Dysphoric Milk Ejection Reflex

Dysphoric milk ejection reflex (D-MER) is a transient dysphoria that occurs as a physiologic response to milk letdown in breastfeeding parents. It is believed to be clinically distinct from postpartum mood and anxiety disorders. Individuals with D-MER report rapid-onset negative affect at the time of milk release that lasts for a short duration of seconds to minutes, though symptom intensity can vary by individual. While the exact cause of D-MER remains unclear, two leading theories suggest that abrupt hormonal changes may play a role. Treatment consists largely of psychoeducation, peer support, distraction techniques, and lifestyle strategies.