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. 2023 Sep 16;15(18):4006.
doi: 10.3390/nu15184006.

Effects of Maternal Stress on Breast Milk Production and the Microbiota of Very Premature Infants

María Del Carmen Fernández-Tuñas  1   2   3 , Alejandro Pérez-Muñuzuri  1   2   3   4 , Rocío Trastoy-Pena  5 , María Luisa Pérez Del Molino  5 , María L Couce  1   2   3   4
Affiliations

Effects of Maternal Stress on Breast Milk Production and the Microbiota of Very Premature Infants

María Del Carmen Fernández-Tuñas et al. Nutrients. .

Abstract

Perinatal stress experienced by mothers of very premature newborns may influence the mother's milk and the infant's intestinal microbiota. This prospective study of mothers of very preterm infants fed with mother's own milk (MOM) was carried out in a tertiary hospital over a 2-year period. The assessment of maternal stress in 45 mothers of 52 very preterm newborns using the parental stress scale (PSS:NICU) revealed an inverse relationship between stress and MOM production in the first days of life (p = 0.012). The greatest contributor to stress was the one related to the establishment of a mother-child bond. Maternal stress was lower in mothers in whom the kangaroo method was established early (p = 0.011) and in those with a higher educational level (p = 0.032). Levels of fecal calprotectin (FC) decreased with the passage of days and were directly correlated with birthweight (p = 0.044). FC levels 7 days post-delivery were lower in newborns that received postnatal antibiotics (p = 0.027). High levels of maternal stress resulted in progressive decreases and increases in the proportions of Firmicutes and Proteobacteria species, respectively, over 15 days post-delivery, both in MOM and in fecal samples from premature newborns. These findings underscore the importance of recognizing and appropriately managing maternal stress in neonatal units, given its marked influence on both the microbiota of maternal milk and the intestinal microbiota of premature newborns.

Keywords: fecal calprotectin; maternal stress; microbiota; mother’s own milk; very preterm.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Stress scale scores for mothers on days 3, 7, and 15 post-delivery. CS, common stress; CWS, communication with healthcare team; d, day; MR, maternal role; PAB, physical appearance and behavior; TS, total stress; VAS, visual and auditory stimuli.
Figure 2
Figure 2
Microbiota of MOM and neonatal stool samples collected at days 3 (A), 7 (B), and 15 (C) post-delivery.
Figure 2
Figure 2
Microbiota of MOM and neonatal stool samples collected at days 3 (A), 7 (B), and 15 (C) post-delivery.
See this image and copyright information in PMC

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