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.

Grinnell College

- Stress 
- Trauma (discredited)
- Dopamine
- Oxytocin

Possible causes of Dysphoric Milk-Ejection Reflex

Prolactin is a hormone that causes milk production. It is released gradually after 10-20 minutes  from the point a parent begins breastfeeding. Prolactin release is mediated by the decrease of dopamine levels in the hypothalamus. The dopamine affect prolactin-producing cells in the anterior pituitary.

Prolactin during breastfeeding

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?

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 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.

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