Maternal plasma levels of oxytocin during breastfeeding-A systematic review

Introduction Oxytocin is a key hormone in breastfeeding. No recent review on plasma levels of oxytocin in response to breastfeeding is available. Materials and methods Systematic literature searches on breastfeeding induced oxytocin levels were conducted 2017 and 2019 in PubMed, Scopus, CINAHL, and PsycINFO. Data on oxytocin linked effects and effects of medical interventions were included if available. Results We found 29 articles that met the inclusion criteria. All studies had an exploratory design and included 601 women. Data were extracted from the articles and summarised in tables. Breastfeeding induced an immediate and short lasting (20 minutes) release of oxytocin. The release was pulsatile early postpartum (5 pulses/10 minutes) and coalesced into a more protracted rise as lactation proceeded. Oxytocin levels were higher in multiparous versus primiparous women. The number of oxytocin pulses during early breastfeeding was associated with greater milk yield and longer duration of lactation and was reduced by stress. Breastfeeding-induced oxytocin release was associated with elevated prolactin levels; lowered ACTH and cortisol (stress hormones) and somatostatin (a gastrointestinal hormone) levels; enhanced sociability; and reduced anxiety, suggesting that oxytocin induces physiological and psychological adaptations in the mother. Mechanical breast pumping, but not bottle-feeding was associated with oxytocin and prolactin release and decreased stress levels. Emergency caesarean section reduced oxytocin and prolactin release in response to breastfeeding and also maternal mental adaptations. Epidural analgesia reduced prolactin and mental adaptation, whereas infusions of synthetic oxytocin increased prolactin and mental adaptation. Oxytocin infusion also restored negative effects induced by caesarean section and epidural analgesia. Conclusions Oxytocin is released in response to breastfeeding to cause milk ejection, and to induce physiological changes to promote milk production and psychological adaptations to facilitate motherhood. Stress and medical interventions during birth may influence these effects and thereby adversely affect the initiation of breastfeeding

Maternal plasma levels of oxytocin during breastfeeding - a systematic review

Introduction: Oxytocin is a key hormone in breastfeeding. No recent review on plasma levels of oxytocin in response to breastfeeding is available. Materials and methods: Systematic literature searches on breastfeeding induced oxytocin levels were conducted 2017 and 2019 in PubMed, Scopus, CINAHL, and PsycINFO. Data on oxytocin linked effects and effects of medical interventions were included if available. Results: We found 29 articles that met the inclusion criteria. All studies had an exploratory design and included 601 women. Data were extracted from the articles and summarised in tables. Breastfeeding induced an immediate and short lasting (20 minutes) release of oxytocin. The release was pulsatile early postpartum (5 pulses/10 minutes) and coalesced into a more protracted rise as lactation proceeded. Oxytocin levels were higher in multiparous versus primiparous women. The number of oxytocin pulses during early breastfeeding was associated with greater milk yield and longer duration of lactation and was reduced by stress. Breastfeeding-induced oxytocin release was associated with elevated prolactin levels; lowered ACTH and cortisol (stress hormones) and somatostatin (a gastrointestinal hormone) levels; enhanced sociability; and reduced anxiety, suggesting that oxytocin induces physiological and psychological adaptations in the mother. Mechanical breast pumping, but not bottle-feeding was associated with oxytocin and prolactin release and decreased stress levels. Emergency caesarean section reduced oxytocin and prolactin release in response to breastfeeding and also maternal mental adaptations. Epidural analgesia reduced prolactin and mental adaptation, whereas infusions of synthetic oxytocin increased prolactin and mental adaptation. Oxytocin infusion also restored negative effects induced by caesarean section and epidural analgesia. Conclusions: Oxytocin is released in response to breastfeeding to cause milk ejection, and to induce physiological changes to promote milk production and psychological adaptations to facilitate motherhood. Stress and medical interventions during birth may influence these effects and thereby adversely affect the initiation of breastfeeding

Postnatal quality of life - A content analysis of qualitative results to the Mother-Generated Index.

BACKGROUND: The Mother-Generated Index (MGI) assesses postnatal quality of life (QoL) without providing a predefined checklist, thus offering mothers the opportunity to identify areas of life affected by having a baby. AIM: To identify: (a) details and particularities of areas of life affected after childbirth and thus specific domains defining postnatal quality of life; (b) changes in the importance of domains specifying QoL within the first weeks postpartum; and (c) the potential role of cultural differences with regard to the nature of QoL definitions. METHODS: Prospective, cross-cultural, longitudinal survey. We applied a qualitative content analysis to Mother-Generated Index data collected in Switzerland and Germany using combined deductively and inductively category building. RESULTS: Women participated at three days (n=124) and six and a half weeks (n=82) postpartum. Eleven domains were identified, each with several subdomains: 'physical well-being' (e.g. fatigue), 'psychological well-being' (e.g. happiness, emotional confusion), 'general well-being', 'motherhood' (e.g. bonding with the baby), 'family and partnership' (e.g. time for partner and children), 'social life' (e.g. friends, being isolated), 'everyday life' (e.g. organisation daily routine), 'leisure' (e.g. less time), 'work life' (e.g. worries about job), 'financial issues' (e.g. less money), and further aspects. The most frequently indicated domains were 'motherhood' and 'family and partnership'. Differences between the stages of assessment and countries were identified. DISCUSSION: Mothers faced challenges in defining their new role but welcomed the slowdown in the rhythm of life and experienced overwhelming maternal feelings. CONCLUSION: Our findings suggest that postnatal quality of life is a concept that changes over time and differs between countries

