Diurnal salivary cortisol levels in postpartum mothers as a function of infant feeding choice and parity

Abstract

Daily stress and sleep deprivation can influence the diurnal pattern of cortisol, which normally consists of high morning levels and a gradual decline throughout the day. While most individuals have consistent declining cortisol concentrations over days, others display either flat or inconsistent profiles. Postpartum mothers experience considerable home demands and sleep deprivation, yet, breastfeeding mothers perceive lower stress and reduced negative mood states compared to bottlefeeders. On the other hand, multiparity (having more than one child) is associated with reduced steepness in diurnal cortisol decline. Interestingly, no study to date has investigated the diurnal cortisol pattern and its stability across days in postpartum women as a function of their choice of infant feeding and parity. In this study, we measured salivary cortisol at four different time points during the day, on two non-consecutive days in first-time (primiparous) and second-time (multiparous) mothers at 5-20 weeks postpartum who were exclusively breastfeeding or bottlefeeding, and in non-postpartum mothers of young children (1-6 years). Among multiparous mothers, we found that cortisol levels in those who were bottlefeeding were higher than in breastfeeding mothers at both awakening and 1600 h. This effect remained significant after controlling for individual differences related to infant feeding choice, such as estradiol levels, education and income. No effect of infant feeding choice on cortisol concentrations was observed in primiparous mothers. While a consistent decline across days was common, some mothers presented a flat or inconsistent profile, a profile that was not associated with infant feeding choice or parity. Importantly, mothers with consistent declining profiles had the highest household income. Our findings suggest that although breastfeeding might promote a tighter regulation of diurnal basal cortisol secretion, in particular for multiparous mothers who are likely to be exposed to greater home demands and maternal responsibilities, some aspects of socioeconomic status such as income can also play a significant role in the stability of diurnal cortisol secretion across days.