Oxytocin release and plasma anterior pituitary and gonadal hormones in women during lactation

The interplay of oxytocin and sex hormones

The neuropeptide oxytocin has historically been associated with reproduction and maternal behavior. However, more recent research has uncovered that oxytocin has a much wider range of roles in physiology and behavior. Despite the excitement surrounding potential therapeutical applications of intranasally administered oxytocin, the results of these intervention studies have been inconsistent. Various reasons for these mixed results have been proposed, which tend to focus on methodological issues, such as study design. While methodological issues are certainly important, emerging evidence suggests that the interaction between oxytocin and sex hormones may also account for these varied findings. To better understand the purpose and function of the interaction of oxytocin with sex hormones, with a focus on estrogens, progesterone, and testosterone, we conducted a comprehensive thematic review via four perspectives: evolutionary, developmental, mechanistic, and survival. Altogether, this synergistic approach highlights the critical function of sex hormone activity for accomplishing the diverse roles of oxytocin via the modulation of oxytocin release and oxytocin receptor activity, which is also likely to contribute to the heterogeneity of outcomes after oxytocin administration.

Maternal physiological calming responses to infant suckling at the breast

The mother-infant relation is key to infant physical, cognitive and social development. Mutual regulation and cooperation are required to maintain the dyadic system, but the biological foundation of these responses remains to be clarified. In this study, we report the maternal calming responses to infant suckling during breastfeeding. Using behavioral measures and a Holter electrocardiogram as a readout of the maternal autonomic nervous system, the maternal activities during resting, sitting with her infant on her lap, and breastfeeding were assessed. We found that during breastfeeding, mothers talked less and maternal heart rate was lower than during sitting with the infant without breastfeeding. Congruently, maternal heart rate variability measurements indicated a higher parasympathetic activity during breastfeeding. Time-locked analyses suggested that this maternal calming response was initiated by the tactile stimulation at the breast by the infant face or mouth latch, which preceded the perceived milk ejection. These findings suggest that somatosensory stimuli of breastfeeding activate parasympathetic activity in mothers. Just as how the infant Transport Response facilitates the carrying of infants, the maternal calming responses during breastfeeding may promote efficient milk intake by inhibiting spontaneous maternal activities.

Infant Stimulation Induced a Rapid Increase in Maternal Salivary Oxytocin

Oxytocin (OT) is a neuropeptide involved in human social behaviors and reproduction. Non-invasive OT levels in saliva have recently roused interest as it does not require a specialized medical setting. Here, we observed one woman’s basal serum and saliva OT from pregnancy to 1 year postpartum to track OT concentration changes over this period. We examined the changes in salivary OT levels over time in response to maternal physiological and behavioral responses. The fluctuation of saliva OT levels is well correlated with serum OT during pregnancy and breastfeeding. However, while salivary OT increased rapidly during direct interaction (social interaction tests) with the infant and/or when the mother was watching her own infant’s video (video tests), no increase was observed in serum. We used social interaction and video tests on a group of mothers (nine mothers for social interaction and six for the video test) to clarify these single-subject results. In both tests, the mothers had increased OT in their saliva but not serum. Our study may suggest that salivary samples reflect not only the physical but also the emotional state and that saliva samples may be useful for monitoring women’s OT levels during pre- and postpartum periods. Further studies with larger sample numbers are necessary to confirm the rapid changes in salivary OT levels in response to maternal physiological and behavioral responses.

Dysfunctions of brain oxytocin signaling: Implications for poor mothering

Good mothering has profound impact on both the mother's and the young's well-being. Consequently, experiencing inadequate maternal care - or even neglect - in the first stages of life is a major risk factor for the development of psychiatric disorders, and even for poor parenting towards the future offspring. Thus, understanding the neurobiological basis of maternal neglect becomes crucial. Along with other neurotransmitters and neuropeptides, oxytocin (OXT) has long been known as one of the main modulators of maternal behavior. In rodents, disruptions of central OXT transmission have been associated with poor maternal responses, like impaired onset of nursing behaviors, and reduced care and defense of the pups. Importantly, such behavioral and molecular deficits can be transmitted through generations, creating a vicious circle of low-quality maternal behavior. Similarly, evidence from human studies shows that OXT signaling is defective in conditions of inadequate mothering and child neglect. On those premises, this review aims at providing a comprehensive overview of animal and human studies linking perturbed OXT transmission to poor maternal behavior. Considering the important fallouts of inadequate maternal responses, we believe that unraveling the alterations in OXT transmission might provide useful insights for a better understanding of maternal neglect and, ultimately, for future intervention approaches.

The action of oxytocin on the bone of senescent female rats

AIMS

This study verified the action of oxytocin (OT) as a preventive measure to control bone damage during aging in female rats.

MAIN METHODS

Wistar rats received saline (0.15 mol/L/IP; Vehicle Group), Atosiban/AT (300 μg/Kg/IP; At Group), OT (134 μg/Kg/IP; Ot Group), or AT+OT (OT injections 5 min after AT; At+Ot Group), at 19 and 20 months of age. A functional test was performed immediately before and 30 days after the injections to analyze the animals' gait.

KEY FINDINGS

Animals in the At group had higher alkaline phosphatase (ALP) activity, lower cortical and trabecular thickness, fewer trabeculae, higher expression of tartrate-resistant acid phosphatase (TRAP) and lower osteocalcin (OCN), higher cortical porosity, and lower moment of inertia and bone strength at the femoral neck. OT administration increased lipidic peroxidation and plasma superoxide dismutase (SOD), and provided, in the femoral neck, lower expression of TRAP and higher OCN, greater cortical and trabecular thickness, a greater number of trabeculae, bone mineral density (BMD), higher inertia bone strength, and lower cortical porosity. At + Ot group showed great similarity with the vehicle group, higher SOD, and BMD. An increase in stride length and no increase in base width of 21-month-old animals were observed after OT, unlike animal's vehicle or AT.

SIGNIFICANCE

Endogenous OT plays an important role in the regulation of bone remodeling during periestropause, and exogenous OT stands out as a potential preventive intervention in this period to improve bone quality with functional repercussions, possibly providing better gait activity.

Maternal plasma levels of oxytocin during breastfeeding-A systematic review

Introduction

Oxytocin is a key hormone in breastfeeding. No recent review on plasma levels of oxytocin in response to breastfeeding is available.

Materials and methods

Systematic literature searches on breastfeeding induced oxytocin levels were conducted 2017 and 2019 in PubMed, Scopus, CINAHL, and PsycINFO. Data on oxytocin linked effects and effects of medical interventions were included if available.

