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Review
. 2025 Jun 19;26(12):5909.
doi: 10.3390/ijms26125909.

When Your Body Tells You to Not Breastfeed-The Connivance of Oxytocin, Prolactin, and Dopamine

Vladimír Kraus Jr  1 , Beáta Čižmárová  2 , Anna Birková  2
Affiliations
Review

When Your Body Tells You to Not Breastfeed-The Connivance of Oxytocin, Prolactin, and Dopamine

Vladimír Kraus Jr et al. Int J Mol Sci. .

Abstract

Breastfeeding is universally recognized for its extensive health benefits for both infants and mothers. However, for some women, the experience of breastfeeding can be complicated by intense negative emotional and physical reactions, including phenomena such as dysphoric milk ejection reflex and breastfeeding aversion/agitation. This review explores the neuroendocrine underpinnings of these conditions, emphasizing the interplay between oxytocin, prolactin, and dopamine. Oxytocin, traditionally viewed as a hormone promoting bonding and emotional regulation, can paradoxically provoke a stress response in vulnerable individuals. Prolactin, a key hormone for lactation and maternal behaviors, is implicated in stress resilience and mood regulation, but its dysregulation may contribute to depressive states. Dopamine, critical for reward processing and emotional stability, may underlie the acute emotional dysregulation seen in dysphoric milk ejection reflex. Together, disturbances in these neurohormonal systems may explain the aversive emotional experiences during breastfeeding. An improved understanding of these mechanisms offers critical insights into maternal mental health during lactation and underscores the importance of supportive clinical approaches for affected women.

Keywords: BAA; D-MER; breastfeeding aversion response; breastfeeding aversion/agitation; dopamine; dysphoric milk ejection reflex; oxytocin; prolactin.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Cornucopia of emotions associated with D-MER.
Figure 2
Figure 2
Illustration of the physiological “let down” reflex, also known as milk ejection reflex.
Figure 3
Figure 3
D-MER/oxytocin theory: aberrant signaling of oxytocin responsible for negative sensations.
Figure 4
Figure 4
D-MER/dopamine theory: drop of dopamine and its areas of effect.
Figure 5
Figure 5
Possible symptoms of BAA/BAR.
See this image and copyright information in PMC

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