Dysphoric Milk Ejection Reflex

Breastfeeding your baby is a wonderful experience that has many benefits for both of you. However, experiencing some difficulties along the way is common and most issues you encounter, are problems with a simple solution. One of the less common difficulties is a condition called dysphoric milk ejection reflex, also known as D-MER. 

What is D-MER? 

Dysphoria is an unpleasant or negative mood. Some lactating women find that they experience such emotions just before milk is released and this does not usually last for more than a few minutes each time. The point when milk is about to be released is commonly referred to as letdown. There are generally three levels of severity of this condition - mild, moderate and severe. This is dependent on the length and the intensity of the negative emotions. 

What Causes This Condition?

dysphoric milk ejection reflex

Research suggests that Dopamine levels play a large part in causing D-MER. Dopamine controls the secretion of prolactin. For prolactin levels to rise, the levels of Dopamine must briefly drop. Prolactin triggers the release of milk from the breasts. Dopamine levels stabilize once the levels of prolactin have begun their climb. If the levels of Dopamine drop too quickly, or act inappropriately, then the mother will experience the symptoms of dysphoric milk ejection reflex. 

Common Symptoms of Dysphoric Milk Ejection Reflex

  • The dysphoria is sudden and experienced before the physical sensation of letdown, however, not all mothers feel a letdown.
  • The length of time dysphoria is experienced usually lasts between 30 seconds and two minutes.
  • Some women experience this problem with every letdown, while others only experience it at the first letdown during a breastfeeding session.
  • A mother cannot control this condition. It is controlled by hormones.
  • Depending on the severity of the condition, some mothers experience dysphoria when using a breast pump or during a spontaneous letdown and others do not.
  • Contact with the nipple and nipple tugging do not have any effect on D-MER.
  • Thinking about breastfeeding will not cause dysphoria. 

What D-MER is Not:

This condition is often confused with other difficulties or the label is incorrectly applied causing confusion about what exactly the condition entails. The following are examples of what dysphoric milk ejection reflex is not: 

  • It is not postpartum mood disorder or postpartum depression.
  • It is not a psychological response to breastfeeding or breastfeeding aversion.
  • It is not a dislike of breastfeeding.
  • It is not a physical manifestation during breastfeeding, such as nausea

Can it be Treated?

There is some evidence to suggest that it can be treated, if it is proven that during the milk ejection reflex there is inappropriate Dopamine activity. This can only be diagnosed and treated by a medical professional. 

Dysphoric milk ejection reflex is a condition experienced by many lactating mothers. Women with this condition commonly experience negative thoughts, but this only lasts for a short time. For some women, the condition is more severe than for others. Although the mother has no control over the feelings she experiences before letdown, it is possible to treat the condition if it is correctly identified and diagnosed by a relevant professional. 

A Video about D-MER

Other pages on breastfeeding problems in connection with this page

* Support for mothers who for some reason have not been able to breastfeed. 

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