Results

We found 29 articles that met the inclusion criteria. All studies had an exploratory design and included 601 women. Data were extracted from the articles and summarised in tables. Breastfeeding induced an immediate and short lasting (20 minutes) release of oxytocin. The release was pulsatile early postpartum (5 pulses/10 minutes) and coalesced into a more protracted rise as lactation proceeded. Oxytocin levels were higher in multiparous versus primiparous women. The number of oxytocin pulses during early breastfeeding was associated with greater milk yield and longer duration of lactation and was reduced by stress. Breastfeeding-induced oxytocin release was associated with elevated prolactin levels; lowered ACTH and cortisol (stress hormones) and somatostatin (a gastrointestinal hormone) levels; enhanced sociability; and reduced anxiety, suggesting that oxytocin induces physiological and psychological adaptations in the mother. Mechanical breast pumping, but not bottle-feeding was associated with oxytocin and prolactin release and decreased stress levels. Emergency caesarean section reduced oxytocin and prolactin release in response to breastfeeding and also maternal mental adaptations. Epidural analgesia reduced prolactin and mental adaptation, whereas infusions of synthetic oxytocin increased prolactin and mental adaptation. Oxytocin infusion also restored negative effects induced by caesarean section and epidural analgesia.

Conclusions

Oxytocin is released in response to breastfeeding to cause milk ejection, and to induce physiological changes to promote milk production and psychological adaptations to facilitate motherhood. Stress and medical interventions during birth may influence these effects and thereby adversely affect the initiation of breastfeeding.

Breastfeeding dynamically changes endogenous oxytocin levels and emotion recognition in mothers

Breastfeeding behaviours can significantly change mothers' physiological and psychological states. The hormone oxytocin may mediate breastfeeding and mothers' emotion recognition. This study examined the effects of endogenous oxytocin fluctuation via breastfeeding on emotion recognition in 51 primiparous mothers. Saliva oxytocin was assessed before and after the manipulation (breastfeeding or holding an infant), and emotion recognition tasks were conducted. Among mothers who breastfed daily, mothers with more increased levels of oxytocin after breastfeeding showed more reduced negative recognition and enhanced positive recognition of adult facial expressions. These oxytocin functions accompanying breastfeeding may support continued nurturing behaviours and also affect the general social cognition of other adults beyond any specific effect on infants.

Bottlenose dolphin calves have multi-year elevations of plasma oxytocin compared to all other age classes

Providing for infants nutritionally via lactation is one of the hallmarks of mammalian reproduction, and infants without motivated mothers providing for them are unlikely to survive. Mothers must maintain regular contact with infants both spatially and temporally while utilising their environment to forage, avoid threats and find shelter. However, mothers can only do this and maximise their reproductive success with some degree of co-operation from infants, despite their developing physical and cognitive capabilities. The neuropeptide hormone oxytocin (OT) triggers proximity-seeking behaviour and acts in a positive feedback loop across mother-infant bonds, stimulating appropriate pro-social behaviour across the pair. However, data on infant OT levels is lacking, and it is unclear how important infants are in maintaining mother-infant associations. The bottlenose dolphin (Tursiops truncatus) is a mammalian species that is fully physically mobile at birth and has multi-year, but individually variable, lactation periods. We investigated OT concentrations in mother-infant pairs of wild individuals compared to other age and reproductive classes. An ELISA to detect OT in dolphin plasma was successfully validated with extracted plasma. We highlight a statistical method for testing for parallelism that could be applied to other ELISA validation studies. OT concentrations were consistently elevated in calves up to at least 4 years of age with lactating mothers (12.1 ± 0.9 pg/ml), while all mothers (4.5 ± 0.4 pg/ml) had OT concentrations comparable to non-lactating individuals (5.9 ± 0.5 pg/ml). Concentrations within infants were individually variable, and may reflect the strength of the bond with their mother. The OT system likely provides a physiological mechanism for motivating infants to perform behaviours that prevent long-term separation from their mothers during this crucial time in their life history. Elevated infant OT has also been linked to energetic and developmental advantages which may lead to greater survival rates. Environmental or anthropogenic disturbances to OT release can occur during bond formation or can disrupt the communication methods used to reinforce these bonds via OT elevation. Variation in OT expression in infants, and its behavioural and physiological consequences, may explain differences in reproductive success despite appropriate maternal behaviour expression.

Psychological effects of breastfeeding on children and mothers

While the nutritional and physical health benefits of breastfeeding are well established, accumulating research demonstrates the far-reaching psychological effects of breastfeeding on children and their mothers. Here, we provide a non-exhaustive review of the empirical evidence, showing that breastfeeding impacts children's brain, cognitive, and socio-emotional development. In mothers, research is presented indicating that breastfeeding influences mood, affect, stress, and maternal care. The current review aims to provide a broad overview of existing findings on the psychological effects of breastfeeding, highlighting the important role that breastfeeding plays across several dimensions of psychological functioning. We also discuss the potential mechanisms that may underpin the observed effects, provide a constructive commentary on the limitations of the existing work, and put forth some considerations when evaluating this line of research.

Neuromodulation of maternal circuits by oxytocin

Motherhood in mammals involves tremendous changes throughout the body and central nervous system, which support attention and nurturing of infants. Maternal care consists of complex behaviors, such as nursing and protection of the offspring, requiring new mothers to become highly sensitive to infant needs. Long-lasting neural plasticity in various regions of the cerebral cortex may enable the perception and recognition of infant cues, important for appropriate caregiving responses. Recent findings have demonstrated that the neuropeptide oxytocin is involved in a number of physiological processes, including parturition and lactation and dynamically shaping neuronal responses to infant stimuli as well. Here, we review experience-dependent changes within the cortex occurring throughout motherhood, focusing on plasticity of the somatosensory and auditory cortex. We outline the role of oxytocin in gating cortical plasticity and discuss potential mechanisms regulating oxytocin release in response to different sensory stimuli.

Effects of Breastfeeding on Maternal Health and Well-Being

Lactation occurs as part of a reproductive and may have different effects on maternal nutritional status, depending on its duration and intensity. Thus, its effect on maternal health will differ with cultural setting and level of development. Lactation helps women to maintain a healthy body weight. Among well-nour-shed women, it may help to prevent obesity. Among poorly pour/shed women, breastfeeding also leads to weight loss, but with adequate birth spacing brought about by lactational anovulation, maternal depletion can be avoided. Lactation is probably not responsible for osteoporosis. Current evidence suggests that breastfeeding helps to prevent pre-menopausal breast cancer and is not associated with post-menopausal disease Furthermore, breastfeeding may also help reduce ovarian cancer. Positive effects of breastfeeding occur at all levels of development and are most likely when biological, political, and sociocultural conditions interact to support its initiation and continuation.

