Case Report of Dysphoric Milk Ejection Reflex

Dysphoric milk ejection reflex (D-MER) is a dysregulation of emotions (dysphoria) that can occur during the milk ejection reflex and during breastfeeding or expressing breast milk. Symptoms of D-MER present suddenly and can include hopelessness, sadness, nervousness, irritability, nausea, dread, palpitations, and a hollow feeling in the stomach. Although D-MER was first reported in 2007, it remains understudied to date and should not be confused with postnatal depression or anxiety disorders. Knowing that they are experiencing symptoms of a named condition is very supportive for women who experience D-MER. It is important that health care professionals who interact with the breastfeeding dyad be aware of D-MER so they can provide supportive care, manage symptoms, and protect the breastfeeding relationship. In this article, we describe the case of a woman who experienced D-MER while she breastfed her newborn. A greater understanding of the characteristic symptoms of dysphoric milk ejection reflex and management strategies is important for health care professionals who support breastfeeding.