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Clinical Obstetrics

Poster Session 3

(855) Incidence of Dysphoric Milk Ejection Reflex

Wednesday, February 14, 2024
8:30 AM – 10:00 AM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: Dysphoric Milk Ejection Reflex (DMER) is a condition described as brief, abrupt, negative emotions experienced by breastfeeding individuals prior to milk letdown. It may negatively impact the breastfeeding relationship. Our primary objective was to determine the incidence of DMER.

Study Design: A prospective cohort study with English speakers who delivered a liveborn infant between December 2022-May 2023 at two hospitals within a large healthcare system in New York. Patients who elected to breastfeed were eligible for the study. Participants were emailed an initial survey at the time of consent. The following morning, they started receiving surveys three times daily for one week assessing for DMER symptoms, with symptom severity rated on a Likert scale. Medical records were reviewed to obtain patient demographics, antepartum course, and obstetrical and fetal outcomes. Descriptive statistics were performed to determine incidence and characterize the patient population.

Results: 203 patients were approached for participation. 151 consented and 1 withdrew, leaving 150 participants in the study. Of those, 59 did not complete any surveys, and 73 were lost to follow up. The 18 remaining participants completed the initial survey and >50% of the surveys assessing for DMER symptoms, for a total of 321 surveys completed. 33.% (n=6) screened positive for DMER in more than 50% of breastfeeding episodes. Patients who screened positive were more likely to be <35 years old, non-Hispanic white, married, obese, privately insured, and delivered at term by cesarean section. Amongst those who screened positive for DMER, no one had a history of psychiatric disorders. DMER symptom severity was mostly very mild to moderate (Table 1). One patient reported severe symptoms.

Conclusion: More than 1 in 4 breastfeeding women screened positive for DMER. It is important to extend this research to better define, quantify, qualify, and publicize this condition in an effort to inform clinical practices to facilitate successful, healthy, breastfeeding relationships.