Dysphoric Milk Ejection Reflex (DMER) is a physiological phenomenon experienced by individuals who breastfeed or pump. It involves the sudden onset of negative emotions just before or as milk is released from the breast. This reflex is distinct from typical emotional responses to breastfeeding challenges and is not a psychological reaction to the act itself.
Understanding Dysphoric Milk Ejection Reflex
DMER manifests as a wave of negative emotions that arise abruptly, coinciding with the milk ejection reflex, known as let-down. Individuals describe feelings such as sadness, anxiety, dread, anger, or irritability. These sensations are brief, lasting from 30 seconds to a few minutes, and dissipate rapidly once milk flow is established. This experience is an automatic bodily response, not a psychological state or a reflection of one’s feelings about breastfeeding or their baby. It is distinct from conditions like postpartum depression or anxiety, though it can coexist with them.
Prevalence of DMER
The prevalence of DMER is still being investigated, but research suggests it affects a notable percentage of lactating individuals. Studies report varying prevalence rates, with some estimates between 5% and 9%. Other research indicates higher incidence, with one study reporting 9.1% and another 14.2%. More recent data suggests the incidence could be as high as 26.9%, placing the overall reported range between 6.0% and 27.7%.
The variability in reported figures can be attributed to several factors, including the relatively recent recognition of DMER and potential underreporting. Many individuals experiencing these negative emotions may not realize it is a recognized physiological phenomenon and might attribute their feelings to other causes or simply endure them in silence. Increased awareness and improved diagnostic tools are helping to provide a clearer picture, as individuals may not discuss their experiences due to lack of understanding or feelings of shame.
The Biology Behind DMER
The physiological mechanisms underlying DMER involve a temporary fluctuation in neurochemicals, primarily dopamine, during the milk ejection reflex. When a baby suckles or milk is expressed, the body releases oxytocin, a hormone that triggers milk let-down. This oxytocin release is thought to cause a temporary decrease in dopamine levels in the brain.
Dopamine is a neurotransmitter that plays a role in mood regulation, motivation, and feelings of pleasure. A sudden drop in dopamine can lead to negative emotions like anxiety, sadness, and irritability, which are symptoms of DMER. While the precise interplay of hormones and neurotransmitters is still being researched, the theory points to this abrupt dopamine dip as the primary cause of the dysphoria, explaining why the feelings are automatic and not consciously controlled.
Managing DMER and Seeking Support
For individuals experiencing DMER, understanding that it is a physiological reflex, not a psychological failing, can be a significant first step toward coping. Coping strategies focus on managing the brief period of dysphoria during let-down. Distraction techniques, such as engaging in a pleasant activity or listening to music, can help some individuals navigate the intense feelings. Prioritizing adequate sleep, maintaining good nutrition, and ensuring proper hydration are also supportive measures, as stress and lack of self-care can sometimes exacerbate symptoms.
Practices like deep breathing or mindfulness during the let-down can help to mitigate the intensity of the emotions. Increasing skin-to-skin contact with the baby during feeding may also provide a calming effect for some individuals. If DMER symptoms are severe, persist beyond the let-down, or significantly interfere with daily life, seeking professional help is advisable. Lactation consultants, healthcare providers, or mental health professionals can offer tailored support and discuss management options, ensuring overall well-being.