Human milk cortisol concentration predicts experimentally induced infant fear reactivity: moderation by infant sex

Little consideration has been given to the possibility of human infant development being shaped via lactocrine programming, and by breast milk cortisol levels specifically. Despite animal models indicating that glucocorticoid (GC) exposure via lactation might modify brain development and behavior, only one study has reported that milk cortisol levels were positively associated with infant negative affectivity, especially fearfulness and sadness-early emerging risk factors for internalizing difficulties such as anxiety. The aim of the current study was to investigate whether human milk cortisol is associated with mother-reported fearfulness and experimentally induced infant fear reactivity. Mother-infant dyads (n = 65) enrolled in the FinnBrain Cohort Study participated. Breast milk samples were obtained 2.5 months postpartum, and milk cortisol concentrations were ascertained using validated luminescence immunoassay methodology. Infant fear reactivity was assessed using maternal reports 6 months postpartum and in a laboratory 8 months postpartum. There was a significant interaction between infant sex and milk cortisol such that higher milk cortisol was related to higher infant fear reactivity in a laboratory setting in girls (β = 0.36, p = .04) but not in boys (β = -0.15, p = .40). Milk cortisol was not associated with mother-reported infant fearfulness. Results suggest that higher human milk cortisol concentrations are associated with elevated experimentally induced fear in infancy. Findings support lactocrine programming, and suggest that mothers may "communicate" vital information about stressful environments via cortisol contained in breast milk, shaping girls' early emotional reactivity.

The neurocircuitry involved in oxytocin modulation of methamphetamine addiction

The role of oxytocin in attenuating the abuse of licit and illicit drugs, including the psychostimulant methamphetamine, has been examined with increased ferocity in recent years. This is largely driven by the potential application of oxytocin as a pharmacotherapy. However, the neural mechanisms by which oxytocin modulates methamphetamine abuse are not well understood. Recent research identified an important role for the accumbens core and subthalamic nucleus in this process, which likely involves an interaction with dopamine, glutamate, GABA, and vasopressin. In addition to providing an overview of methamphetamine, the endogenous oxytocin system, and the effects of exogenous oxytocin on drug abuse, we propose a neural circuit through which exogenous oxytocin modulates methamphetamine abuse, focusing on its interaction with neurochemicals within the accumbens core and subthalamic nucleus. A growing understanding of exogenous oxytocin effects at a neurochemical and neurobiological level will assist in its evaluation as a pharmacotherapy for drug addiction.

G-Protein-coupled receptors as potential drug candidates in preeclampsia: targeting the relaxin/insulin-like family peptide receptor 1 for treatment and prevention

BACKGROUND

Important roles for G-protein-coupled receptors (GPCRs) have been identified in the maternal physiological adaptations to pregnancy and in the pathogenesis of preeclampsia. On this basis, GPCRs are potential therapeutic targets for preeclampsia.

OBJECTIVES AND RATIONALE

In this review, vasopressin and apelin are initially considered in this context before the focus on the hormone relaxin and its cognate receptor, the relaxin/insulin-like family peptide receptor 1 (RXFP1). Based on both compelling scientific rationale and a promising safety profile, the relaxin ligand-receptor system is comprehensively evaluated as a potential therapeutic endpoint in preeclampsia.

SEARCH METHODS

The published literature relating to the topic was searched through January 2016 using PubMed.

OUTCOMES

Relaxin is a peptide hormone secreted by the corpus luteum; it circulates in the luteal phase and during pregnancy. Activation of RXFP1 is vasodilatory; thus, relaxin supplementation is expected to at least partly restore the fundamental vasodilatory changes of normal pregnancy, thereby alleviating maternal organ hypoperfusion, which is a major pathogenic manifestation of severe preeclampsia. Specifically, by exploiting its pleiotropic hemodynamic attributes in preeclampsia, relaxin administration is predicted to (i) reverse robust arterial myogenic constriction; (ii) blunt systemic and renal vasoconstriction in response to activation of the angiotensin II receptor, type 1; (iii) mollify the action of endogenous vasoconstrictors on uterine spiral arteries with failed remodeling and retained smooth muscle; (iv) increase arterial compliance; (v) enhance insulin-mediated glucose disposal by promoting skeletal muscle vasodilation and (vi) mobilize and activate bone marrow-derived angiogenic progenitor cells, thereby repairing injured endothelium and improving maternal vascularity in organs such as breast, uterus, pancreas, skin and fat. By exploiting its pleiotropic molecular attributes in preeclampsia, relaxin supplementation is expected to (i) enhance endothelial nitric oxide synthesis and bioactivity, as well as directly reduce vascular smooth muscle cytosolic calcium, thus promoting vasodilation; (ii) improve the local angiogenic balance by augmenting arterial vascular endothelial and placental growth factor (VEGF and PLGF) activities; (iii) ameliorate vascular inflammation; (iv) enhance placental peroxisome proliferator-activated receptor gamma, coactivator 1 alpha (PCG1α) expression, and hence, peroxisome proliferator-activated receptor gamma (PPAR-γ) activity and (v) confer cytotrophoblast and endothelial cytoprotection. Insofar as impaired endometrial maturation (decidualization) predisposes to the development of preeclampsia, relaxin administration in the late secretory phase and during early pregnancy would be anticipated to improve decidualization, and hence trophoblast invasion and spiral artery remodeling, thereby reducing the risk of preeclampsia. Relaxin has a favorable safety profile both in the non-pregnant condition and during pregnancy.

WIDER IMPLICATIONS

There is a strong scientific rationale for RXFP1 activation in severe preeclampsia by administration of relaxin, relaxin analogs or small molecule mimetics, in order to mollify the disease pathogenesis for safe prolongation of pregnancy, thus allowing time for more complete fetal maturation, which is a primary therapeutic endpoint in treating the disease. In light of recent data implicating deficient or defective decidualization as a potential etiological factor in preeclampsia and the capacity of relaxin to promote endometrial maturation, the prophylactic application of relaxin to reduce the risk of preeclampsia is a plausible therapeutic approach to consider. Finally, given its pleiotropic and beneficial attributes particularly in the cardiovascular system, relaxin, although traditionally considered as a 'pregnancy' hormone, is likely to prove salutary for several disease indications in the non-pregnant population.

Maternal Mineral and Bone Metabolism During Pregnancy, Lactation, and Post-Weaning Recovery

During pregnancy and lactation, female physiology adapts to meet the added nutritional demands of fetuses and neonates. An average full-term fetus contains ∼30 g calcium, 20 g phosphorus, and 0.8 g magnesium. About 80% of mineral is accreted during the third trimester; calcium transfers at 300-350 mg/day during the final 6 wk. The neonate requires 200 mg calcium daily from milk during the first 6 mo, and 120 mg calcium from milk during the second 6 mo (additional calcium comes from solid foods). Calcium transfers can be more than double and triple these values, respectively, in women who nurse twins and triplets. About 25% of dietary calcium is normally absorbed in healthy adults. Average maternal calcium intakes in American and Canadian women are insufficient to meet the fetal and neonatal calcium requirements if normal efficiency of intestinal calcium absorption is relied upon. However, several adaptations are invoked to meet the fetal and neonatal demands for mineral without requiring increased intakes by the mother. During pregnancy the efficiency of intestinal calcium absorption doubles, whereas during lactation the maternal skeleton is resorbed to provide calcium for milk. This review addresses our current knowledge regarding maternal adaptations in mineral and skeletal homeostasis that occur during pregnancy, lactation, and post-weaning recovery. Also considered are the impacts that these adaptations have on biochemical and hormonal parameters of mineral homeostasis, the consequences for long-term skeletal health, and the presentation and management of disorders of mineral and bone metabolism.

