Factors Influencing Cortisol Concentrations in Breastmilk and Its Associations with Breastmilk Composition and Infant Development in the First Six Months of Lactation
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Data Collection
2.2. Participants
2.3. Breastmilk Sample Collection
2.4. Breastmilk Chemical Analysis
2.5. Statistical Analysis
3. Results
3.1. Breastmilk Cortisol Level and Its Determinants
3.2. Breastmilk Cortisol and Breastmilk Macronutrient and FA Profile
3.3. Breastmilk Cortisol and Infant Anthropometric Development
3.4. Breastmilk Cortisol Level and Infant Psychomotor Development and Temperament
4. Discussion
4.1. Factors Associated with Breastmilk Cortisol
4.1.1. Maternal Factors
4.1.2. Infant- and Delivery-Related Factors
4.2. Breastmilk Cortisol and Breastmilk Composition
4.3. Breastmilk Cortisol and Infant Anthropometric Development
4.4. Breastmilk Cortisol and Infant Psychomotor Development and Temperament
4.5. Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variable | Mean ± SD | Min–Max | n (%) |
---|---|---|---|
Maternal sociodemographic factors | |||
Maternal age (years) | 30.9 ± 3.7 | 22.7–40.0 | |
Parity, primiparous | 19 (50) | ||
University education | 38 (100) | ||
Marital status, married | 32 (84) | ||
Self-assessment of the economic situation, very good | 14 (37) | ||
Average monthly income, >1500 PLN per capita | 25 (66) | ||
Maternal biological and psychological factors | |||
Gestational weight gain (kg) | 13.5 ± 4.4 | 0.7–22.0 | |
BMI, pre-pregnancy (kg/m2); overweight or obesity | 22.7 ± 3.7 | 18.4–38.6 | 5 (13) |
BMI, 1st visit (kg/m2); overweight or obesity | 24.0 ± 3.9 | 18.4–39.7 | 9 (24) |
BMI, 2nd visit (kg/m2); overweight or obesity | 23.5 ± 4.1 | 18.1–40.8 | 6 (16) |
BMI, 3rd visit (kg/m2); overweight or obesity | 23.1 ± 4.3 | 19.1–42.6 | 7 (18) |
EPDS, 1st visit (points); depression risk | 5.9 ± 4.0 | 0–18 | 3 (8) |
EPDS, 3rd visit (points); depression risk | 4.7 ± 3.7 | 0–18 | 2 (5) |
EPDS, 6th visit postpartum (points); depression risk | 5.2 ± 4.1 | 0–19 | 3 (8) |
PSS-10, 1st visit (points); high stress | 21.0 ± 5.1 | 4–28 | 23 (61) |
PSS-10, 2nd visit (points); high stress | 20.4 ± 3.8 | 13–28 | 22 (58) |
PSS-10, 3rd visit (points); high stress | 21.5 ± 4.0 | 14–29 | 23 (61) |
Infant and breastfeeding factors | |||
Infant gender, boys | 19 (50) | ||
Infant age, 1st visit (weeks) | 4.8 ± 0.8 | 3.4–6.9 | |
Infant age, 2nd visit (weeks) | 13.4 ± 1.7 | 9.6–20.1 | |
Infant age, 3rd visit (weeks) | 26.9 ± 1.2 | 24–29.6 | |
Gestational age (Hbd) | 39.3 ± 1.3 | 37–42 | |
Mode of delivery, C section | 16 (42) | ||
Birthweight (g) | 3413.9 ± 373.7 | 2870–4240 | |
BMI z-score, 2nd visit | −1.15 ± 1.48 | −4.17–3.82 | |
BMI z-score, 3rd visit | −1.31 ± 1.32 | −4.17–1.24 | |
Children Development Scale (DSR) Results | |||
Performance Scale, Manipulation (points); average | 6.4 ± 1.1 | 3–7 | 28 (74) |
Performance Scale, Perception (points) | 4.9 ± 1.1 | 2–7 | |
Performance Scale, Memory (points) | 0.8 ± 0.4 | 0–1 | |
Performance Scale, Speech and language (points) | 2.1 ± 1.0 | 1–5 | |
Performance Scale, Social behavior (points); high | 6.7 ± 1.0 | 4–9 | 3 (8) |
Performance Scale, Motor skill (points); high | 4.1 ± 1.1 | 2–6 | 15 (39) |
Performance Scale, total result (centiles); elevated | 40.4 ± 13.8 | 16–74 | 2 (5) |
Observational Scale, Vigor (points); high | 10.6 ± 1.2 | 9–13 | 3 (8) |
