Determinants of maternal breast milk cortisol increase: Examining dispositional and situational factors.

BACKGROUND: Breast milk is a rich nutritional source, containing numerous proteins, carbohydrates, and hormones that impact long-term offspring development. Strikingly, predictors and correlates of breast milk composition remain largely unknown. Building on a previously discovered increase in breast milk cortisol concentration from 2 to 12 weeks postpartum, we investigated potential predictors of maternal breast milk cortisol in the first three months post-delivery by examining a suite of maternal dispositional (e.g., attachment, adverse childhood experiences or ACEs) and situational factors (e.g., partner support, self-efficacy). METHODS: Data from 73 mothers were collected prenatally, at birth, and 2-, 6- and 12 weeks postpartum. The analyses, which sought to predict postnatal changes in breast milk cortisol, included a pool of theoretically-sound constructs (Table 1) and an exploratory data-driven approach. We fit models differing in complexity as preregistered: 1) Random Forest models, capable of modeling interactions and non-linear relationships, and 2) Bayesian linear models, allowing to model change over time while less prone to overfitting. RESULTS: Overall, we found that no single variable had strong predictive value beyond the known predictors of cortisol, such as time since awakening and time of collection. However, results from both models suggest that ACEs carry information that warrants future investigations, pointing towards a negative relationship with cortisol concentration in breast milk, albeit with a minimal effect size. CONCLUSION: Using sophisticated models, we found that early life stress may play a role in physiological stress markers in breast milk in the first three months postpartum, with potential implications for offspring development.