Effects of suckling on hypothalamic-pituitary-adrenal axis responses to psychosocial stress in postpartum lactating women
Abstract
In several studies lactation has been shown to be associated with a hypothalamic-pituitary-adrenal axis hyporesponsiveness to physical and psychological stressors. As it is not known whether the marked blunting of endocrine stress reactivity in women can be ascribed to suckling as a short-term effect or to lactation in general, the acute effects of suckling on the hypothalamic-pituitary-adrenal axis and the sympathetic-adrenal-medullary system responses to mental stress were investigated in lactating women. Forty-three lactating women were randomly assigned either to breast-feed or to hold their infants for a 15-min period with the onset 30 min before they were exposed to a brief psychosocial stressor (Trier Social Stress Test). Both breast-feeding and holding the infant yielded significant decreases in ACTH, total plasma cortisol, and salivary free cortisol (all P < 0.01). There were no significant differences in baseline hormone levels between the groups 1 min before the stress test. In response to stress exposure, ACTH, total plasma cortisol, salivary free cortisol, norepinephrine, and epinephrine were significantly increased in all lactating women (all P < 0.001). However, total cortisol and free cortisol responses to stress were attenuated in breast-feeding women (P = 0.001 and P = 0.067, respectively), who also showed significantly decreasing PRL levels during the stress test (P = 0.005). In addition, there was no change in plasma oxytocin or vasopressin in response to the stressor. Breast-feeding as well as holding led to decreased anxiety (P < 0.05), whereas, in contrast, stress exposure worsened mood, calmness, and anxiety in the total group (all P < 0.001). From these data we conclude that lactation in women, in contrast to that in rats, does not result in a general restraint of the hypothalamic-pituitary-adrenal axis response to a psychosocial stressor. Rather, suckling is suggested to exert a short-term suppression of the cortisol response to mental stress.
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The high level of stability found in basal OT levels may suggest that baseline OT levels are relatively stable during the postpartum period, except for moments of specific physiological processes such as breastfeeding or sexual intercourse that lead to considerable rise in OT but are short in duration.
“The high level of stability found in basal OT levels may suggest that baseline OT levels are relatively stable during the postpartum period, except for moments of specific physiological processes such as breastfeeding or sexual intercourse that lead to considerable rise in OT but are short in duration (26,39–41).”
From Oxytocin and the development of parenting in humans (2010) · cites this paper as [40]
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References 63 · Cited by 386
- Authors
- Heinrichs, M., Meinlschmidt, G., Neumann, I., Wagner, S., Kirschbaum, C., Ehlert, U., & Hellhammer, D. H.
- Affiliations
- University of Zurich (CH)
- Universität Trier (DE)
- University of Regensburg (DE)
- Heinrich Heine University Düsseldorf (DE)
- Corresponding author
- Heinrichs, Markus
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2001-10-01
- Volume
- 86
- Issue
- 10
- Pages
- 4798-4804
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2103166950
- Semantic Scholar
- 1e100e6e631e99458824feeabafdd4aa13422a8a
- Cited by
- 386
- References
- 63
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 13 · 2023: 7 · 2022: 14 · 2021: 12 · 2020: 11 · 2019: 10 · 2018: 13 · 2017: 21 · 2016: 19 · 2015: 24 · 2014: 26 · 2013: 34 · 2012: 17
- FWCI
- 3.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- edoc (University of Basel) (acceptedVersion)
- University of Regensburg Publication Server (University of Regensburg) (acceptedVersion)
- Research Bank (Australian Catholic University) (submittedVersion)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Social Sciences › Psychology › Social Psychology › Neuroendocrine regulation and behavior
- Health Sciences › Medicine › Epidemiology › Breastfeeding Practices and Influences
- Keywords
- suckling, lactation, hypothalamic-pituitary-adrenal axis, psychosocial stress, cortisol, ACTH, breastfeeding, infant holding, sympathoadrenal system, norepinephrine, epinephrine, prolactin, oxytocin, vasopressin, anxiety, postpartum women
- MeSH terms
- Adrenocorticotropic Hormone, Adult, Affect, Breast Feeding, Female, Humans, Hypothalamo-Hypophyseal System, Lactation, Pituitary-Adrenal System, Prolactin, Stress, Psychological
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