Experiences of Women with Dysphoric Milk Ejection Reflex: A Qualitative Study

Background: Dysphoric milk ejection reflex (D-MER) is a physiologic condition in which some women experience brief but intense negative emotions immediately before or during milk release. Awareness and understanding of D-MER remain limited among both mothers and healthcare providers, and qualitative evidence on women’s experiences of dysphoric D-MER remains limited. Research Aim: The aim of this study was to explore the experiences and coping strategies and support the needs of women with D-MER during breastfeeding and/or expressing milk. Methods: A qualitative descriptive design was employed. Six women in Türkiye who reported at least two D-MER symptoms were recruited using convenience sampling. Data were collected through in-depth online interviews between February and June of 2024 and analyzed using inductive thematic analysis. Results: Four main themes emerged: (a) valuing breastfeeding despite emotional discomfort—breastfeeding was generally valued yet negatively affected by D-MER; (b) onset, duration, and nature of D-MER symptoms—symptoms such as restlessness, unhappiness, irritability, chest tightness, and longing occurred within the first few minutes of milk flow and resolved quickly; (c) coping through distraction and social support—distraction techniques and social support were most frequently used; and (d) desire for recognition and nonjudgmental support—women desired greater understanding, nonjudgmental support, and recognition of D-MER in healthcare settings. Conclusion: D-MER can undermine the emotional experience of breastfeeding despite women’s desire to continue. Healthcare providers should be able to recognize D-MER, differentiate it from postpartum depression, and provide individualized education, reassurance, and practical coping guidance.