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Relation of Plasma Oxytocin and Prolactin Concentrations to Milk Production in Mothers of Preterm Infants: Influence of Stress¹

Department of Obstetrics and Gynecology, Northwestern University (R.T.C., K.R.H.), Chicago, Illinois 60611; University of Illinois College of Nursing (P.D.H.), Chicago, Illinois 60612; University of Illinois College of Medicine J.C.A., S.M.B.), Peoria, Illinois 61656; and Loyola Medical School (M.J.Z.), Chicago, Illinois 60153

Address all correspondence and requests for reprints to: Dr. Robert T. Chatterton, Department of Obstetrics and Gynecology, Northwestern University Medical School, 333 East Superior Street, Chicago, Illinois 60611. E-mail: chat{at}nwu.edu

Responses of oxytocin and PRL to mechanical breast pumping and the influence of physiological indicators of stress were measured at 2, 4, and 6 weeks postpartum to determine potential causes of inadequate milk production in 18 women with prematurely delivered, nonnursing (<1500 g) infants. Median milk production was similar to that reported in breastfeeding mothers, but a third of mothers were producing less than half as much by week 6. Plasma oxytocin was similar to that previously reported for breastfeeding mothers. The oxytocin area under the curve (AUC) for breast-pumping sessions (70 min) was correlated at each occasion (r = 0.37, 0.58, and 0.55, respectively) with milk yield. Unlike reports of PRL levels in breastfeeding women, PRL AUC declined between weeks 2 and 6 weeks postpartum (P = 0.03); significant increases in plasma PRL occurred in response to pumping at 2 and 4 weeks, but not at 6 weeks. Salivary amylase, a measure of -adrenergic activity, was highly negatively correlated on each occasion with PRL AUC (r = -0.58, -0.68, and -0.86, respectively), but not with oxytocin. Salivary cortisol was negatively correlated to a lesser degree. We hypothesize that deficiencies in preterm lactation are mediated in part upon stress-induced suppression of PRL secretion through an adrenergic mechanism.

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