Introduction
Dysphoric milk ejection reflex is a condition that affects the lactating mother. Here dysphoria means the state of dissatisfaction or unease, whereas milk ejection reflex means the let-down reflex. The lactating mother feels this dissatisfaction suddenly a second before letdown and leaves within a few minutes, from 30 seconds to 2 minutes. Dysphoric milk ejection reflex always differs from postnatal depression; thus, it is not a psychological condition. Instead, it is a physiological condition that always happens only during the letdown of breast milk.
Dysphoric milk ejection reflex also differs from general dislikes by the mother while breastfeeding, like feeling irritated when there is a nipple sore and impatience with the baby during pumping. It also differs from breastfeeding aversion, which usually happens to mothers during breastfeeding when they are pregnant and feeding older toddlers. The dysphoric milk ejection reflex is controlled by hormones and not by mothers. The reflex episodes depend on their intensity to the dysphoric milk ejection reflex.
How Does a Mother Feel During the Dysphoric Milk Ejection Reflex?
Mothers usually describe these feelings in many words. Some of them are:
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Sadness.
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Feel very afraid.
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Nervousness.
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Hopelessness.
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Angry.
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Irritated.
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Feel scared in the stomach.
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Anxiousness.
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Self-loathing (self irritated).
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Introspective (feeling inward).
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Emotionally weak.
This dysphoric milk ejection reflex condition is usually mild to severe. In mild cases, the mothers show they are very tired and disappointed, whereas in severe cases, the mothers may get thoughts of suicide and self-harming. In addition, the time of ejection reflex varies; in mild cases, it may last up to two minutes, whereas in severe cases, it may last up to ten minutes. In some mothers, the dysphoric milk ejection reflex might decrease within three months after giving birth. However, in some mothers, the dysphoric milk ejection reflex lasts as long as they breastfeed their babies. In addition, some mothers feel it is easier to manage when their babies age.
Usually, the dysphoric milk ejection reflex symptoms are similar to those of postpartum anxiety and postnatal depression. However, people with postpartum depression have an increased tendency to dysphoric milk ejection reflex due to emotional instability. In addition, mothers can experience both postnatal depression and dysphoric milk ejection reflex simultaneously; thus, it makes it hard to understand what is happening to them and makes it difficult to pinpoint the symptoms of dysphoric milk ejection reflex.
What Causes Dysphoric Milk Ejection Reflex?
There is no evident cause for dysphoric milk ejection reflex. However, some theories show that the drop in dopamine causes the dysphoric milk ejection reflex during breast milk's letdown. Dopamine is a compound in the body as a neurotransmitter responsible for feeling happy, dissatisfied, and angry. A drop of dopamine does not cause the letdown of breast milk; the oxytocin rise causes it. Oxytocin is a hormone responsible for moving milk out of the breast. Therefore, in the dysphoric milk ejection reflex, the dysphoria is caused by the dopamine drop, and milk ejection is caused by oxytocin rise. In breastfeeding, dopamine gets involved as it needs to inhibit prolactin. Prolactin is a hormone responsible for the growth of the breast and makes milk during pregnancy. Therefore, dopamine and prolactin are inversely proportional. In normal mothers, the dopamine level drops to produce more milk; the mother is unaware of this. In the case of mothers with dysphoric milk ejection, the dopamine level drops inappropriately, leading to negative emotions, and it lasts until the dopamine restabilizes.
What Is the Severity of the Dysphoric Milk Ejection Reflex?
Dysphoric milk ejection reflex severity varies as mild, moderate, or severe. Therefore, the severity of the mother's interpretation determines the severity of the dysphoric milk ejection reflex. In addition, the severity is determined by how often the mother feels dysphoria during the letdown of breast milk per breastfeeding and how long the dysphoric milk ejection reflex lasts. The milk ejection reflex varies in all mothers, and their lasting time also differs. Mild dysphoric milk ejection reflex lasts within three months, whereas in mothers with moderate dysphoric milk ejection reflex, it lasts up to nine months. In severe cases, it lasts until the mothers stop breastfeeding their baby. Mothers with dysphoric milk ejection reflex can result in decreased breast milk supply. Stress is the major risk factor for breast milk supply. Mothers who feel stressed due to dysphoric milk ejection reflex may end in less breast milk supply.
How Is Dysphoric Milk Ejection Treated?
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In mild dysphoric milk ejection reflex, the mother is treated with an education that goes a long way. But, first, educating a mother that dysphoric milk ejection reflex is a medical condition, not a psychological condition, is necessary.
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In moderate dysphoric milk ejection reflex, the mothers should regularize the symptoms in which it is aggravated and relieved; for example, the aggravating factors may be dehydration and stress, whereas the relieving factors may be rest, better hydration, and exercise.
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Changing lifestyles makes the mothers' life better.
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In severe dysphoric milk ejection reflex, the treatment that increases dopamine levels is prescribed, effectively treating the mother.
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In some cases, weaning should be indicated; however, if the mother is not at risk of weaning, the treatment includes education, lifestyle changes, and some natural remedies.
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In addition, the mother should distract themselves while breastfeeding with other activities like eating.
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Mothers should prioritize sleeping over other activities, as lack of sleep worsens the dysphoric milk ejection reflex.
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Mothers should divert themselves from the factors that make them stressed.
Conclusion
Mothers should contact the lactation consultant when they struggle with dysphoric milk ejection reflex. Then, with the help of healthcare providers, the mothers and babies enjoy comfortable breastfeeding. Mothers should take dysphoric milk ejection reflex seriously as it may affect the baby's behavioral pattern and weight issues. Mothers should get the help of family members and should feel free to ask doubts about it. Happy feeding makes both mother and child happier. Mothers can be satisfied as they give good nutritious food to their babies through breastfeeding.
