Dysphoric Milk Ejection Reflex: A Descriptive Study

Breastfeed Med. 2019 Nov;14(9):666-673. doi: 10.1089/bfm.2019.0091. Epub 2019 Aug 8.

Abstract

Introduction: Dysphoric milk ejection reflex (D-MER) is emerging as a recognized phenomenon to describe an abrupt dysphoria, or undesirable feeling that occurs with the milk ejection reflex (MER) and then goes away after a few minutes. The purpose of this study was to determine the prevalence of D-MER among breastfeeding women and to describe the experience of symptoms associated with D-MER. Materials and Methods: To determine the prevalence of D-MER, a retrospective chart review was conducted over a 12-month period on women presenting for their 6- to 8-week postpartum visit. To describe the experience of D-MER, an anonymous cross-sectional survey consisting of 36 items was made accessible through a link to an online survey management platform. Participants were recruited through both paper and electronic posters at a variety of venues. Results: A prevalence rate of 9.1% was found. The respondents described similarities in their experiences with D-MER, to include feelings coming on suddenly and lasting for <5 minutes. The respondents described feeling anxious, sad, irritable, panicky, agitated, oversensitive, and tearful most often. Conclusion: This is the first study to quantify a prevalence rate and describe suspected experiences of D-MER. It provides the groundwork for future research to explore other contributing factors or relationships that may be relevant to D-MER. The findings support that the experience of D-MER is different from that of postpartum depression. Future research exploring the behavior of hormones and neurotransmitters within the context of lactation could contribute to the knowledge regarding D-MER.

Keywords: dysphoric milk ejection reflex; milk ejection reflex; postpartum depression.

MeSH terms

  • Adult
  • Breast Feeding / psychology*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Lactation / psychology*
  • Milk Ejection*
  • Mothers / psychology*
  • Prevalence
  • Psychological Distress*
  • Retrospective Studies