Dysphoric Milk Ejection Reflex
Why is this website here?
The Dopamine Hypothesis
A quick look at how breastfeeding works: There are two reasons why nursing mothers don’t just dribble milk from their breasts all day long:
We know a lot about the oxytocin spike that lets milk flow. We know much less about dopamine. But research on sheep and rats points to an abrupt drop in dopamine around the time of milk release.*
* Knight PG, Howles CM, Cunningham FJ: Evidence that opioid peptides and dopamine participate in the suckling-induced release of prolactin in the ewe. Neuroendocrinol 1986, 44:29-35. Plotsky PM, Neill JD: The decrease in hypothalamic dopamine secretion induced by suckling: comparison of voltammetric and radioisotopic methods of measurement. Endocrinology 1982, 110(3):691-696.
What can help D-MER?
The first thing to try is… cold water! Try drinking a half-cup of very cold water just before brining baby to breast or starting to pump. (Don’t sip slowly or use a straw.) Or suck on some ice chips. It’s not known why having a cold mouth can help, but many mothers with D-MER have found that it does. There are also online suggestions for other behavioral, environmental, and herbal approaches.
A medical approach that shows promise.
IF self-help suggestions aren’t enough, is the use of low-dose naltrexone, an approach used by Mark Shukhman, MD:
Hale TW. Hale's Medications & Mothers' Milk. TM 2021: A Manual of Lactational Pharmacology. Springer Publishing Company; 2020 Jul 14.
Low-Dose Naltrexone - a promising treatment.
Dysphoric Milk Ejection Reflex Help
Dr. Mark Shukhman's interest in D-MER was inspired by the works of Alia Macrina Heise and Diane Wiessinger, known in the field of lactation. For many years, they have been not only collecting data, but also gaining practical experience by being personally involved in helping D-MER sufferers. By the time Dr. Shukhman was introduced to D-MER, he had already developed a strategy for the treatment of a very similar intermittent dysphoria, postcoital dysphoria. The strategy is outlined in his chapter in "The LDN Book" and in his presentation at the LDN Research Trust 2016 Conference. The two dysphorias have striking similarities and, likely, similar mechanisms, which means that the same treatment approach may work.