Maternal Oxytocin Is Linked to Close Mother-Infant Proximity in Grey Seals (Halichoerus grypus)

Maternal behaviour is a crucial component of reproduction in all mammals; however the quality of care that mothers give to infants can vary greatly. It is vital to document variation in maternal behaviour caused by the physiological processes controlling its expression. This underlying physiology should be conserved throughout reproductive events and should be replicated across all individuals of a species; therefore, any correlates to maternal care quality may be present across many individuals or contexts. Oxytocin modulates the initiation and expression of maternal behaviour in mammals; therefore we tested whether maternal plasma oxytocin concentrations correlated to key maternal behaviours in wild grey seals (Halichoerus grypus). Plasma oxytocin concentrations in non-breeding individuals (4.3 ± 0.5 pg/ml) were significantly lower than those in mothers with dependent pups in both early (8.2 ± 0.8 pg/ml) and late (6.9 ± 0.7 pg/ml) lactation. Maternal plasma oxytocin concentrations were not correlated to the amount of nursing prior to sampling, or a mother's nursing intensity throughout the dependent period. Mothers with high plasma oxytocin concentrations stayed closer to their pups, reducing the likelihood of mother-pup separation during lactation which is credited with causing starvation, the largest cause of pup mortality in grey seals. This is the first study to link endogenous oxytocin concentrations in wild mammalian mothers with any type of maternal behaviour. Oxytocin's structure and function is widely conserved across mammalian mothers, including humans. Defining the impact the oxytocin system has on maternal behaviour highlights relationships that may occur across many individuals or species, and such behaviours heavily influence infant development and an individual's lifetime reproductive success.

Genetic variation in CD38 and breastfeeding experience interact to impact infants' attention to social eye cues

Attending to emotional information conveyed by the eyes is an important social skill in humans. The current study examined this skill in early development by measuring attention to eyes while viewing emotional faces in 7-mo-old infants. In particular, we investigated individual differences in infant attention to eyes in the context of genetic variation (CD38 rs3796863 polymorphism) and experiential variation (exclusive breastfeeding duration) related to the oxytocin system. Our results revealed that, whereas infants at this age show a robust fear bias (increased attention to fearful eyes), their attention to angry and happy eyes varies as a function of exclusive breastfeeding experience and genetic variation in CD38. Specifically, extended exclusive breastfeeding duration selectively enhanced looking preference to happy eyes and decreased looking to angry eyes. Importantly, however, this interaction was impacted by CD38 variation, such that only the looking preferences of infants homozygous for the C allele of rs3796863 were affected by breastfeeding experience. This genotype has been associated with reduced release of oxytocin and higher rates of autism. In contrast, infants with the CA/AA genotype showed similar looking preferences regardless of breastfeeding exposure. Thus, differences in the sensitivity to emotional eyes may be linked to an interaction between the endogenous (CD38) and exogenous (breastfeeding) availability of oxytocin. These findings underline the importance of maternal care and the oxytocin system in contributing to the early development of responding to social eye cues.

Emotion Reactivity Is Increased 4-6 Weeks Postpartum in Healthy Women: A Longitudinal fMRI Study

Marked endocrine alterations occur after delivery. Most women cope well with these changes, but the postpartum period is associated with an increased risk of depressive episodes. Previous studies of emotion processing have focused on maternal–infant bonding or postpartum depression (PPD), and longitudinal studies of the neural correlates of emotion processing throughout the postpartum period in healthy women are lacking. In this study, 13 women, without signs of post partum depression, underwent fMRI with an emotional face matching task and completed the MADRS-S, STAI-S, and EPDS within 48 h (early postpartum) and 4–6 weeks after delivery (late postpartum). Also, data from a previous study including 15 naturally cycling controls assessed in the luteal and follicular phase of the menstrual cycle was used. Women had lower reactivity in insula, middle frontal gyrus (MFG), and inferior frontal gyrus (IFG) in the early as compared to the late postpartum assessment. Insular reactivity was positively correlated with anxiety in the early postpartum period and with depressive symptoms late postpartum. Reactivity in insula and IFG were greater in postpartum women than in non-pregnant control subjects. Brain reactivity was not correlated with serum estradiol or progesterone levels. Increased reactivity in the insula, IFG, and MFG may reflect normal postpartum adaptation, but correlation with self-rated symptoms of depression and anxiety in these otherwise healthy postpartum women, may also suggest that these changes place susceptible women at increased risk of PPD. These findings contribute to our understanding of the neurobiological aspects of the postpartum period, which might shed light on the mechanisms underlying affective puerperal disorders, such as PPD.

Duration of exclusive breastfeeding is associated with differences in infants' brain responses to emotional body expressions

Much research has recognized the general importance of maternal behavior in the early development and programing of the mammalian offspring's brain. Exclusive breastfeeding (EBF) duration, the amount of time in which breastfed meals are the only source of sustenance, plays a prominent role in promoting healthy brain and cognitive development in human children. However, surprisingly little is known about the influence of breastfeeding on social and emotional development in infancy. In the current study, we examined whether and how the duration of EBF impacts the neural processing of emotional signals by measuring electro-cortical responses to body expressions in 8-month-old infants. Our analyses revealed that infants with high EBF experience show a significantly greater neural sensitivity to happy body expressions than those with low EBF experience. Moreover, regression analyses revealed that the neural bias toward happiness or fearfulness differs as a function of the duration of EBF. Specifically, longer breastfeeding duration is associated with a happy bias, whereas shorter breastfeeding duration is associated with a fear bias. These findings suggest that breastfeeding experience can shape the way in which infants respond to emotional signals.

Breastfeeding experience differentially impacts recognition of happiness and anger in mothers

Breastfeeding is a dynamic biological and social process based on hormonal regulation involving oxytocin. While there is much work on the role of breastfeeding in infant development and on the role of oxytocin in socio-emotional functioning in adults, little is known about how breastfeeding impacts emotion perception during motherhood. We therefore examined whether breastfeeding influences emotion recognition in mothers. Using a dynamic emotion recognition task, we found that longer durations of exclusive breastfeeding were associated with faster recognition of happiness, providing evidence for a facilitation of processing positive facial expressions. In addition, we found that greater amounts of breastfed meals per day were associated with slower recognition of anger. Our findings are in line with current views of oxytocin function and support accounts that view maternal behaviour as tuned to prosocial responsiveness, by showing that vital elements of maternal care can facilitate the rapid responding to affiliative stimuli by reducing importance of threatening stimuli.

Neuroendocrinology of childbirth and mother-child attachment: the basis of an etiopathogenic model of perinatal neurobiological disorders

This review focuses on the neuroendocrine mechanisms in the mother and the newborn that are involved in the generation and consolidation of mother-child attachment. The role that different hormones and neurotransmitters play on the regulation of these mechanisms during parturition, the immediate postpartum period and lactation is discussed. Interferences in the initiation of mother-child attachment may have potential long-term effects for the behavior and affection of the newborn. Therefore, the possible consequences of alterations in the physiological neuroendocrine mechanisms of attachment, caused by elective Cesarean section, intrapartum hormonal manipulations, preterm delivery, mother-infant postpartum separation and bottle-feeding instead of breastfeeding are also discussed.

