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Maternal Psychological Distress and Lactation and Breastfeeding Outcomes: a Narrative Review 1 Introduction 2 Lactation and the Mother-Infant Dyad 2 Maternal Psychological Distress 3 Methods 3 Results 3 Maternal Psychological Distress and Lactation and Infant Feeding Outcomes 3 Delayed Onset of Lactogenesis 4 Insufficient Milk Supply and Decreased Duration and Exclusivity of Breastfeeding 4 Potential Mechanisms by Which Psychological Distress Affects Lactation 5 Regulation of Hormones Implicated in Lactation 5 Cortisol and HPA Axis-Related Mechanisms 6 Future Directions 6 Conclusion 8 Disclosure 8 Acknowledgments 8 References 8
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