title: Correlation between maternal and infant cortisol varies by breastfeeding status.
abstract: OBJECTIVE
  The objective of this study was to examine associations of mother and infant salivary cortisol, measured three times over the course of a day, and assess whether these varied by breastfeeding status.
  
  
  METHODS
  We conducted a cross-sectional study of 54 mothers and their infants aged 4-11 months. Mothers collected their own saliva and that of their infants upon awakening, 30min after waking and at bedtime. Breastfeeding status was reported by mothers and cortisol level was measured in saliva in μg/dl using standard techniques. We used generalized linear models to evaluate relationships between maternal and infant cortisol levels, and assessed whether the relationship differed by breastfeeding status: formula only compared to partial and full breastfeeding, adjusting for infant sex, race, age, maternal education, and family income.
  
  
  RESULTS
  Thirty-four infants received formula only and 20 were either partially or fully breastfed. Breastfeeding was associated with higher household income, higher maternal education, and white race. Cortisol levels were higher among breastfed infants at all three time points. After adjustment, maternal cortisol levels were related with infant cortisol at bedtime only (regression estimate 0.06; 95% CI: 0.10, 1.1; p=0.02). The adjusted association between bedtime maternal and infant cortisol was stronger among breastfeeding dyads than among formula-feeding dyads (regression estimate 1.0; 95% CI: 0.1, 2.0; p=0.04 vs. 0.6; CI: -0.1, 1.3; p=0.10). In addition, we assessed the influence of maternal education and household income in our adjusted model; income strengthened the observed association, whereas maternal education did not change the estimate.
  
  
  CONCLUSIONS
  Breastfeeding mothers and infants had significant correlations for cortisol at bedtime, while formula-feeding dyads did not. These data suggest that several factors may contribute to cortisol synchrony observed in mother/infant dyads, including the transfer of cortisol in human milk, physical interaction such as skin-to-skin contact, and shared environment. In addition, our findings support household income as a possible contributor.
authors.affiliation: Duke University Medical Center, 2200 W Main Street, DUMC 104006, Durham 27705, United States. Electronic address: sara.neelon@jhu.edu.
authors.forename: Sara E
authors.initials: SE
authors.lastname: Benjamin Neelon
authors.affiliation: Department of Community and Family Medicine, Duke University Medical Center, United States.
authors.forename: Marissa
authors.initials: M
authors.lastname: Stroo
authors.affiliation: Department of Community and Family Medicine, Duke University Medical Center, United States.
authors.forename: Meghan
authors.initials: M
authors.lastname: Mayhew
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center and Duke Global Health Institute, United States.
authors.forename: Joanna
authors.initials: J
authors.lastname: Maselko
authors.affiliation: Department of Biological Sciences, North Carolina State University, United States.
authors.forename: Cathrine
authors.initials: C
authors.lastname: Hoyo
mesh_terms: D000328:Adult; D000375:Aging / Q000502:physiology; D001835:Body Weight / Q000502:physiology; D001942:Breast Feeding / Q000523:psychology*; D003430:Cross-Sectional Studies; D004522:Educational Status; D005006:Ethnicity; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007182:Income; D007223:Infant; D007225:Infant Food; D016014:Linear Models; D008297:Male; D009035:Mothers; D012463:Saliva / Q000737:chemistry / Q000378:metabolism; D012727:Sex Characteristics; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000378:metabolism
chemical_list: D006854:Hydrocortisone
keywords: Breastfeeding; Cortisol; Human milk; Stress