Biological aspects of postpartum depression

In comparison with the vast epidemiological literature on postpartum depression (PPD), relatively few studies have examined the biological aspects of the disorder. However, research into the biological mechanisms of PPD is a challenging task, as normal pregnancy and the postpartum period cause adaptive endocrine changes, which would otherwise be considered pathological in nonpregnant women. This review focuses on the adaptive changes of childbearing and nursing, which ultimately may put women at increased risk of PPD. In light of the normal physiology, the authors also attempt to describe the current evidence of the biological changes associated with the development of depression in the postpartum period, including ovarian steroids, the hypothalamic-pituitary-adrenal axis, the serotonergic neurotransmitter system, the thyroid system and inflammatory markers. In addition, current knowledge on candidate genes associated with PPD is reviewed.

Lactating Ctcgrp nulls lose twice the normal bone mineral content due to fewer osteoblasts and more osteoclasts, whereas bone mass is fully restored after weaning in association with up-regulation of Wnt signaling and other novel genes

The maternal skeleton resorbs during lactation to provide calcium to milk and the lost mineral content is restored after weaning. The changes are particularly marked in Ctcgrp null mice, which lose 50% of spine mineral content during lactation but restore it fully. The known calciotropic hormones are not required for skeletal recovery to occur; therefore, unknown factors that stimulate bone formation may be responsible. We hypothesized that the genes responsible for regulating postweaning bone formation are differentially regulated in bone or marrow, and this regulation may be more marked in Ctcgrp null mice. We confirmed that Ctcgrp null mice had twice as many osteoclasts and 30-40% fewer osteoblasts as compared with wild-type mice during lactation but no deficit in osteoblast numbers after weaning. Genome-wide microarray analyses on tibial RNA showed differential expression of 729 genes in wild-type mice at day 7 after weaning vs prepregnancy, whereas the same comparison in Ctcgrp null mice revealed only 283 genes. Down-regulation of Wnt family inhibitors, Sost and Dkk1, and inhibition of Mef2c, a sclerostin stimulator, were observed. Ctsk, a gene expressed during osteoclast differentiation, and Igfbp2, which stimulates bone resorption, were inhibited. Differential regulation of genes involved in energy use was compatible with a net increase in bone formation. The most marked changes occurred in genes not previously associated with bone metabolism. In conclusion, the postlactation skeleton shows dynamic activity with more than 700 genes differentially expressed. Some of these genes are likely to promote bone formation during postweaning by stimulating the proliferation and activity of osteoblasts, inhibiting osteoclasts, and increasing energy use.

Prefrontal activity during response inhibition decreases over time in the postpartum period

The postpartum period is characterized by complex hormonal changes, but human imaging studies in the postpartum period have thus far predominantly focused on the neural correlates of maternal behavior or postpartum depression, whereas longitudinal studies on neural correlates of cognitive function across the postpartum period in healthy women are lacking. The aim of this study was to longitudinally examine response inhibition, as a measure of executive function, during the postpartum period and its neural correlates in healthy postpartum women and non-postpartum controls. Thirteen healthy postpartum women underwent event-related functional magnetic resonance imaging while performing a Go/NoGo task. The first assessment was made within 48 h of delivery, and the second at 4-7 weeks postpartum. In addition, 13 healthy women examined twice during the menstrual cycle were included as non-postpartum controls. In postpartum women region of interest analyses revealed task-related decreased activations in the right inferior frontal gyrus, right anterior cingulate, and bilateral precentral gyri at the late postpartum assessment. Generally, postpartum women displayed lower activity during response inhibition in the bilateral inferior frontal gyri and precentral gyri compared to non-postpartum controls. No differences in performance on the Go/NoGo task were found between time-points or between groups. In conclusion, this study has discovered that brain activity in prefrontal areas during a response inhibition task decreases throughout the course of the first postpartum weeks and is lower than in non-postpartum controls. Further studies on the normal adaptive brain activity changes that occur during the postpartum period are warranted.

Variations in the response of pituitary lactotrophs to oxytocin during the rat estrous cycle

Although removal of dopamine inhibition is established as a major factor in prolactin (PRL) release, a large body of evidence suggests that hypothalamic oxytocin (OT) may serve as a PRL-releasing hormone in the rat. PRL release is modulated by estradiol (E2), which rises between diestrus and proestrus of the estrous cycle, causing a PRL surge in the afternoon of proestrus. Given that E2 strongly modulates OT actions in both central and peripheral tissues, OT action on lactotrophs might also be modulated by the stage of the estrous cycle. To test this hypothesis, we have monitored PRL release and intracellular calcium levels ([Ca(2+)](i)) induced by OT in pituitary lactotrophs obtained from female rats in either diestrus 1 or proestrus. We found that both secretory and [Ca(2+)](i) responses to OT are significantly increased in lactotrophs obtained on proestrus. Moreover, we show that these differences are due to an increase in both the number of OT-responding lactotrophs and the magnitude of their individual [Ca(2+)](i) responses. Both secretory and [Ca(2+)](i) responses were abolished by a specific OT antagonist. Finally, dose-dependent studies show that the increased PRL-releasing effect of OT on proestrus is significant over a wide range of concentrations, particularly those observed in hypophyseal portal plasma. These results suggest that the rising E2 titers that culminate on proestrus facilitate the stimulatory action of OT on lactotrophs and support the notion that OT is a PRL-releasing hormone with an important role in the production of the proestrous surge of PRL.

Effects of intrapartum oxytocin administration and epidural analgesia on the concentration of plasma oxytocin and prolactin, in response to suckling during the second day postpartum

BACKGROUND

Oxytocin and prolactin stimulate milk ejection and milk production during breastfeeding. The aim of the present study was to make a detailed analysis of maternal release of oxytocin and prolactin in response to breastfeeding during the second day postpartum in mothers who had received oxytocin either intravenously for stimulation of labor or intramuscularly for prevention of postpartum hemorrhage and/or epidural analgesia or those who had received no such treatment in connection with birth.

METHODS

In a descriptive comparative study plasma oxytocin and prolactin concentrations were measured in response to suckling during the second day postpartum in women who had received intravenous intrapartum oxytocin (n = 8), intramuscular postpartum oxytocin (n = 13), or epidural analgesia, either with (n = 14) or without (n = 6) intrapartum oxytocin infusion, and women who received none of these interventions (n = 20). Hormone levels were analyzed by enzyme immunoassay.

