Putting a finger on the problem: Finger stick blood draw and immunization at the well-child exam elicit a cortisol response to stress among one-year-old children

Abstract

Research examining stress reactivity of the hypothalamic-pituitary-adrenocortical (HPA) axis in young children has historically been hampered by a lack of reliable methods to invoke a cortisol stress response. This report details an effective method of eliciting a cortisol rise in one-year-old children (N = 83) by modifying and combining two naturalistic stressors previously used with infants and children. Salivary cortisol levels were collected from children before and after a finger stick blood draw and immunizations performed during their one year well-child checkup at their pediatrician's office. Results indicated that the stressor was successful at eliciting a significant cortisol response. An extensive set of potential demographic and clinical confounds were also assessed in order to identify methodological considerations important in studies of infant cortisol. The stress paradigm presented here provides a promising alternative for studies of infant HPA activity to enable investigators to more effectively evaluate early functioning of the biological stress system during this developmentally important life stage.

Keywords: Cortisol; Hypothalamic pituitary adrenal axis; Infant; Stress.

Conflict of interest statement

Conflicts of Interest

All authors verify that they have no conflicts of interest to declare.

Copyright © 2018 Elsevier Ltd. All rights reserved.

Figures

Figure 1. Cortisol response following finger stick blood draw and immunization stressor

Note: Levels are shown controlling for maternal age and time since morning awakening. Error bars denote standard error. Baseline M = 0.19 μg/dL, SD = 0.15; +20 min M = 0.31 μg/dL, SD = 0.22; +40 min M=0.25 μg/dL, SD = 0.16.