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Review
. 2024 May;40(2):237-247.
doi: 10.1177/08903344241231239. Epub 2024 Feb 22.

Dysphoric Milk Ejection Reflex in Human Lactation: An Integrative Literature Review

Affiliations
Review

Dysphoric Milk Ejection Reflex in Human Lactation: An Integrative Literature Review

Stephanie Lynn Herr et al. J Hum Lact. 2024 May.

Abstract

Background: Dysphoric Milk Ejection Reflex is an understudied condition of lactation involving emotional dysregulation during letdown or milk ejection. Affected individuals may experience transient feelings of helplessness, melancholy, and general unhappiness.

Research aim: To evaluate the scope of published literature on Dysphoric Milk Ejection Reflex.

Method: Whittemore and Knafl's methodology guided this integrative review. Five databases were searched for primary research, summaries, and editorials on Dysphoric Milk Ejection Reflex in lactating individuals. Literature searched also included websites, pamphlets, and conference proceedings via Google and Google Scholar. A total of 11 articles, from five different countries, met inclusion criteria for review.

Results: Studies on Dysphoric Milk Ejection Reflex and negative emotional sensations during lactation were synthesized under five conceptual umbrellas: (1) Experiences, Sensations, and Symptom Management; (2) Biological Underpinnings; (3) Influence on Maternal Role and Breastfeeding Self-Efficacy; (4) Support, Understanding, and Awareness; and (5) Reduction and Cessation of Breastfeeding.

Conclusion: Dysphoric Milk Ejection Reflex is a neurobiological condition characterized by low mood and negative feelings during milk ejection throughout lactation. Dysphoric Milk Ejection Reflex is linked to maternal psychological distress and breastfeeding discontinuation. Priority areas for future research include biological origins and interventions aimed at prevention, symptom control, and greater awareness of the condition on a more international scope.

Keywords: Dysphoric Milk Ejection Reflex; breastfeeding; emotional sensations; integrative review; lactation; milk letdown; psychological distress.

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Conflict of interest statement

Disclosures and Conflicts of InterestThe authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr. Jill Demirci serves on the editorial boards of several journals, including the BMC Pregnancy and Childbirth and Journal of Perinatal and Neonatal Nursing (contributing editor) and reviews manuscripts for journals within her area of expertise. During the time of this research, she was an Editor for the Journal of Human Lactation. She has contributed to and reviewed lactation support position statements and clinical practice guidelines for AWHONN and the International Lactation Consultant Association, respectively. Dr. Jessica Devido served as dissertation committee chair and faculty advisor during primary author’s doctoral program.

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