[ **up: [[Breastfeeding (Chestfeeding)]]** ]] --- # Dysphoric milk ejection reflex (D-MER) > D-MER, or dysphoric milk ejection reflex, is a condition that affects people who are lactating. It causes you to have intense negative feelings when your milk lets down during a feeding.[^1] - physiological, not psychological.[^2] + sometimes improves around three month mark; sometimes does not improve.[^3] --- > Often, just learning that you’re experiencing D-MER makes it easier to keep what’s happening in perspective and cope with the experience.[^4] - *See also:* [[Diagnoses, labels, validation]] --- ## Causes > \[…] ost studies show that hormones — specifically, an abrupt decrease in a hormone called [[Dopamine|dopamine]] — cause D-MER. Dopamine is a hormone associated with reward and mood. Many studies show low dopamine levels can have a negative effect on your mood and emotions.[^5] > When you breastfeed, your body releases [[Prolactin|prolactin]] (a hormone necessary for milk production) and oxytocin. [[Oxytocin]] is the hormone that triggers the flow or ejection of milk from your breasts when your baby suckles (or you begin pumping). Oxytocin suppresses dopamine, which means your dopamine levels decrease. For reasons researchers don’t completely understand, some people’s dopamine levels drop very quickly and cause a sudden feeling of unhappiness and other negative emotions. This is D-MER.[^6] [^1]: Cleveland Clinic, ‘Dysphoric Milk Ejection Reflex (D-MER)’, *Cleveland Clinic*, updated 6 April 2023, https://my.clevelandclinic.org/health/diseases/24879-dysphoric-milk-ejection-reflex. [^2]: Wendy Wisner, ‘What to Know About Depression and Anxiety While Breastfeeding’, *Healthline*, 22 September 2021, https://www.healthline.com/health/breastfeeding/dysphoric-milk-ejection-reflex. [^3]: Wendy Wisner, ‘What to Know About Depression and Anxiety While Breastfeeding’, *Healthline*, 22 September 2021, https://www.healthline.com/health/breastfeeding/dysphoric-milk-ejection-reflex. [^4]: Wendy Wisner, ‘What to Know About Depression and Anxiety While Breastfeeding’, *Healthline*, 22 September 2021, https://www.healthline.com/health/breastfeeding/dysphoric-milk-ejection-reflex. [^5]: Cleveland Clinic, ‘Dysphoric Milk Ejection Reflex (D-MER)’, *Cleveland Clinic*, updated 6 April 2023, https://my.clevelandclinic.org/health/diseases/24879-dysphoric-milk-ejection-reflex. [^6]: Cleveland Clinic, ‘Dysphoric Milk Ejection Reflex (D-MER)’, *Cleveland Clinic*, updated 6 April 2023, https://my.clevelandclinic.org/health/diseases/24879-dysphoric-milk-ejection-reflex.