Dysphoric Milk Ejection Reflex: A Case Series

Dysphoric milk ejection reflex (D-MER) is characterized by an abrupt dysphoria, or undesirable feeling that occurs with the MER and continues for no more than a few minutes. After milk ejection, the dysphoria vanishes.This case series provides a report of three women who have experienced D-MER. All three women described the sudden onset of negative feelings at the initiation of each breastfeeding session. The dysphoria vanished after each milk ejection.Literature on D-MER is limited to one published qualitative research study and two published case reports. As a result, lactation professionals and other providers in the healthcare setting rarely recognize this condition.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.