Observational Scale, Adaptability (points); high | 13.7 ± 1.8 | 7–17 | 14 (36) |
Observational Scale, Regularity (points); high | 3.3 ± 0.8 | 1–7 | 2 (5) |
Observational Scale, Sensitivity (points); high | 3.4 ± 0.5 | 3–4 | 13 (34) |
Breastmilk Cortisol [ng/mL] | |||
---|---|---|---|
Mean ± SD | |||
Min–Max | |||
1 Month Postpartum | 3 Months Postpartum | 6 Months Postpartum | |
Total group (n = 38) | 11.2 ± 6.2 | 11.2 ± 4.3 | 12.7 ± 6.2 |
5.0–32.0 | 4.8–23.6 | 4.4–29.4 | |
p-value 1 | 0.154 | ||
Season of breastmilk sample collection | |||
spring-summer | n = 19 | n = 24 | n = 21 |
9.0 ± 3.6 | 11.9 ± 5.0 | 14.3 ± 5.9 | |
5.0–16.4 | 4.8–23.6 | 5.0–29.4 | |
n = 19 | n = 14 | n = 17 | |
autumn-winter | 13.5 ± 7.5 | 9.9 ± 2.6 | 10.8 ± 6.1 |
5.8–32.0 | 5.0–14.2 | 4.4–26.0 | |
p-value 2 | 0.020 | 0.332 | 0.041 |
Variable | Breastmilk Cortisol (Log) | |||
---|---|---|---|---|
1 Month Postpartum | 3 Months Postpartum | 6 Months Postpartum | ||
Maternal factors | Maternal age | 0.028 | 0.008 | −0.305 |
Maternal BMI | −0.091 | 0.040 | −0.081 | |
EPDS score | 0.262 | 0.090 | −0.055 | |
PSS-10 score | 0.299 | 0.026 | −0.038 | |
Infant factors | Infant age | −0.182 | −0.001 | 0.030 |
Gestational age | 0.186 | 0.063 | 0.258 | |
Birthweight | −0.107 | 0.111 | 0.077 | |
Number of breastfeedings | 0.147 | −0.166 | 0.086 | |
Breastmilk composition | Fat | 0.005 | −0.016 | 0.212 |
Protein | 0.081 | 0.281 | 0.151 | |
Carbohydrates | 0.081 | 0.013 | 0.258 | |
Total solids | −0.092 | −0.001 | 0.358 * | |
Crude protein | −0.080 | 0.366 * | 0.126 | |
Energy | −0.089 | 0.011 | 0.282 |
Breastmilk Crude Protein | Breastmilk Cortisol(log) | ||
---|---|---|---|
Model 1 | Model 2 | Model 3 | |
1 month lactation | β = −0.013 (−0.351–0.325) R2= −0.03; p = 0.940 | β = 0.022 (−0.331–0.376) R2= 0.07; p = 0.143 | β = −0.011 (−0.434–0.412) R2 = −0.02; p = 0.518 |
3 months lactation | β = 0.395 (0.084–0.705) ** R2 = 0.13; p = 0.014 | β = 0.311 (0.021–0.601) * R2= 0.27; p = 0.002 | β = 0.318 (0.007–0.630) * R2 = 0.19; p = 0.030 |
6 months lactation | β = 0.150 (−0.184–0.484) R2 = −0.01; p = 0.369 | β = 0.133 (−0.232–0.498) R2 = −0.06; p = 0.830 | β = 0.108 (−0.273–0.489) R2 = −0.08; p = 0.882 |
Variable | Breastmilk Cortisol (Log) | |||
---|---|---|---|---|
1 Month Postpartum | 3 Months Postpartum | 6 Months Postpartum | ||
Total | 3 months | −0.052 | 0.412 * | −0.077 |
6 months | 0.094 | 0.372 * | −0.004 | |
∆ 3–6 months | −0.187 | −0.079 | 0.097 | |
Girls | 3 months | 0.005 | 0.541 * | - |
6 months | −0.121 | 0.388 | 0.021 | |
∆ 3–6 months | −0.165 | −0.204 | −0.385 | |
Boys | 3 months | −0.002 | 0.371 | - |
6 months | 0.141 | 0.288 | 0.088 | |
∆ 3–6 months | 0.184 | −0.183 | 0.395 |
BMI z-Score Month | Model 1 | Model 2 | Model 3 | Model 4 | |
---|---|---|---|---|---|
cortisollog 1 month | 3 | β = 0.061 | β = 0.081 | β = −0.081 | β = −0.071 |
(−0.403–0.282) | (−0.429–0.268) | (−0.388–0.277) | (−0.395–0.253) | ||
R2 = −0.02 | R2 = −0.02 | R2 = 0.21 * | R2 = 0.18 * | ||
6 | β = 0.094 | β = 0.104 | β = 0.096 | β = 0.018 | |
(−0.253–0.441) | (−0.260–0.468) | (−0.262–0.454) | (−0.346–0.382) | ||
R2 = −0.02 | R2 = −0.05 | R2 = 0.02 | R2 = 0.02 | ||
cortisollog 3 month | 3 | β = 0.338 | β = 0.359 | β = 0.265 | β = 0.286 |
(0.015–0.661) * | (0.021–0.697) * | (−0.046–0.577) | (−0.034–0.607) | ||
