University of Skövde, Skövde, Sweden.
Department of Animal Environment and Health, Swedish University of Agriculture, Skara, Sweden.

Notes

Address correspondence to:
Linda Handlin, B.S.
School of Life Sciences
University of Skövde
P.O. Box 408
541 28 Skövde,
Sweden
E-mail: [email protected]

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