Dysphoric Milk Ejection Reflex: A Case Series

Ureño, Tamara L; Buchheit, Toni L; Hopkinson, Susan G; Berry‐Cabán, Cristóbal S.

doi:10.1089/bfm.2017.0086

Cited by 18 publications

(47 citation statements)

References 6 publications

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“…The phenomena of dysphoric milk ejection reflex (D-MER) which is a diagnosable condition is one such experience, which is characterised by feelings of dysphoria that last during the milk ejection reflex and then cease. 8,9 Research on breastfeeding women, who have a history of childhood sexual assault (CSA), describes another type of aversion experience during breastfeeding, Which is known and has a defined rationale as the presentation includes feelings of dissociation and triggered trauma memories. 10 In contrast to these aversion categories described in the empirical literature, anecdotal social discourse from online breastfeeding support groups 11 and lay literature 7 suggests women describe a different experience of aversion which occurs in other circumstances.…”

Section: Introductionmentioning

confidence: 99%

Women who experience feelings of aversion while breastfeeding: A meta-ethnographic review

et al. 2021

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Problem: Limited literature is available about women who wish to breastfeed but experience unexpected feelings of aversion in reaction to their infant suckling at the breast while breastfeeding. Background: Breastfeeding benefits mothers, infants and society yet breastfeeding rates continue to fall below recommendations in part due to inadequate tailored support after hospital discharge. Influences on breastfeeding are complex and include many physiological, psychosocial and cultural factors. Aim: To better understand the experience of women who have feelings of aversion during breastfeeding by synthesising the existing literature. Methods: MEDLINE, CINAHL, PsycINFO, Maternity and Infant Care databases were searched for relevant literature published between 2000 to 2019. Using Covidence software, five qualitative research studies were identified. Studies were then analysed using meta-ethnographic qualitative synthesis. Findings: Feelings of aversion during breastfeeding were described as visceral and overwhelming; leading to feelings of shame and inadequacy. This synthesis identified five findings; a central conceptual category of "it's such a strong feeling of get away from me" with four key metaphors translated from this central conceptual category: "I do it because I feel it is best for my baby", "I can't control those feelings", "I should be able to breastfeed my son and enjoy it", and "I'm glad I did it". This phenomenon may negatively affect a women's sense of self and impact on the motherinfant relationship. Conclusion: Some women who want to breastfeed can experience feelings of aversion while breastfeeding. The feelings of 'aversion' while breastfeeding can inhibit women from achieving their personal breastfeeding goals.

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Section: Introductionmentioning

confidence: 99%

Women who experience feelings of aversion while breastfeeding: A meta-ethnographic review

et al. 2021

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“…Different hypotheses of mechanisms of action underlying dysphoria have been proposed, but dopamine has been the most probable candidate ( 19 ). The secretion of prolactin, which also happens during lactation, is dependent on the inhibition of dopamine ( 5 ). Pseudoephedrine, which stops milk production, was seen to eliminate D-MER without acting on oxytocin, but rather by reducing levels of prolactin.…”

Section: The Neurobiology Of Breastfeedingmentioning

confidence: 99%

“…It is likely to recur with each milk ejection response, or in certain cases, only the initial milk ejection response of each feeding session ( 4 ). Such sensations create a hollow or churning sensation in the pit of the stomach ( 5 , 6 ). Symptoms may diminish by 3 months or may persist during the course of breastfeeding ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

“…In 2008, Heise created the web domain, www.d-mer.org , to educate the public about this condition and provide support for mothers ( 19 ) and in 2010, the first D-MER case study was issued. Two other case analyses were released in 2011 and 2018 ( 5 , 19 ). Unfortunately, there is not enough evidence confirming D-MER as a clinical phenomenon given the limited case cases and anecdotal data ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

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Dysphoric Milk Ejection Reflex: The Psychoneurobiology of the Breastfeeding Experience

Deif

Burch

Azar

et al. 2021

Front. Glob. Womens Health

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Breastfeeding, given its biochemical and physiological basis, is known for its many benefits for both the lactating mother and the infant. Among the many challenges new breastfeeding mothers experience is the feeling of aversion in response to their newborn's suckling which has been termed dysphoric milk-ejection reflex (D-MER). Characterized by intense feelings of dysphoria which may eventually interfere with the mother's ability to breastfeed regularly, evidence suggests both the neurobiological and psychological basis of D-MER in an attempt to explain its complexity. Biologically, breastfeeding is expressed by the intracerebral release of oxytocin, an increased expression of oxytocin receptors in specific brain regions, increased mesocorticolimbic reward region activation, the secretion of prolactin and possibly the inhibition of dopamine. Hence, different theories explain D-MER in terms of disrupted neurotransmitter and hormonal activity. Breastfeeding has also proven to influence mood and stress reactivity in nursing mothers with a potential link with postpartum depression. Psychological theories attempt to explain D-MER from a sociopsychosexual lense shedding light on the significance of mother-infant attachment, the sexualization of the female body and the motherhood experience as a developmental stage in a woman's lifespan. The aim of this review is to provide a literature update of D-MER incorporating both neurobiological and psychological theories calling for raising awareness about the complexity of breastfeeding and for the need for mother-centered interventions for the management of D-MER and other postpartum-specific conditions.

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“…• Post-and urge clients to post-their experiences through d-mer. or g. Several authors have already mined those stories for insights (Pettersson & Packalén, 2018;Ureño, Buchheit, Hopkinson, & Berry-Cabán, 2018;Watkinson, Murray, & Simpson, 2016).…”

mentioning

confidence: 99%

Letter to the Editor

Heise¹,

Wiessinger²

2018

Clin Lactation

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Dysphoric Milk Ejection Reflex: A Case Series

Abstract: The case studies presented here provide evidence for the presence of D-MER. Research is needed to better understand its pathophysiology, incidence, and treatment options.

Cited by 18 publications

References 6 publications

Women who experience feelings of aversion while breastfeeding: A meta-ethnographic review

Women who experience feelings of aversion while breastfeeding: A meta-ethnographic review

Dysphoric Milk Ejection Reflex: The Psychoneurobiology of the Breastfeeding Experience

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