Impaired lactation performance following elective delivery at term: role of maternal levels of cortisol and prolactin

Objective: Lactation performance depends on stress surrounding labor and delivery, and it is likely to be different in women who underwent elective cesarean delivery (ECD) or vaginal (VD). The aim of this study was to assess the relationship between cortisol and human prolactin (hPRL), following ECD and lactation performance, from the delivery room to the 6th month of life. Methods: A total of 106 mothers were consecutively enrolled: 38 after ECD, 28 after emergency cesarean delivery (EmCD), and 40 after VD. Results: Basal stress-, lactogenic-hormones, cortisol, and hPRL were comparable on day 3 postpartum in all the women. Multivariate analysis indicated that ECD has a negative impact (OR; 95% CI) on breastfeeding prevalence on the seventh day (0.14; 0.0-0.44, p = 0.008) and at third month post partum (0.19; 0.05-0.71, p = 0.05) in comparison to VD. In addition, hPRL levels proved to have a statistically significant role in early breastfeeding (1.01; 1-1.01, p = 0.002). Conclusions: ECD is a risk factor for successful lactation performance. This information should be provided to mothers and caregivers for extra breastfeeding guidance.