Maternal Work and Infant Feeding Practices in the First 6 Months.

OBJECTIVES: The purpose of this study was to examine the relationship between maternal work and infant feeding practices and explore the moderating impact of parental stress. METHODS: Prospective data on categorical hours worked and infant feeding practices were collected at 3 and 6 months postpartum in a prospective prenatal cohort of 95 women. Chi-square tests were used to compare change in proportion of exclusive breastfeeding from birth to 6 months and maternal work status. RESULTS: Rates of exclusive breastfeeding significantly decreased from birth to 6 months, while the percent of mothers working outside of the home significantly increased from 3 to 6 months. At 6 months, mothers who worked full time pumped significantly more than their non-working counterparts. Multivariate logistic regression models were used to test the prediction of exclusive breastfeeding by maternal work, including sociodemographic covariates, and the moderating impact of parental stress. Results indicated that maternal education, paternal education, and maternal work significantly predicted exclusive breastfeeding at 6 months. Full time work (OR = 0.09, 95% CI = 0.01, 0.62) was associated with a decreased odds of exclusive breastfeeding. Additionally, higher maternal (OR = 1.44, 95% CI = 1.05, 1.97) and paternal (OR = 1.28, 95% CI = 1.00, 1.66) education was associated with an increased odds of exclusive breastfeeding. Maternal stress did not predict exclusive breastfeeding, nor did it have a moderating effect on the relationship between maternal work and breastfeeding. CONCLUSIONS FOR PRACTICE: Future studies should investigate maternal work in more diverse birthing populations to better understand how families can incorporate breastfeeding as a primary infant feeding practice.

Ontogeny of the Dyad: the Relationship Between Maternal and Offspring Neuroendocrine Function.

PURPOSE OF REVIEW: We review ontogeny of the maternal-offspring neuroendocrine relationship in human pregnancy. We present bidirectional genetic, physiological, and behavioral influences that enhance or disrupt HPA activity and its end product cortisol at the individual level and within the dyad. RECENT FINDINGS: Consistent evidence supports that maternal mood and caregiving behavior are associated with maternal and offspring cortisol levels. Select studies support the buffering effects of antidepressant use and maternal positive affect on offspring cortisol. Growing research highlights evocative effects of fetal neuroendocrine activity, antenatal gene transfer, and infant behavioral distress and risk characteristics on maternal cortisol levels and dyadic attunement. There is potential to advance our understanding of the mother-offspring neuroendocrine relationship by consideration of other neuroactive steroids in addition to cortisol, and to consider developmental timing and measurement source in study design. Future study should emphasize in what context or for whom neuroendocrine attunement is adaptive versus maladaptive for mother and child.