RESULTS

All mothers showed a pulsatile oxytocin pattern during the first 10 minutes of breastfeeding. Women who had received epidural analgesia with oxytocin infusion had the lowest endogenous median oxytocin levels. The more oxytocin infusion the mothers had received during labor, the lower their endogenous oxytocin levels were during a breastfeeding during the second day postpartum. A significant rise of prolactin was observed after 20 minutes in all women, but after 10 minutes in mothers having received oxytocin infusion during labor. In all women, oxytocin variability and the rise of prolactin levels between 0 and 20 minutes correlated significantly with median oxytocin and prolactin levels.

CONCLUSION

Oxytocin, released in a pulsatile way, and prolactin were released by breastfeeding during the second day postpartum. Oxytocin infusion decreased endogenous oxytocin levels dose-dependently. Furthermore, oxytocin infusion facilitated the release of prolactin. Epidural analgesia in combination with oxytocin infusion influenced endogenous oxytocin levels negatively.

Oxytocin is an anabolic bone hormone

We report that oxytocin (OT), a primitive neurohypophyseal hormone, hitherto thought solely to modulate lactation and social bonding, is a direct regulator of bone mass. Deletion of OT or the OT receptor (Oxtr) in male or female mice causes osteoporosis resulting from reduced bone formation. Consistent with low bone formation, OT stimulates the differentiation of osteoblasts to a mineralizing phenotype by causing the up-regulation of BMP-2, which in turn controls Schnurri-2 and 3, Osterix, and ATF-4 expression. In contrast, OT has dual effects on the osteoclast. It stimulates osteoclast formation both directly, by activating NF-kappaB and MAP kinase signaling, and indirectly through the up-regulation of RANK-L. On the other hand, OT inhibits bone resorption by mature osteoclasts by triggering cytosolic Ca(2+) release and NO synthesis. Together, the complementary genetic and pharmacologic approaches reveal OT as a novel anabolic regulator of bone mass, with potential implications for osteoporosis therapy.

Prolactin-stimulated transepithelial calcium transport in duodenum and Caco-2 monolayer are mediated by the phosphoinositide 3-kinase pathway

Prolactin (PRL) has been shown to stimulate intestinal calcium absorption but the mechanism was still unknown. This study aimed to investigate the mechanism and signaling pathway by which PRL enhanced calcium transport in the rat duodenum and Caco-2 monolayer. Both epithelia strongly expressed mRNAs and proteins of PRL receptors. Ussing chamber technique showed that the duodenal active calcium fluxes were increased by PRL in a dose-response manner with the maximal effective dose of 800 ng/ml. This response diminished after exposure to LY-294002, a phosphoinositide 3-kinase (PI3K) inhibitor. Caco-2 monolayer gave similar response to PRL with the maximal effective dose of 600 ng/ml. By nullifying the transepithelial potential difference, we showed that the voltage-dependent paracellular calcium transport did not contribute to the PRL-enhanced flux in Caco-2 monolayer. In contrast, the calcium gradient-dependent paracellular transport and calcium permeability were increased by PRL. Effects of PRL on Caco-2 monolayer were abolished by PI3K inhibitors (LY-294002 and wortmannin), but not by inhibitors of MEK (U-0126) or JAK2 (AG-490). To investigate whether the PRL-enhanced paracellular transport was linked to changes in the epithelial charge selectivity, the permeability ratio of sodium and chloride (P(Na)/P(Cl)) was determined. We found that PRL elevated the P(Na)/P(Cl) in both epithelia, and the effects were blocked by PI3K inhibitors. In conclusion, PRL directly and rapidly stimulated the active and passive calcium transport in the rat duodenum and Caco-2 monolayer via the nongenomic PI3K-signaling pathway. This PRL-enhanced paracellular calcium transport could have resulted from altered charge selectivity.

Endocrinology of lactation

The endocrine control of lactation is one of the most complex physiologic mechanisms of human parturition. Mammogenesis, lactogenesis, galactopoiesis, and galactokinesis are all essential to assure proper lactation. Prolactin is the key hormone of lactation and seems to be the single most important galactopoietic hormone. Oxytocin, serotonin, opioids, histamine, substance P, and arginine-leucine modulate prolactin release by means of an autocrine/paracrine mechanism, whereas estrogen and progesterone hormones can act at the hypothalamic and adenohypophysial levels. Human placental lactogen and growth factors play an essential role to assure successful lactation during pregnancy. Oxytocin is the most powerful galactokinetic hormone.

Prepregnant overweight and obesity diminish the prolactin response to suckling in the first week postpartum

OBJECTIVE

The population subgroups with the highest proportion of overweight and obese women often are characterized by the lowest rates of initiation and shortest durations of breastfeeding. We previously documented that these 2 population-level trends may be related. In a population of white women who lived in a rural area, we observed that prepregnant overweight and obesity were associated with failure to initiate and also to sustain lactation. The means by which being overweight or obese negatively affect lactational performance is unknown and likely to be multifactorial in origin, including the simple mechanical difficulties of latching on and proper positioning of the infant. In addition, we have shown that prepregnant body mass index (BMI) is negatively associated with the timing of lactogenesis II, the onset of copious milk secretion. Although the effects of obesity on the prolactin response to infant suckling have never been studied, we postulated that maternal obesity could compromise this important response. We proposed that this might occur because obesity alters the 24-hour spontaneous release of prolactin and also because prolactin secretion is blunted in response to various stimuli among obese subjects. The fall in progesterone concentration that occurs immediately postpartum is the trigger for the onset of copious milk secretion, but maintenance of prolactin and cortisol concentrations is necessary for this trigger to be effective. Adipose tissue concentrates progesterone. We proposed that this additional source of progesterone would lead to consistently higher progesterone concentrations among obese compared with normal-weight women. This, in turn, would lead to a delay in reaching the appropriate concentration to trigger the onset of lactogenesis II. We tested the hypotheses that a reduced prolactin response to suckling and higher-than-normal progesterone concentration in the first week after delivery might be among the means by which maternal overweight could compromise early lactation.

METHODS

We enrolled 40 mothers of term infants from the same population that we studied previously. We measured serum prolactin and progesterone concentrations by radioimmunoassay before and 30 minutes after the beginning of a suckling episode at 48 hours and 7 days after delivery. We used path analysis to develop a parsimonious multivariate prediction of the prolactin response to suckling at 48 hours and 7 days postpartum.

RESULTS

As expected, prolactin values decreased from 48 hours to 7 days postpartum. Women who were overweight or obese (using the Institute of Medicine's cutoff for women of a BMI >26 kg/m2) before conception had a lower prolactin response to suckling than normal-weight women at 48 hours but not at day 7. In multivariate analyses, overweight/obesity, primiparity, and birth weight were negatively associated with the prolactin response to suckling at 48 hours. After adjustment for confounding by time since delivery and the duration of the nursing episode, only overweight/obesity remained a significant negative predictor of prolactin response to suckling at day 7. Concentrations of progesterone decreased dramatically from 48 hours to 7 days postpartum but did not differ between normal-weight and overweight/obese women at either time. In addition, the decreases in progesterone concentrations from 48 hours to 7 days postpartum did not differ between the prepregnant BMI groups.

