title: Evaluation of the effect of natural and emotional stress of labor on lactation and breast-feeding.
abstract: BACKGROUND
  The amount of stress experienced by both the mother and fetus during labor and delivery varies considerably and is likely to be different in primiparous and multiparous women as well as in those who receive analgesia during labor and those who do not receive.
  
  
  OBJECTIVE
  In this study, we explored relations between stress during birth experience and lactogenesis of 100 women, who experienced vaginal delivery in Department of Obstetrics and Gynecology of University Hospital of Alexandroupolis.
  
  
  METHODS
  Stress hormones (cortisol and glucose) were measured in serum (cord and maternal blood) immediately after delivery. Moreover, breast-feeding frequency on day 4, the time when the subjects first felt fullness in the breasts, milk volume on day 4 postpartum and duration of labor were recorded. Also, we recorded maternal exhaustion score during labor and positive and negative affects, posttraumatic stress score and mother-infant bonding rate, with the use of questionnaires.
  
  
  RESULTS
  There were significant intercorrelations among the outcome variables. Mothers who experienced pain, exhaustion and negative feelings in a stressful and long labor had delayed onset of lactation.
  
  
  CONCLUSIONS
  These results indicate that primiparity, long labor, stress to the mother and fetus during labor and delivery, negative affects and high score of posttraumatic stress are risk factors for delayed lactogenesis.
authors.affiliation: Department of Ob/Gyn, University Hospital of Alexandroupolis, Democritus University of Thrace, 68100, Alexandroupolis, Greece.
authors.forename: Marina
authors.initials: M
authors.lastname: Dimitraki
authors.affiliation: Department of Ob/Gyn, University Hospital of Alexandroupolis, Democritus University of Thrace, 68100, Alexandroupolis, Greece. ptsikour@med.duth.gr.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Tsikouras
authors.affiliation: Department of Ob/Gyn, University Hospital of Alexandroupolis, Democritus University of Thrace, 68100, Alexandroupolis, Greece.
authors.forename: Bachar
authors.initials: B
authors.lastname: Manav
authors.affiliation: Department of Laboratory, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece.
authors.forename: Theodora
authors.initials: T
authors.lastname: Gioka
authors.affiliation: Department of Ob/Gyn, University Hospital of Alexandroupolis, Democritus University of Thrace, 68100, Alexandroupolis, Greece.
authors.forename: Nikoletta
authors.initials: N
authors.lastname: Koutlaki
authors.affiliation: Department of Ob/Gyn, University Davilla of Romania and Rhea Hospital Athens, Bucharest, Greece.
authors.forename: Stefanos
authors.initials: S
authors.lastname: Zervoudis
authors.affiliation: Department of Ob/Gyn, University Hospital of Alexandroupolis, Democritus University of Thrace, 68100, Alexandroupolis, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Galazios
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D001942:Breast Feeding; D036861:Delivery, Obstetric; D005260:Female; D005865:Gestational Age; D006115:Greece; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007223:Infant; D007231:Infant, Newborn; D007743:Labor, Obstetric / Q000502:physiology / Q000523:psychology; D007774:Lactation / Q000502:physiology* / Q000523:psychology; D007775:Lactation Disorders / Q000209:etiology*; D008297:Male; D009035:Mothers / Q000523:psychology*; D010298:Parity; D049590:Postpartum Period; D011247:Pregnancy; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications*; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D001786:Blood Glucose; D006854:Hydrocortisone
keywords: Breastfeeding; Cortisol; Glucose; Labor; Stress; Stress hormones