Exploring the Association Between Stress and the Experience of the Milk Ejection Reflex: A Scoping Review Protocol

BACKGROUND: The impact of stress exposure on the experience of the human milk ejection reflex in lactation has largely been neglected within the literature. Animal studies suggest an inhibiting effect on milk release, although applicability of these findings to the human mammary gland is limited due to species-specific variation in both lactation physiology and stress response pathways. Incidental findings regarding the newly identified condition of dysphoric milk ejection reflex present the possibility that the release of human milk is heavily dependent upon a robust stress response system. RESEARCH AIM: The primary aim of this scoping review protocol is to provide a transparent method for the mapping of existing evidence related to stress exposure and the experience of the milk ejection reflex in human lactation. Within this, a secondary aim will be to outline an approach to collate extant literature on stress and the experience of dysphoric milk ejection reflex and determine whether there is a stress-related aetiology to the condition. METHODS: This protocol is informed by an established five-stage framework for conducting scoping reviews, supporting the identification and selection of relevant studies. Qualitative data will be reflexively thematically analysed, while quantitative data will be extracted and summarised in diagrammatic form. DISCUSSION: This scoping review protocol addresses a significant knowledge gap in human lactation by outlining an approach to investigating stress and the experience of the human milk ejection reflex in lactation, while advancing understanding of dysphoric milk ejection reflex.