CONCLUSION

The unique and important finding from this study is that overweight/obese women had a lower prolactin response to suckling. This would be expected to compromise the ability of overweight/obese women to produce milk and, over time, could lead to premature cessation of lactation. These findings are important because, during our observation period (just before and after lactogenesis II, the time of onset of copious milk secretion), the prolactin response to suckling is more important for milk production than it is later in lactation. We have previously shown that a high proportion of the overweight and obese women in women in this population who give up on breastfeeding do so at this time. This finding thus provides evidence of a biological basis for this association, and additional study of it is likely to be informative. We postulated that there would be consistently higher progesterone concentrations in the early postpartum period among obese compared with normal-weight women because adipose tissue is an extraplacental source of this hormone. This hypothesis was not supported in this study because there were no significant differences between normal-weight and overweight/obese women in progesterone concentrations at either 48 hours or 7 days postpartum. The values that we observed at these times were similar to those reported by others in the early postpartum period. The findings from this study add plausibility to our observation that initiation, not just duration of breastfeeding, is negatively affected by maternal overweight/obesity. Although women should begin pregnancy at a healthy weight and gain reasonably during gestation, not all will. Pediatricians can help overweight/obese women to succeed at breastfeeding by targeting them for contact with a lactation consultant before discharge from the hospital to be sure that they have received optimal advice on breastfeeding techniques. In addition, early contact with the mother after discharge--by calling her at home to offer her support and counseling for breastfeeding, by scheduling the first pediatric visit earlier than for other patients, or by enlisting the assistance of public health nurses for a home visit if this is possible--would help overweight/obese women to continue to breastfeed. Being overweight or obese is negatively associated with the prolactin response to suckling in the first week postpartum and, thus, may contribute to early lactation failure.

Selecting pumps for breastfeeding mothers

By understanding how a breast pump works, the nurse can suggest a pump best suited to meet the needs of the mother and her infant. When the infant is well, issues of cost and convenience can be the priority; when the infant is ill, primary considerations are how negative pressure is created, maintained, and released and how pathogens are controlled. Understanding these mechanisms helps solve technical problems that contribute to malfunction or maternal discomfort.

Oxytocin receptor mRNA expression in rat brain: implications for behavioral integration and reproductive success

The nonapeptide, oxytocin (OT), has been implicated in a wide range of physiological, behavioral and pharmacological effects related to learning and memory, parturition and lactation, maternal and sexual behavior, and the formation of social attachments. Specific G-protein linked membrane bound OT receptors mediate OTs effects. The unavailability of highly selective pharmacological ligands that discriminate the OT receptor from the highly homologous vasopressin receptors (V1a, V1b and V2 subtypes) has made it difficult to confirm specific effects of oxytocin, particularly in brain regions where OT and multiple AVP receptor subtypes may be coexpressed. Here, data on the oxytocin receptor (OTR) messenger ribonucleic acid (mRNA) localization in brain are presented in the context of a model that proposes a reproductive state-dependent role for steroid-hormone restructuring of neural circuits, and a role for oxytocin in the integration of neural transmission in pathways subserving: (1) steroid-sensitive reproductive behaviors; (2) learning; and (3) reinforcement. It is hypothesized that social attachments emerge as a consequence of a conditioned association between OT-related activity in these pathways and the eliciting stimulus.

Compression stimuli increase the efficacy of breast pump function

OBJECTIVE

The dynamics of milk ejection and also prolactin concentration in the blood during milk expression by means of a breast pump were studied in 82 lactating women.

STUDY DESIGN

The design of the breast pump used in this study is new. It is based on the correlation with the amplitude, duration and frequency of vacuum and compression stimuli formed by the baby's mouth apparatus during the suckling process.

RESULTS

It was found that during continuous co-action of the vacuum and compression stimuli at a frequency of 1 cycle per second, the rate of milk ejection from the breast changed periodically. The highest rates of milk ejection coincided with the greatest rises in intramammary pressure. When the compression stimulus was turned off, leaving only the vacuum, the period of the first rise in pressure increased 1.5-2 fold, with a 1.5-2 fold reduction in the milk ejection rate as compared with the normal function of the breast pump. The basal prolactin level on day 3 and 5 post delivery in women who used a breast pump was not significantly different from that of puerperal women who only breast-fed their babies. Prolactin concentration in the blood of puerperal women did not change within the 5-6 min of expression and stimulation with the breast pump. The prolactin level began to increase by the 10th minute, whereas by the 25th minute it exceeded the initial concentration 1.3-1.5-fold.

CONCLUSION

It is suggested that by introducing a tactile component to the mechanism of the breast pump, milk secretion is enhanced, as well as stimulating the breast milk flow. This directly improves the dynamics of breast milk expression.

Prolactin as an immunoreactive agent

Prolactin (PRL), an endocrine hormone from the anterior pituitary, is also synthesized and secreted by activated immunocytes, mostly T cells and thymocytes. In vitro PRL acts as an autocrine or paracrine growth factor which regulates the proliferation of previously stimulated immunocompetent cells. PRL acts through its specific cell surface receptors expressed on different immunocytes including T cells, B cells, monocytes, NK cells and neutrophils. In vivo the immunoregulatory role of PRL is still the subject of intense investigation, especially in the conditions of stress and reproduction. The conflicting results suggest that PRL concentration, sex hormones and some other factors influence the immunomodulatory role of PRL.

Releases of oxytocin and prolactin during breast massage and suckling in puerperal women

The responses of prolactin (PRL) and oxytocin (OT) to suckling and breast massage were examined in lactating women. The suckling group showed increase in frequency of pulsatile release of OT and increase of the plasma PRL level. In contrast, the breast massage group showed a significant, but not a pulsatile increase in the plasma OT level and no increase in the plasma PRL level. These findings suggest that suckling causes both milk production and milk ejection, while breast massage causes only ejection of milk already stored in acini, and that prolactin release is not related to increase of the oxytocin level itself, but to its pulsatile release.

Characteristics of the spontaneous milk ejecting activity occurring during human lactation

Continuous recordings of intramammary pressure performed in 158 normal lactating women, and 22 women during spontaneous labor were retrospectively analyzed in order to characterize spontaneous milk ejecting activity (SA). SA appeared as spurts of contraction waves as early as the first post-partum day and throughout the first two months of lactation. The spurts of SA differed from reflex milk ejection evoked by baby's suckling. It showed two different patterns: a) single contraction waves with a rapid rise time, a slow decay time, high amplitude and a short duration; b) multiple contraction waves with a longer rise and decay times, progressively decreasing intensity and a large duration depending on the number of contractions per spurt. The multiple pattern occurred in 34.2% (41/120) of patients at 2.7 +/- 0.1 days of post-partum and increased to 84.3% (59/70) at 34.5 +/- 1.2 days. Accordingly, duration and the area under contraction curves increased throughout lactation. Mammary gland sensitivity to exogenous oxytocin (OT) did not change during the 2 months studies. SA was significantly greater in full nursing mothers than in the partially nursing ones. The existence of a system for milk-ejection different from baby's suckling was further described. A neuroendocrine mechanism and the release of increasing amounts of OT are suggested as important factors in the control of this phenomenon.

