Impact of Dysphoric Milk Ejection Reflex on Mental Health

Kacır A., KARABAYIR N., Karademir F., BAŞIBÜYÜK M., Öcal Ö., Büke Ö., ...More

Breastfeeding Medicine, 2024 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Publication Date: 2024
  • Doi Number: 10.1089/bfm.2024.0055
  • Journal Name: Breastfeeding Medicine
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CAB Abstracts, CINAHL, EMBASE, MEDLINE, Veterinary Science Database
  • Keywords: breastfeeding, D-MER, dysphoric milk ejection reflex, peripartum depression, weaning
  • Istanbul Medipol University Affiliated: Yes


Objective: Postpartum mental health, significantly influences breastfeeding. Dysphoric milk ejection reflex (D-MER) is defined as negative emotional reaction to milk ejection, such as unpleasant feelings, anger-irritability or a strange feeling in the stomach. This study investigates the impacts of D-MER on mothers experiencing negative emotions during breastfeeding. Method: This cross-sectional, descriptive study was conducted between July 1 and September 30, 2023 among surveyed mothers with babies of ages 0-2 experiencing discomfort while breastfeeding. Mothers reached out through Instagram and Facebook and completed a semi-structured 45-question survey using a Google form. Results: Out of 141 mothers, 27.7% (n: 39) had D-MER findings. Common emotions included tension (48%), exhaustion (43%), intolerance (41%), hypersensitivity (35%), and restlessness (33%). Symptoms reported to begin within the first month of breastfeeding in 59% of D-MER cases. Nausea was reported in 30% of mothers. The most common conditions that increased the severity of D-MER symptoms were insomnia, stress and breast fullness. Sleeping or resting, being alone, doing something else, drinking cold water, listening to music and talking to mothers who had similar experiences helped the mothers relax. In cases with D-MER findings, about 17.9% considered stopping breastfeeding, with 7.7% stopping. The postpartum depression score was ≥13 in 59% of D-MER cases. Conclusion: D-MER, which can cause early cessation of breastfeeding, may also be associated with the mother’s mental health problems. Raising awareness about D-MER and equipping health professionals on this subject are important in the continuity of breastfeeding.