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  • 1.
    Ekström, Anette
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Abrahamsson, Hanna
    Department of Obstetrics and Gynecology, Central Hospital, Skövde, Sweden.
    Eriksson, Rose-Marie
    Department of Obstetrics and Gynecology, Central Hospital, Skövde, Sweden.
    Mårtensson, Lena B.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Women’s use of nipple shields - their influence on breastfeeding duration after a process-oriented education for health professionals2014In: Breastfeeding Medicine, ISSN 1556-8253, E-ISSN 1556-8342, Vol. 9, no 9, p. 458-466Article in journal (Refereed)
  • 2.
    Handlin, Linda
    et al.
    University of Skövde, The Systems Biology Research Centre. University of Skövde, School of Life Sciences. Department of Animal Environment and Health, Swedish University of Agriculture, Skara, Sweden.
    Jonas, Wibke
    Department of Women and Child Health, Division of Reproductive and Perinatal Health Care, Karolinska Institute, Stockholm, Sweden.
    Petersson, Maria
    Department of Molecular Medicine, Endocrine and Diabetes Unit, Karolinska University Hospital/Karolinska Institute, Stockholm, Sweden.
    Ejdebäck, Mikael
    University of Skövde, School of Life Sciences. University of Skövde, The Systems Biology Research Centre.
    Ransjö-Arvidsson, Anna-Berit
    Department of Women and Child Health, Division of Reproductive and Perinatal Health Care, Karolinska Institute, Stockholm, Sweden.
    Nissen, Eva
    University of Skövde, School of Life Sciences. Department of Women and Child Health, Division of Reproductive and Perinatal Health Care, Karolinska Institute, Stockholm, Sweden.
    Uvnäs-Moberg, Kerstin
    University of Skövde, School of Life Sciences. Department of Animal Environment and Health, Swedish University of Agriculture, Skara, Sweden.
    Effects of Sucking and Skin-to-Skin Contact on Maternal ACTH and Cortisol Levels During the Second Day Postpartum - Influence of Epidural Analgesia and Oxytocin in the Perinatal Period2009In: Breastfeeding Medicine, ISSN 1556-8253, E-ISSN 1556-8342, Vol. 4, no 4, p. 207-220Article in journal (Refereed)
    Abstract [en]

    Background and Aims: In this study we made a detailed analysis of the mothers' release pattern of adreno-corticotropic hormone (ACTH) and cortisol during a breastfeeding session during the second day postpartum and related these patterns to maternal oxytocin levels as well to the duration of sucking and the duration of skin-to-skin contact before sucking the breast. Furthermore, we investigated if epidural analgesia and oxytocin administration during and after labor influenced the release pattern of ACTH and cortisol.

    Methods: Sixty-three primiparae were included in the study. Fourteen received oxytocin intramuscularly postpartum, nine received oxytocin infusion, 14 received epidural analgesia combined with oxytocin infusion, and six received epidural analgesia alone. Twenty mothers did not receive any of these medical interventions. Blood samples were analyzed for ACTH and cortisol by enzyme-linked immunoassay.

    Results: Both ACTH and cortisol levels fell significantly during the breastfeeding session. A significant negative relationship was found between oxytocin and ACTH levels, but not between oxytocin and cortisol levels. A contact before onset of sucking was significantly and negatively associated with lower cortisol levels, but not with ACTH levels. Cortisol levels differed significantly between mothers having received epidural analgesia with and without oxytocin.

    Conclusions: Breastfeeding is associated with a decrease of ACTH and cortisol levels. Skin-to-skin contact contributes to this effect. ACTH correlated negatively with the duration of sucking and median oxytocin levels, whereas cortisol levels correlated inversely with the duration of skin-to-skin contact preceding sucking, suggesting a partial dissociation between the mechanisms regulating ACTH and cortisol release. In addition, medical interventions in connection with birth influence the activity of the hypothalamic-pituitary-adrenal axis 2 days after birth.

  • 3.
    Jonas, W.
    et al.
    Division of Reproductive and Perinatal Heath Care, Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden.
    Johansson, Linda M.
    University of Skövde, The Systems Biology Research Centre. University of Skövde, School of Life Sciences. Department of Animal Environment and Health, Swedish University of Agriculture, Skara, Sweden.
    Nissen, Eva
    University of Skövde, School of Life Sciences. Division of Reproductive and Perinatal Heath Care, Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden.
    Ejdebäck, Mikael
    University of Skövde, The Systems Biology Research Centre. University of Skövde, School of Life Sciences.
    Ransjö-Arvidson, A. B.
    Division of Reproductive and Perinatal Heath Care, Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden.
    Uvnäs-Moberg, Kerstin
    Department of Animal Environment and Health, Swedish University of Agriculture, Skara.
    Effects of Intrapartum Oxytocin Administration and Epidural Analgesia on the Concentration of Plasma Oxytocin and Prolactin, in Response to Suckling During the Second Day Postpartum2009In: Breastfeeding Medicine, ISSN 1556-8253, E-ISSN 1556-8342, Vol. 4, no 2, p. 71-82Article in journal (Refereed)
    Abstract [en]

    Background: Oxytocin and prolactin stimulate milk ejection and milk production during breastfeeding. The aim of the present study was to make a detailed analysis of maternal release of oxytocin and prolactin in response to breastfeeding during the second day postpartum in mothers who had received oxytocin either intravenously for stimulation of labor or intramuscularly for prevention of postpartum hemorrhage and/or epidural analgesia or those who had received no such treatment in connection with birth.

    Methods: In a descriptive comparative study plasma oxytocin and prolactin concentrations were measured in response to suckling during the second day postpartum in women who had received intravenous intrapartum oxytocin (n = 8), intramuscular postpartum oxytocin (n = 13), or epidural analgesia, either with (n = 14) or without (n = 6) intrapartum oxytocin infusion, and women who received none of these interventions (n = 20). Hormone levels were analyzed by enzyme immunoassay.

    Results: All mothers showed a pulsatile oxytocin pattern during the first 10 minutes of breastfeeding. Women who had received epidural analgesia with oxytocin infusion had the lowest endogenous median oxytocin levels. The more oxytocin infusion the mothers had received during labor, the lower their endogenous oxytocin levels were during a breastfeeding during the second day postpartum. A significant rise of prolactin was observed after 20 minutes in all women, but after 10 minutes in mothers having received oxytocin infusion during labor. In all women, oxytocin variability and the rise of prolactin levels between 0 and 20 minutes correlated significantly with median oxytocin and prolactin levels.

    Conclusion: Oxytocin, released in a pulsatile way, and prolactin were released by breastfeeding during the second day postpartum. Oxytocin infusion decreased endogenous oxytocin levels dose-dependently. Furthermore, oxytocin infusion facilitated the release of prolactin. Epidural analgesia in combination with oxytocin infusion influenced endogenous oxytocin levels negatively.

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