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Beyond the Letdown: Dysphoric Milk Ejection Reflex and the Breastfeeding Mother

by Alia Macrina Heise, IBCLC
  • Duration: 60 Mins
  • Credits: 1 CERP, 1 L-CERP, 1 Nursing Contact Hours, 1 CME, 0.1 Midwifery CEU, 1 Dietetic CEU
  • Handout: No
Abstract:

Dysphoric milk ejection reflex (D-MER), is not a new phenomenon. In the past, it was almost like Voldemort, the Problem That Must Not Be Named. But for over 10 years now, it has had a name and been brought into daylight. Though still not widely known or understood by many, the hypothesis of the mechanism and possible sustainable solutions are becoming better documented all the time. D-MER has been the subject of two case studies, one case series, and a qualitative research study. Two other studies as also in process at this time.

Mothers with D-MER feel, as a reflexive response with every single milk release, a wave of negative emotions ranging (depending on severity) from homesickness to hopelessness and despair, perhaps even anger and suicidal ideation. These emotions dissipate shortly after milk release and reoccur with the start of every MER, whether with breastfeeding, expressing or with spontaneous releases. Many sufferers keep the problem to themselves preferring the weaning of their baby to being incorrectly labeled as depressed or victims of abuse. Upon experiencing D-MER mothers are initially convinced the problem is physiological and not psychological, and they are correct.

As both a lactation consultant and a sufferer of D-MER, I first named and identified D-MER over 10 years ago. Now, through the case studies that have been done, collaboration with other medical and breastfeeding care providers, and the collection of information from the anecdotal reports from over 1,000 mothers, there is now a foundation of understanding of D-MER. Though the evidence base for D-MER is still mainly unestablished at this time, there are many professionals always working to bring evidenced-based information to the study of human lactation. This is exactly what the slow work and understanding of D-MER is about; the process of bringing new information into the light for further research and understanding.

In the PowerPoint presentation that I have to present, I discuss how D-MER presents, its tell-tale manifestation, and its spectrum and intensities. The presentation also explains the currently proposed mechanism of the MER anomaly, how health care providers can identify a mother it D-MER and how to help and support mothers with the condition.

Learning Objectives:

Objective 1: Explain and define what D-MER is and what it is not;

Objective 2: Distinguish how D-MER presents and it’s variances;

Objective 3: Hypothesize and illustrate the possible cause and treatment of D-MER;

Objective 4: Describe how to best help a mother with D-MER;

Presentations: 6  |  Hours / CE Credits: 6  |  Viewing Time: 4 Weeks