Maternal plasma levels of oxytocin during physiological childbirth - a systematic review with implications for uterine contractions and central actions of oxytocin

Oxytocin is a key hormone in childbirth, and synthetic oxytocin is widely administered to induce or speed labour. Due to lack of synthetized knowledge, we conducted a systematic review of maternal plasma levels of oxytocin during physiological childbirth, and in response to infusions of synthetic oxytocin, if reported in the included studies. An a priori protocol was designed and a systematic search was conducted in PubMed, CINAHL, and PsycINFO in October 2015. Search hits were screened on title and abstract after duplicates were removed (n = 4039), 69 articles were examined in full-text and 20 papers met inclusion criteria. As the articles differed in design and methodology used for analysis of oxytocin levels, a narrative synthesis was created and the material was categorised according to effects. Basal levels of oxytocin increased 3-4-fold during pregnancy. Pulses of oxytocin occurred with increasing frequency, duration, and amplitude, from late pregnancy through labour, reaching a maximum of 3 pulses/10 min towards the end of labour. There was a maximal 3- to 4-fold rise in oxytocin at birth. Oxytocin pulses also occurred in the third stage of labour associated with placental expulsion. Oxytocin peaks during labour did not correlate in time with individual uterine contractions, suggesting additional mechanisms in the control of contractions. Oxytocin levels were also raised in the cerebrospinal fluid during labour, indicating that oxytocin is released into the brain, as well as into the circulation. Oxytocin released into the brain induces beneficial adaptive effects during birth and postpartum. Oxytocin levels following infusion of synthetic oxytocin up to 10 mU/min were similar to oxytocin levels in physiological labour. Oxytocin levels doubled in response to doubling of the rate of infusion of synthetic oxytocin. Plasma oxytocin levels increase gradually during pregnancy, and during the first and second stages of labour, with increasing size and frequency of pulses of oxytocin. A large pulse of oxytocin occurs with birth. Oxytocin in the circulation stimulates uterine contractions and oxytocin released within the brain influences maternal physiology and behaviour during birth. Oxytocin given as an infusion does not cross into the mother's brain because of the blood brain barrier and does not influence brain function in the same way as oxytocin during normal labour does

Postnatal quality of life : domains and changes identified from the Mother-Generated Index

Background: Quality of Life (QoL) is a multidimensional concept lacking a uniform definition. The Mother-Generated Index (MGI) assesses postnatal QoL without providing a predefined checklist of questions. Mothers indicate areas of life affected by having a baby. Previous study did not consider the changes during the first weeks postpartum. Hence our study investigated: a) details and particularities of the areas of life affected after childbirth and thus to identify specific domains defining postnatal QoL; and b) differences in the relevance of these domains between weeks one and seven postpartum. Methods: Two-stage survey at three days (124 participants) and seven weeks (83 participants) after birth. We applied a qualitative content analysis of MGI data deductively and inductively build categories. Two raters independently coded with 72% of agreement. Disagreements were solved by discussion. Frequencies of the responses, the diversity of mentioned aspects and their specificity for the life situation of women during the postpartum period were used for the interpretation of the relevance of categories and subcategories. Preliminary results: Thirteen main domains defining postnatal QoL were identified, each with several subdomains: ‘physical wellbeing’ (e.g. fatigue, body consciousness), ‘psychological wellbeing’ (e.g. happiness, emotional confusion), ‘general wellbeing’ (not specified), motherhood (e.g. love and bonding to the baby, experience of giving birth, maternal feelings, breastfeeding), ‘family and partnership’ (e.g. responsibility for family, time for partner and other children), ‘social life’ (e.g. friends, being isolated), ‘everyday life’ (e.g. organisation daily routine, housework), ‘leisure’ (e.g. less time), ‘work life’ (e.g. worries about job), ‘financial issues’ (e.g. less money), ‘future’ (e.g. meaning in life), a ‘shift of priorities’ and a ‘changed role from being a working women’. The most frequently indicated and most specific domains at both stages were ‘family and partnership’ as well as ‘motherhood’. Working life was mentioned more often at three days than seven weeks postpartum. Social life in contrast, either positively or negatively affected, was noticed more often after seven weeks than after three days. Discussion: Women after childbirth identified a wide variety of areas of life affected by having a baby. Some mothers faced challenges to find their new role inside and outside their families and lacked of time for themselves, their leisure, the partner and the other children. Other women welcomed the slowdown of the life rhythm and experienced overwhelming maternal feelings. Conclusion: This study identified domains defining postnatal QoL which differed between weeks one and seven postpartum, suggesting that postnatal QoL is a concept that changes over time for new mothers by having a baby. Ethical matters: Ethical approval from Ethics Committee of Hannover Medical School (Nr. 1556-2012). Funding source: Self-funded study

