School of Nursing, Oregon Health and Science University, Portland, OR, USA.
Director Kinsey Institute, Indiana University, Bloomington, IN, USA.
J Hum Lact. 2020 Feb;36(1):136-145. doi: 10.1177/0890334419838225. Epub 2019 Apr 29.
Maternal milk production requires the neuropeptide oxytocin. Individual variation in oxytocin function is a compelling target for understanding low milk production, a leading cause of breastfeeding attrition. Complicating the understanding of oxytocin pathways is that vasopressin may interact with oxytocin receptors, yet little is known about the role of vasopressin in lactation.
The aims of this study were (1) to describe maternal plasma oxytocin, vasopressin, and prolactin patterns during breastfeeding following low-risk spontaneous labor and birth in healthy first-time mothers and (2) to relate hormone patterns to maternal characteristics and breastfeeding measures.
Eligible women were recruited before hospital discharge. Forty-six participants enrolled and 35 attended the study visit. Participants kept a journal of breastfeeding frequency, symptoms of lactogenesis, and infant weight. Plasma samples were obtained at breastfeeding onset on Day 4-5 postpartum, and repeated after 20 min. Hormones were measured with immunoassays. Infant weight change, milk transfer, and onset of lactogenesis were also measured.
Baseline oxytocin and vasopressin were inversely related to one another. Oxytocin and prolactin increased significantly across the 20-min sampling period while vasopressin decreased. Higher oxytocin was associated with higher maternal age, lower BMI, shorter active labor, physiologic labor progression, and less weight loss in the newborn. Higher vasopressin correlated with younger maternal age, higher BMI, and greater newborn weight loss.
Oxytocin and vasopressin have contrasting relationships with maternal clinical characteristics and newborn weight gain in early breastfeeding infants. Further study is needed to understand how oxytocin and vasopressin influence lactation outcomes.
母乳的产生需要神经肽催产素。催产素功能的个体差异是理解低产奶量的一个重要目标，而低产奶量是母乳喂养中断的主要原因。使催产素途径的理解变得复杂的是，加压素可能与催产素受体相互作用，但人们对加压素在哺乳中的作用知之甚少。
本研究的目的是（1）描述健康初产妇在低危自发性分娩和分娩后进行母乳喂养时的母体血浆催产素、加压素和催乳素模式，（2）将激素模式与产妇特征和母乳喂养措施联系起来。
在出院前招募符合条件的女性。46 名参与者报名，35 名参加了研究访问。参与者记录了母乳喂养的频率、泌乳症状和婴儿体重。在产后第 4-5 天的母乳喂养开始时以及 20 分钟后采集血浆样本。使用免疫测定法测量激素。还测量了婴儿体重变化、乳汁转移和泌乳开始情况。
基线催产素和加压素呈负相关。催产素和催乳素在 20 分钟的采样期间显著增加，而加压素则减少。较高的催产素与产妇年龄较大、BMI 较低、活跃分娩时间较短、产程生理性进展和新生儿体重减轻较少有关。较高的加压素与产妇年龄较小、BMI 较高和新生儿体重减轻较多有关。
在早期母乳喂养的婴儿中，催产素和加压素与产妇临床特征和新生儿体重增加呈相反关系。需要进一步研究以了解催产素和加压素如何影响哺乳结果。
