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Updated: Jun 23, 2026

Evaluation of Mammary Gland Development and Function in Mouse Models
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Dysphoric Milk Ejection Reflex: Prevalence, persistence, and implications.

Romy Cappenberg1, Jesus Garcia Garcia2, Ioannis Liolios3

  • 1Department of Pediatric Pulmonology, Allergology and Neonatology, Hannover, Germany.

European Journal of Obstetrics, Gynecology, and Reproductive Biology
|March 5, 2025
PubMed
Summary

Dysphoric Milk Ejection Reflex (D-MER) affects 14.2% of lactating parents, causing negative emotions during milk letdown. Stress and lack of sleep worsen symptoms, while partner support and sleep can improve them.

Keywords:
Breast milkBreastfeedingD-MERDMERHuman milkLactatingLactationLetdownNursingPostpartum

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Area of Science:

  • Lactation and Perinatal Health
  • Reproductive Health
  • Maternal Mental Health

Background:

  • Dysphoric Milk Ejection Reflex (D-MER) is a poorly understood condition causing negative emotions during milk letdown.
  • It affects a significant proportion of lactating parents and can influence feeding decisions.

Purpose of the Study:

  • To investigate the prevalence of D-MER in a cohort of lactating parents.
  • To explore the emotional experiences associated with D-MER.
  • To identify factors that exacerbate or alleviate D-MER symptoms and its impact on breastfeeding.

Main Methods:

  • A cross-sectional study was conducted using an online survey.
  • Participants included lactating parents with children 18 months or younger who had breastfed for any duration.

Main Results:

  • The prevalence of D-MER was 14.2%.
  • Commonly reported emotions included tension, hypersensitivity, frustration, irritability, overwhelm, sadness, and loneliness.
  • While pumping reduced D-MER symptoms for many, 16.9% stopped breastfeeding due to symptoms, and 19.2% considered it.
  • Stress and lack of sleep were primary exacerbating factors, while partner support and sleep were most helpful.

Conclusions:

  • D-MER is a prevalent condition with a significant emotional impact on lactating parents.
  • Understanding exacerbating and alleviating factors is crucial for supporting breastfeeding parents.
  • Further research is needed to develop effective interventions for D-MER.