Maternal plasma levels of oxytocin during physiological childbirth – a systematic review with implications for uterine contractions and central actions of oxytocin

Background:Oxytocin is a key hormone in childbirth, and synthetic oxytocin is widely administered to induce orspeed labour. Due to lack of synthetized knowledge, we conducted a systematic review of maternal plasma levelsof oxytocin during physiological childbirth, and in response to infusions of synthetic oxytocin, if reported in theincluded studies.Methods:An a priori protocol was designed and a systematic search was conducted in PubMed, CINAHL, andPsycINFO in October 2015. Search hits were screened on title and abstract after duplicates were removed (n=4039), 69 articles were examined in full-text and 20 papers metinclusion criteria. As the articles differed in designand methodology used for analysis of oxytocin levels,a narrative synthesis was created and the material wascategorised according to effects.Results:Basal levels of oxytocin increased 3–4-fold during pregnancy. Pulses of oxytocin occurred with increasingfrequency, duration, and amplitude, from late pregnancy through labour, reaching a maximum of 3 pulses/10 mintowards the end of labour. There was a maximal 3- to 4-fold rise in oxytocin at birth. Oxytocin pulses also occurred inthe third stage of labour associated with placental expulsion. Oxytocin peaks during labour did not correlate in timewith individual uterine contractions, suggesting additional mechanisms in the control of contractions. Oxytocin levelswere also raised in the cerebrospinal fluid during labour, indicating that oxytocin is released into the brain, as well asinto the circulation. Oxytocin released into the brain induces beneficial adaptive effects during birth and postpartum.Oxytocin levels following infusion of synthetic oxytocin up to 10 mU/min were similar to oxytocin levels inphysiological labour. Oxytocin levels doubled in response to doubling of the rate of infusion of synthetic oxytocin.Conclusions:Plasma oxytocin levels increase gradually during pregnancy, and during the first and second stages oflabour, with increasing size and frequency of pulses of oxytocin. A large pulse of oxytocin occurs with birth. Oxytocin inthe circulation stimulates uterine contractions and oxytocin released within the brain influences maternal physiologyand behaviour during birth. Oxytocin given as an infusion does not cross into the mother’s brain because of the bloodbrain barrier and does not influence brain function in the same way as oxytocin during normal labour does

Maternal plasma levels of oxytocin during breastfeeding: a systematic review

Introduction: Oxytocin is a key hormone in breastfeeding. No recent review on plasma levels of oxytocin in response to breastfeeding is available. Materials and methods: Systematic literature searches on breastfeeding induced oxytocin levels were conducted 2017 and 2019 in PubMed, Scopus, CINAHL, and PsycINFO. Data on oxytocin linked effects and effects of medical interventions were included if available. Results: We found 29 articles that met the inclusion criteria. All studies had an exploratory design and included 601 women. Data were extracted from the articles and summarised in tables. Breastfeeding induced an immediate and short lasting (20 minutes) release of oxytocin. The release was pulsatile early postpartum (5 pulses/10 minutes) and coalesced into a more protracted rise as lactation proceeded. Oxytocin levels were higher in multiparous versus primiparous women. The number of oxytocin pulses during early breastfeeding was associated with greater milk yield and longer duration of lactation and was reduced by stress. Breastfeeding-induced oxytocin release was associated with elevated prolactin levels; lowered ACTH and cortisol (stress hormones) and somatostatin (a gastrointestinal hormone) levels; enhanced sociability; and reduced anxiety, suggesting that oxytocin induces physiological and psychological adaptations in the mother. Mechanical breast pumping, but not bottle-feeding was associated with oxytocin and prolactin release and decreased stress levels. Emergency caesarean section reduced oxytocin and prolactin release in response to breastfeeding and also maternal mental adaptations. Epidural analgesia reduced prolactin and mental adaptation, whereas infusions of synthetic oxytocin increased prolactin and mental adaptation. Oxytocin infusion also restored negative effects induced by caesarean section and epidural analgesia. Conclusions: Oxytocin is released in response to breastfeeding to cause milk ejection, and to induce physiological changes to promote milk production and psychological adaptations to facilitate motherhood. Stress and medical interventions during birth may influence these effects and thereby adversely affect the initiation of breastfeeding.COST Action IS1405 BIRTH: "Building Intrapartum Research Through Health - An interdisciplinary whole system approach to understanding and contextualizing physiological labour and birth" (http://www.cost.eu/COST_Actions/isch/IS1405), supported by EU COST (European Cooperation in Science and Technology).Depto. de Lógica y Filosofía TeóricaFac. de FilosofíaTRUEpu