Epidemiological and biochemical support for a theory on the cause and prevention of breast cancer

Damage to the breast epithelium by chemical carcinogens as products of oxygen free radical release can lead to fibroblast proliferation, hyperplasia of epithelium, cellular atypia and breast cancer. Chemical carcinogens may accumulate in breast fluid in the non-lactating breast consequent to superoxide free radical production which occurs via the adenosine triphosphate (ATP) hypoxanthine pathway. This pathway is initiated by hypoxia of local tissue. Under hypoxic conditions ATP is broken down to form hypoxanthine. Hypoxanthine itself is broken down to produce xanthine and then uric acid. This results in the production of superoxide free radicals, the products of which are carcinogenic. The development of localized hypoxia, which is central to this hypothesis, is caused by acinal gland distention from fluid secreted by raised prolactin levels in the absence of oxytocin. Stimulation of the nipple in a non-lactating breast may raise plasma oxytocin and lower plasma prolactin levels. Contraction of the myoepithelial cells of the breast under the influence of oxytocin would relieve distention of the acinal glands and thus reduce hypoxia and the generation of lipid peroxidoses as products of free radical damage. The epidemiology of breast fibrosis and cancer support the notion that lack of nipple stimulation over time may be a significant variable. A review of this literature linked with current biochemical work on fibrosis and carcinogenesis suggest that draining the breasts of the products of superoxide free-radical release by the encouragement of regular nipple erections may prevent such breast disease.

Postpartum infertility in common chimpanzees

The endocrine profile during normal postpartum amenorrhea in chimpanzees (Pan troglodytes) closely resembles that of women, and its duration is similarly extended by nursing. However, when infant chimpanzees in our colony were removed at birth, excessively prolonged postpartum amenorrhea (7-26 months duration) occurred in 24% of cases. Our endocrine studies indicate that such prolonged postpartum amenorrhea (PPAm) is a pathological condition associated with chronically elevated serum prolactin levels and galactorrhea. In the absence of nursing, we sought an alternate behavioral basis for PPAm. Breast and genital auto- and partner-directed manipulation was compared in PPAm chimpanzees, normal 2-3 mo. postpartum chimpanzees (infants removed at birth), and regularly-menstruating chimpanzees. A statistically significant pattern of breast, but not genital, manipulation was observed in the PPAm group only, at levels comparable to normal suckling. In particular, a characteristic pattern of nipple auto-manipulation (spooling) occurred. Two partner-stimulated PPAm animals were also identified: when caged individually, they resumed cycling within a few days. In contrast, 2 self-stimulators did not resume cyclicity when isolated. These observations suggested that interruption of breast stimulation allowed cyclicity to resume. Treatment of PPAm chimpanzees with oral Bromocryptine Mesylate (Sandoz, 2.5-5.0 mg b.i.d.) was associated with depression of prolactin levels in most animals and resumption of cyclicity in 11/13 subjects within 4 months. Oral Pergolide (Eli Lilly, 200 μg once daily, 13-17 days), appeared much more effective, cyclicity resumed in 8/8 animals within 14 days of commencing treatment; both drugs significantly reduced postpartum amenorrhea duration.

Central Oxytocin Stimulates Luteinizing Hormone Release in the Marmoset, a Primate which Fails to Show Lactationally-lnduced Infertility

In several species, including humans, suckling is known to suppress pulsatile gonadotrophin secretion and substantially reduce fertility (1). During suckling high titres of oxytocin are present in both plasma (2, 3) and cerebrospinal fluid (CSF) (4) and there is some evidence that oxytocin is inhibitory to gonadotrophin secretion by an action on t h e central nervous system, (5, 6). The common marmoset, however, has a different physiological response and fails to show lactational infertility; ovarian cyclicity is resumed immediately post-partum (7). We have therefore examined the effect of centrally administered oxytocin on luteinizing hormone (LH) secretion in this species. We report that LH release was stimulated with a rapid:esponse and in a dose-dependent manner by oxytocin injected into t h e third cerebral ventricle. In contrast, oxytocin administered intravenously was without effect on LH secretion. These results clearly indicate, for the first time, a stimulatory role for oxytocin in LH secretion in the marmoset, a species which fails to demonstrate lactational infertility.

Neuropeptides and male sexual behavior

Evidence is rapidly accumulating that a number of neuropeptides are involved in the central control of male sexual behavior. This is consistent with their neuroanatomical distribution, i.e., in CNS loci previously implicated in the control of this behavior such as the medial preoptic area, and with recent findings that the peptide content of some of these regions is regulated by testosterone or its metabolites. Most of the work has been done using rats, but relevant human studies have been included whenever such material has been available. At this point there are relatively few studies which directly demonstrate the involvement of peptides in this behavior. Inhibitory and facilitatory actions, however, have been demonstrated following injections of peptides, peptide antisera, or antagonists into the CNS of male rats. Significant new developments include demonstrations that injections of substance P and A-MSH directly into the medial preoptic area can facilitate this behavior, while ventricular injection of an oxytocin antagonist can produce a powerful inhibition. The emerging picture is that GnRH, oxytocin, A-MSH and substance P stimulate, while CRF, beta-endorphin, prolactin, and neuropeptide Y are inhibitory. The inhibitory peptides CRF, beta-endorphin and prolactin are related, as they are released in response to stress. This may be relevant to the low level of sexual motivation in some depressed men. Questions concerning sites of action and mechanisms of action which mediate the behavioral effects which have been demonstrated remain largely unanswered.

Breast stimulation in cycling women, pregnant women and a woman with induced lactation: pattern of release of oxytocin, prolactin and luteinizing hormone

Levels of oxytocin (OT) and PRL were measured in plasma drawn before and during intermittent mechanical pump and tactile stimulation of the breast in five normal cycling women and 19 women in the third trimester of pregnancy. OT was significantly increased above baseline in response to breast stimulation in two of five cycling women and PRL increased in one of the two OT responders. In pregnant women, mean OT post nipple stimulation was significantly higher than pre nipple stimulation whereas PRL did not increase significantly. The response of OT to nipple stimulation occurred in 18 of 19 pregnant women compared to only two of five normal cycling women but the magnitude of the OT response in pregnant women was less than in cycling women or post-partum lactating women previously studied in this laboratory. In one non post-partum woman who induced lactation for the purpose of breast-feeding an adopted infant, OT and PRL were measured before and during mechanical pump and tactile stimulation before initiation of breast-feeding. OT increased during mechanical pump and tactile stimulation of the breast, as well as suckling, whereas PRL increased only in response to suckling. Levels of LH were measured in plasma every 20 min for 160 min at the following times: before initiation of breast-feeding, during induced lactation while breast-feeding, and 30 d after discontinuation of breast-feeding. Despite the development of oligomenorrhoea during the period of breast-feeding, levels of progesterone were not suppressed and LH was released in a normal pulsatile fashion.