Dysphoric Milk Ejection Reflex: Prevalence, persistence, and implications

European Journal of Obstetrics & Gynecology and Reproductive Biology, vol. 308, pp. 127–131

Abstract

BACKGROUND: Dysphoric Milk Ejection Reflex (D-MER), characterized by an abrupt wave of negative emotions during milk-letdown, affects a relevant proportion of lactating parents and may significantly impact feeding choices, but remains poorly understood. METHODS: We conducted a cross-sectional study using an online survey of lactating parents of children 18 months and younger who were nursed for any period of time. RESULTS: The prevalence of D-MER in our cohort was 14.2 % (n = 209/1469). Among the 209 women who reported having experienced D-MER, the most frequently selected descriptions were: tense, hypersensitive, frustrated, irritable, overwhelmed, sad, lonely. In the D-MER group, 85.9 % (n = 158/184) used a pump to express breastmilk. Of these 57.0 % (n = 90/158) experienced milder or absent D-MER symptoms while pumping as compared to nursing. Only 5.7 %, (n = 9/158) reported more severe symptoms while pumping, and 12.0 % (n = 19/158) experienced symptoms only when pumping. 40.2 % (n = 72/179), of respondents with D-MER reported that their symptoms remained stable between birth and weaning. In 29.6 % (n = 53/179), symptoms became milder and in 9.5 % (n = 17/179) they disappeared. Importantly, 16.9 % (n = 30/177) of D-MER respondents stopped breastfeeding because of D-MER symptoms, and a further 19.2 % (n = 34/177) had considered doing so. The most frequently reported factor worsening D-MER symptoms was stress, which was selected by 62.1 % (n = 113/182), closely followed by lack of sleep (60.4 %, n = 110/182). Loneliness and conflict with a significant other were also frequently cited (49.5 %, n = 90/182 and 48.9 %, n = 89/182, respectively). The factors most likely to ease D-MER symptoms were "support from partner" and "sleep" (34.6 %, n = 63/182 and 29.7 %, n = 54/182, respectively).

Authors 5

1. Romy Cappenberg
   Affiliation as printed

   Department of Pediatric Pulmonology, Allergology and Neonatology, Hannover, Germany

2. Jesus Garcia Garcia Aachen

   Dartmouth College · Leiden University

   Affiliation as printed

   Mathematical Institute, Leiden University, Netherlands; Quantitative Biomedical Sciences Doctoral Program, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA

3. Ioannis Liolios Aachen Mathematical Institute

   Leiden University

   Affiliation as printed

   Mathematical Institute, Leiden University, Netherlands

4. Christine Happle

   German Center for Lung Research

   Affiliation as printed

   Department of Pediatric Pulmonology, Allergology and Neonatology, Hannover, Germany; RESIST Cluster of Excellence Hannover, Germany; Biomedical Research in End-stage and Obstructive Lung Disease Hannover (BREATH) German Center for Lung Research (DZL) Hannover, Germany

5. Anna Zychlinsky Scharff corresponding
   Affiliation as printed

   Department of Pediatric Oncology and Hematology, Hannover, Germany. Electronic address: ZychlinskyScharff.Anna@mh-hannover.de