Dysphoric Milk Ejection Reflex is a condition affecting lactating women that is characterized
by an abrupt dysphoria, or negative emotions, that occur just before milk release and continuing not more than
a few minutes.
D-MER has nothing to do with nipple contact or with irritation with the sensation of nipple tugging.
You do not even have to be
thinking about breastfeeding
(for example with spontaneous letdowns) for the dysphoria to happen when a milk release
You may or may not have dysphoria with letdowns when pumping and before spontaneous letdowns, this also is dependent of the intensity of your D-MER.
This is not postpartum depression and most of these people feel perfectly fine except for that pre-milk moment.
There is no official way to diagnose it.
However it's usually known for the symptoms appearing right before, or during, a letdown and stops afterwards.
D-MER can range in intensity. The common experience is brief wave of negative feelings such as sadness, irritation, restlessness, anger, panic and, in severe cases, depression or anxiety.
D-MER can be managed by having a support system and doing things to make breastfeeding enjoyable
D-MER can resolve on its own in a matter of days or weeks.
Depending on the intensity and severity of the situation it can be helpful to track symptoms. This allows you to work with your doctor to pinpoint any triggers.
Most available research was primarily case studies. At the time of publication this site appears to be a commonly reference and reputable source.
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