R2 = 0.09 * | R2 = 0.10 * | R 2 = 0.27 ** | R2 = 0.26 ** | ||
6 | β = 0.337 | β = 0.451 | β = 0.405 | β = 0.334 | |
(0.009–0.665) * | (0.095–0.808) ** | (0.029–0.780) * | (−0.065–0.733) | ||
R2 = 0.09 * | R2 = 0.11 | R2 = 0.11 | R2 = 0.11 | ||
cortisollog 6 months | 6 | β = 0.032 | β = 0.002 | β = 0.00 | β = −0.006 |
(−0.380–0.317) | (−0.363–0.367) | (−0.359–0.359) | (−0.355–0.343) | ||
R2 = −0.03 | R2 = −0.07 | R2 = −0.03 | R2 = 0.03 |
DSR Scale | Breastmilk Cortisol (Log) | |||
---|---|---|---|---|
1 Month | 3 Months | 6 Months | ||
Total | Manipulation | 0.296 | 0.269 | 0.184 |
Perception | 0.169 | −0.132 | −0.160 | |
Memory | −0.213 | −0.144 | −0.013 | |
Speech | 0.057 | 0.089 | 0.005 | |
Social behavior | −0.049 | 0.162 | −0.085 | |
Motor | −0.219 | 0.053 | −0.057 | |
Performance scale score | 0.069 | 0.144 | −0.035 | |
Performance scale centile | 0.230 | 0.282 | 0.117 | |
Vigor | −0.011 | 0.101 | −0.011 | |
Adaptability | −0.235 | 0.138 | −0.214 | |
Regularity | −0.379 * | 0.038 | −0.421 * | |
Sensitivity | 0.169 | −0.016 | 0.071 | |
Girls | Manipulation | 0.341 | 0.090 | 0.111 |
Perception | 0.385 | −0.448 | −0.109 | |
Memory | −0.025 | −0.079 | 0.425 | |
Speech | 0.468 | 0.229 | 0.425 | |
Social behavior | −0.370 | −0.054 | −0.139 | |
Motor | 0.017 | 0.538 | 0.284 | |
Performance scale score | 0.403 | 0.144 | 0.369 | |
Performance scale centile | 0.634 * | 0.428 | 0.636 * | |
Vigor | 0.060 | 0.419 | −0.148 | |
Adaptability | −0.017 | 0.299 | −0.231 | |
Regularity | −0.353 | 0.088 | −0.276 | |
Sensitivity | −0.121 | −0.344 | 0.047 | |
Boys | Manipulation | −0.084 | 0.100 | 0.139 |
Perception | −0.309 | −0.197 | −0.351 | |
Memory | −0.313 | −0.030 | −0.555 | |
Speech | 0.253 | 0.219 | −0.227 | |
Social behavior | −0.070 | 0.434 | −0.348 | |
Motor | −0.275 | 0.119 | −0.363 | |
Performance scale score | −0.291 | 0.256 | −0.325 | |
Performance scale centile | −0.237 | 0.369 | −0.399 | |
Vigor | 0.244 | 0.167 | −0.046 | |
Adaptability | −0.127 | 0.486 | −0.241 | |
Regularity | −0.428 | 0.207 | −0.173 | |
Sensitivity | 0.580 * | −0.016 | −0.058 |
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Zielinska-Pukos, M.A.; Bryś, J.; Kucharz, N.; Chrobak, A.; Wesolowska, A.; Grabowicz-Chądrzyńska, I.; Hamulka, J. Factors Influencing Cortisol Concentrations in Breastmilk and Its Associations with Breastmilk Composition and Infant Development in the First Six Months of Lactation. Int. J. Environ. Res. Public Health 2022, 19, 14809. https://doi.org/10.3390/ijerph192214809
Zielinska-Pukos MA, Bryś J, Kucharz N, Chrobak A, Wesolowska A, Grabowicz-Chądrzyńska I, Hamulka J. Factors Influencing Cortisol Concentrations in Breastmilk and Its Associations with Breastmilk Composition and Infant Development in the First Six Months of Lactation. International Journal of Environmental Research and Public Health. 2022; 19(22):14809. https://doi.org/10.3390/ijerph192214809
Chicago/Turabian StyleZielinska-Pukos, Monika A., Joanna Bryś, Natalia Kucharz, Agnieszka Chrobak, Aleksandra Wesolowska, Iwona Grabowicz-Chądrzyńska, and Jadwiga Hamulka. 2022. "Factors Influencing Cortisol Concentrations in Breastmilk and Its Associations with Breastmilk Composition and Infant Development in the First Six Months of Lactation" International Journal of Environmental Research and Public Health 19, no. 22: 14809. https://doi.org/10.3390/ijerph192214809