Dysphoric Milk Ejection Reflex (DMER) is a temporary negative emotional response some individuals experience just before or during their milk let-down. This phenomenon is a physiological reflex, not a psychological issue, nor does it indicate an aversion to breastfeeding. Studies suggest DMER affects a notable percentage of lactating individuals, with prevalence rates ranging from approximately 5.9% to 14.2%. Understanding DMER can help normalize this experience.
Understanding Dysphoric Milk Ejection Reflex
Individuals experiencing DMER often describe a wave of sudden negative emotions that surface as milk begins to release. These feelings can include anxiety, sadness, dread, agitation, irritability, or a general sense of unease. Some report sensations such as a hollow or churning feeling in the stomach, hopelessness, or even self-hate.
The feelings associated with DMER are transient, typically lasting from 30 seconds to a few minutes. These sensations appear abruptly just before or as the milk ejection reflex occurs and then quickly subside once milk flow is established. These emotional responses are involuntary and do not reflect personal feelings towards the baby or the desire to breastfeed.
The Physiological Basis of DMER
The understanding of DMER points to a physiological origin, rather than a psychological one. The milk ejection reflex, known as let-down, is driven by the hormone oxytocin. As oxytocin levels rise to facilitate milk release, a simultaneous, temporary decrease in dopamine levels occurs.
Dopamine is a neurotransmitter that plays a role in mood regulation, pleasure, and reward pathways in the brain. A sudden dip in dopamine can lead to the dysphoric feelings characteristic of DMER. This hormonal fluctuation is a reflex, an automatic bodily response, not a conscious thought or emotional state.
Coping Strategies for DMER
While there is no specific medical cure for DMER, various strategies can help manage the discomfort during a let-down.
- Engage in deep breathing exercises or mindfulness techniques to regulate the body’s stress response.
- Use distraction methods, such as listening to music, watching television, or reading, to shift focus away from negative sensations.
- Ensure adequate hydration and nutrition to support overall well-being.
- Prioritize rest and reduce general stress levels.
- Engage in skin-to-skin contact with the baby during feeding for calming effects.
- Seek support from partners, friends, or a lactation consultant for reassurance and practical advice.
Distinguishing DMER from Other Postpartum Experiences
Differentiate DMER from other postpartum mood variations like postpartum depression (PPD), generalized anxiety, or general breastfeeding aversion. DMER is characterized by its transient nature, occurring with the milk let-down and subsiding quickly thereafter. This physiological response is distinct from persistent negative moods or anxieties present regardless of feeding.
Unlike DMER, postpartum depression involves a sustained period of sadness or other mood changes that affect daily life and are not confined to feeding times. Breastfeeding aversion, while also involving negative feelings during feeding, is often linked to nipple sensitivity, overstimulation, or a dislike of breastfeeding itself, rather than the hormonal reflex of milk ejection. If negative feelings are severe, persistent, or interfere with daily life, consulting a healthcare professional is advisable, as this may indicate a different underlying issue requiring support.