The cortisol awakening response in infants: Ontogeny and associations with development-related variables

The cortisol awakening response (CAR) is a frequently used measure in psychoneuroendocrinological research, however, some of its more fundamental aspects still require attention. An important question in this respect concerns the ontogeny of the CAR. Data from two recent reports suggest that the CAR may only emerge relatively late during child development (≥16 months of age). However, as both enquiries did not use objective means of verifying participant adherence or infants' awakening times, it is unclear whether methodological factors may have contributed to these results. Here, we report data from a study on 33 infants aged 2-12 months with close care being taken to ensure the accuracy of sampling times by using wrist actigraphy and electronic monitoring containers. Salivary cortisol levels were assessed at 0 and 30 min post-awakening over three study days. Results revealed evidence for a significant CAR (≥2.5 nmol/L) in 32 (out of 33) infants and on a total 86.9% of study days, with a marked magnitude of the CAR across infants (mean estimated increase = 12.54 nmol/L). In addition, the cortisol level on awakening and the CAR were found to be associated with different aspects of infant's physical and sleep-related development as well as with their weight and body mass index (BMI) at birth. Contrary to previous reports, the current results thus indicate that the ontogeny of the CAR occurs at an early stage of development and that it is present from as early as two months of life. The data also suggest that post-awakening cortisol secretion may undergo considerable changes during the first year of life associated with different aspects of infant development.