Journal of Psychiatry Psychology and Behavioral Research (JPPBR)
Vol. 7 No. 1 (2026): Multidimensional Perspectives on Mental Health Across the Lifespan and Social C

DYSPHORIC MILK EJECTION REFLEX [D-MER] AND ITS IMPLICATIONS FOR POSTPARTUM MATERNAL MENTAL HEALTH: A LITERATURE REVIEW

Wijaya, Dyah Ayu Septika (Unknown)
Nafiati, Dini Latifatun (Unknown)



Article Info

Publish Date
31 Mar 2026

Abstract

Introduction: Dysphoric Milk Ejection Reflex (D-MER) is a breastfeeding-related phenomenon characterized by brief episodes of negative emotional responses occurring immediately before or during milk ejection. Although it arises from normal neuroendocrine changes in the postpartum period, D-MER may significantly affect maternal mental health and breastfeeding continuation if unrecognized or inadequately managed. Methods: This article is a narrative literature review of published studies on D-MER, postpartum mental health, and breastfeeding. Relevant articles were identified from electronic databases and analyzed to describe clinical characteristics, underlying mechanisms, and implications for mental well-being. Results: The reviewed literature indicates that D-MER is marked by transient dysphoric symptoms, including sadness, anxiety, irritability, and, in some cases, suicidal ideation, which typically resolve within 10-15 minutes after milk ejection. Evidence suggests that D-MER is associated s d with complex biopsychosocial mechanisms, particularly involving dopamine fluctuations and oxytocin-related neuroendocrine pathways that influence mood regulation and stress reactivity. Discuss: These symptoms may negatively impact the breastfeeding experience and contribute to early weaning. D-MER should be distinguished from postpartum depression, as its symptoms are reflexive, short-lived, and temporally linked to breastfeeding outcomes. D-MER represents a distinct postpartum mental health concern requiring increased awareness among healthcare providers. Conclusion: Early identification and appropriate support may prevent more severe psychological complications. Further research is needed to clarify its mechanisms and establish evidence-based management strategies.  Keywords: postpartum, mental health, dysphoric milk ejection reflex [D-MER].

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Journal Info

Abbrev

jppbr

Publisher

Subject

Humanities Education Medicine & Pharmacology Nursing Public Health

Description

Journal of Psychiatry Psychology and Behavioral Research (JPPBR) consists of publications such as research studies, case studies, review article, short communication and theories of Psychiatry, Psychology, Human Behavior, and related areas. The journal provides information about mental health and ...