Oxytocin during breastfeeding lasts aproximately 10 minutes, which is the length of time that breastfeeding mothers tend to experience D-MER symptoms. The oxytocin might be triggering the aggression and protectiveness behaviors that occur when the mother is in a stressful environment.

Oxytocin and Dysphoric Milk-Ejection Reflex

Prolactin was originally implicated as the cause of D-MER, however the time profile of it's release does not match oup with the onset of D-MER symptoms. D-MER lasts aproximately 10 minutes after onset of breastfeeding while prolactin starts producing 10 minutes after the onset of breastfeeding.

Prolactin and Dysphoric Milk-Ejection Reflex

Dopamine is involved in the production of prolactin for breastfeeding. Due to this, researchers believe it isn't involved in D-MER symptoms due to the late production time compared to symptom onset.

Dopamine and Dysphoric Milk-Ejection Reflex

Due to oxytocin  triggering the aggressive and fight-or-flight behaviors, people hypothesized that D-MER would only appear in women who experienced high levels of trauma which allowed their bodies to switch into those behaviors easier. There is no evidence that women with D-MER have higher than average rates of experienced trauma compared to women who don't have DMER.

Trauma and Dysphoric Milk-Ejection Reflex

- Stress 
- Trauma (discredited)
- Dopamine
- Oxytocin

Grinnell College

With D-MER, the mother experiences dysphoria during milk ejection or breast feeding.  It is reported as a sudden change in emotions when feeding occures. It typically disappears within 10 minutes after the beginning of feeding. This is different from postpartum depression because it lasts for a short time directly after the beginning of feeding. 

Dysphoric Milk-Ejection Reflex (D-MER)

Unvas-Moberg, K & Kendall-Tackett, K. (2018). The mystery of D-MER; What can hormonal research tell us about dysphoric milk-ejection reflex? Clinical Lactation, 9(1). http://dx.doi.org/10.1891/2158-0782.9.1.23

The Mystery of D-MER; What can hormonal research tell us about dysphoric milk-ejection reflex?

Possible causes of Dysphoric Milk-Ejection Reflex

Symptoms range from dizziness, overwhelming sadness, irritation, restlessness, anger, panic, severe depression and anxiety. It typically disappears within 10 minutes after the beginning of feeding. For some women, the symptoms are severe enough that they have to wean their child. Some mothers only experience the symptoms for a few days while some experience the instances for the entire length of their breastfeeding.

Dysphoric Milk-Ejection Reflex symptoms

- Skin to Skin contact
- Mindfulness
- Stable environment
- self-care
- nutrition

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