Dysphoric milk ejection reflex (DMER) refers to a condition that affects lactating women, whereby one experiences intense sadness and negative emotions that occur seconds before milk ejection and continue for not more than a few seconds.

This condition affects nearly 9% of breastfeeding women. DMER may bring about feelings of sadness, anxiety, nervousness, irritability, and dread. This condition is a physiological response that is associated with a sudden decrease in dopamine before milk let-down. Breastfeeding moms with this condition only experience sadness during milk ejection, but feel fine throughout the rest of the day. DMER is controlled by hormones, and there’s no way you can talk yourself out of the dysphoria. Mothers who experienced DMER with their first child are more likely to experience the condition with their subsequent children.

During breastfeeding, the levels of dopamine (a hormone that creates feelings of pleasure and reward) drop to allow prolactin (a hormone associated with milk production) to rise. A steep drop in dopamine during milk ejection causes chemical imbalance resulting in feelings of sadness. The letdown lasts for about 30 seconds to 2 minutes, and once it’s over, the feelings of sadness fade away. The let-down reflex happens every time a woman breastfeeds their baby –which means it can happen up to 10 times or more within 24 hours. However, breastfeeding mothers may experience DMER even when they are not nursing. Negative emotions can also occur when pumping milk, when thinking about your baby, or hearing the baby crying. Dysphoric milk ejection reflex is not related to postpartum depression, but rather a physiological reflex caused by milk let-down.

Different moms experience dysphoric milk ejection reflex in different ways. The symptoms of DMER range from mild to moderate and severe. Severe DMER may be characterized by thoughts of self-injury and suicide. Mild and moderate symptoms of DMER usually disappear within 3 to 6 months of breastfeeding, but severe cases persist for more than one year.

Treatment for Dysphoric milk ejection reflex
Mild and moderate DMER can be treated using natural treatments such as herbs, B-vitamin complex, foods that increase dopamine, acupuncture, and many other therapies. Research shows that caffeine, dehydration, and stress can worsen symptoms of DMER. Therefore, it’s advisable for nursing mothers to stay hydrated, reduce stress, and avoid caffeine.

Do consult with your doctor if you need medical assistance for DMER.

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