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  1. Caparros-Gonzalez, Rafael A. PhD, BSc, RN
  2. Romero-Gonzalez, Borja BSc
  3. Gonzalez-Perez, Raquel PhD
  4. Lara-Cinisomo, Sandraluz PhD
  5. Martin-Tortosa, Pablo L. RN
  6. Oliver-Roig, Antonio PhD, RN
  7. Peralta-Ramirez, Maria Isabel PhD


Background: Several factors can influence the production of mothers' own milk.


Purpose: To assess the influence of maternal psychological stress, maternal cortisol levels, and neonatal hair cortisol levels on timing of secretory activation.


Methods: A prospective study was conducted at 2 public health centers in Andalusia, Spain. Participants were 60 pregnant women and their 60 neonates. Hair cortisol levels and psychological stress (pregnancy-specific stress [Prenatal Distress Questionnaire, PDQ] and perceived stress [Perceived Stress Scale, PSS]) were evaluated during the third trimester and the postpartum period. This study was part of the GESTASTRESS cohort study on the effects of stress during pregnancy.


Results: Higher PDQ and PSS scores (P < .05) in the third trimester were associated with later onset of secretory activation. Higher postpartum maternal hair cortisol levels were associated with a delayed secretory activation of mother's own milk (P < .05).


Implications for Research: Future studies should look at the influence of psychological stress and cortisol levels on hormones involved in mother's own milk production.


Implications for Practice: Neonatal nurses and other healthcare providers should be familiar with levels of neonates' exposure to maternal prenatal stress prior to birth.