Dysphoric milk ejection reflex among Japanese mothers: a self-administered survey

Abstract Background The dysphoric milk ejection reflex (D-MER) is a reflex that causes temporary discomfort during milk ejection. D-MER develops due to the effects of hormones involved in lactation, and it has been reported that it is a physiological symptom different from postpartum depression, but...

Full description

Bibliographic Details
Main Authors: Yukako Moriyama, Yuko Nakao, Naoko Yamamoto, Toshimichi Oki
Format: Article
Language:English
Published: BMC 2024-03-01
Series:International Breastfeeding Journal
Subjects:
Online Access:https://doi.org/10.1186/s13006-024-00625-0
_version_ 1797233259778670592
author Yukako Moriyama
Yuko Nakao
Naoko Yamamoto
Toshimichi Oki
author_facet Yukako Moriyama
Yuko Nakao
Naoko Yamamoto
Toshimichi Oki
author_sort Yukako Moriyama
collection DOAJ
description Abstract Background The dysphoric milk ejection reflex (D-MER) is a reflex that causes temporary discomfort during milk ejection. D-MER develops due to the effects of hormones involved in lactation, and it has been reported that it is a physiological symptom different from postpartum depression, but the actual situation is unknown in Japan. Methods This study was conducted using a self-administered, anonymous survey of mothers of children who had undergone health checkups at three years of age at five health centers in Kagoshima city and aimed to clarify the reality and perceptions of mothers regarding D-MER. The survey period was from May to September, 2022. The questionnaires were distributed to 389 mothers, and 216 (55.5% recovery rate) responses were received, of which 202 (valid response rate 93.5%) were included in the analysis. Results Regarding the experience of D-MER, 202 mothers in the study population had given birth to a total of 403 children and experienced D-MER when breastfeeding 62 children (15.4%). Of the 202 mothers included in the analysis, 47 (23.3%) answered that they had experienced D-MER with at least one child while breastfeeding. Sixty-six mothers (32.7%) knew about D-MER. Compared to those who had not experienced D-MER, those who had experienced D-MER had significantly higher scores on the items related to having had trouble breastfeeding (odds ratio (OR]: 3.78; 95% confidence interval (CI]: 1.57, 9.09) and knowing about D-MER (OR 2.41; 95% CI 1.20, 4.84). Regarding symptoms, irritability (n = 24, 51.1%), anxiety (n = 22, 46.8%), and sadness (n = 18, 38.3%) ranked high. Coping strategies included distraction, focusing on the child, and, in some cases, cessation of breastfeeding. Thirty mothers (63.8%) answered that they did not consult anyone, citing reasons such as a belief that no one would be likely to understand their symptoms, and that they could not sufficiently explain their symptoms. Conclusion The low level of awareness of D-MER suggests that it is necessary to inform and educate mothers and the public about the physiological symptoms of D-MER. Moreover, it is necessary to listen to the feelings of mothers with D-MER and support them in coping with their symptoms.
first_indexed 2024-04-24T16:13:20Z
format Article
id doaj.art-74314c3bfa754dd5a43e110b6e0763d3
institution Directory Open Access Journal
issn 1746-4358
language English
last_indexed 2024-04-24T16:13:20Z
publishDate 2024-03-01
publisher BMC
record_format Article
series International Breastfeeding Journal
spelling doaj.art-74314c3bfa754dd5a43e110b6e0763d32024-03-31T11:36:43ZengBMCInternational Breastfeeding Journal1746-43582024-03-011911810.1186/s13006-024-00625-0Dysphoric milk ejection reflex among Japanese mothers: a self-administered surveyYukako Moriyama0Yuko Nakao1Naoko Yamamoto2Toshimichi Oki3School of Health Sciences, Faculty of Medicine, Kagoshima universitySchool of Health Sciences, Faculty of Medicine, Kagoshima universitySchool of Health Sciences, Faculty of Medicine, Kagoshima universitySchool of Health Sciences, Faculty of Medicine, Kagoshima universityAbstract Background The dysphoric milk ejection reflex (D-MER) is a reflex that causes temporary discomfort during milk ejection. D-MER develops due to the effects of hormones involved in lactation, and it has been reported that it is a physiological symptom different from postpartum depression, but the actual situation is unknown in Japan. Methods This study was conducted using a self-administered, anonymous survey of mothers of children who had undergone health checkups at three years of age at five health centers in Kagoshima city and aimed to clarify the reality and perceptions of mothers regarding D-MER. The survey period was from May to September, 2022. The questionnaires were distributed to 389 mothers, and 216 (55.5% recovery rate) responses were received, of which 202 (valid response rate 93.5%) were included in the analysis. Results Regarding the experience of D-MER, 202 mothers in the study population had given birth to a total of 403 children and experienced D-MER when breastfeeding 62 children (15.4%). Of the 202 mothers included in the analysis, 47 (23.3%) answered that they had experienced D-MER with at least one child while breastfeeding. Sixty-six mothers (32.7%) knew about D-MER. Compared to those who had not experienced D-MER, those who had experienced D-MER had significantly higher scores on the items related to having had trouble breastfeeding (odds ratio (OR]: 3.78; 95% confidence interval (CI]: 1.57, 9.09) and knowing about D-MER (OR 2.41; 95% CI 1.20, 4.84). Regarding symptoms, irritability (n = 24, 51.1%), anxiety (n = 22, 46.8%), and sadness (n = 18, 38.3%) ranked high. Coping strategies included distraction, focusing on the child, and, in some cases, cessation of breastfeeding. Thirty mothers (63.8%) answered that they did not consult anyone, citing reasons such as a belief that no one would be likely to understand their symptoms, and that they could not sufficiently explain their symptoms. Conclusion The low level of awareness of D-MER suggests that it is necessary to inform and educate mothers and the public about the physiological symptoms of D-MER. Moreover, it is necessary to listen to the feelings of mothers with D-MER and support them in coping with their symptoms.https://doi.org/10.1186/s13006-024-00625-0Dysphoric milk ejection reflexBreastfeeding troubleBreastfeeding support
spellingShingle Yukako Moriyama
Yuko Nakao
Naoko Yamamoto
Toshimichi Oki
Dysphoric milk ejection reflex among Japanese mothers: a self-administered survey
International Breastfeeding Journal
Dysphoric milk ejection reflex
Breastfeeding trouble
Breastfeeding support
title Dysphoric milk ejection reflex among Japanese mothers: a self-administered survey
title_full Dysphoric milk ejection reflex among Japanese mothers: a self-administered survey
title_fullStr Dysphoric milk ejection reflex among Japanese mothers: a self-administered survey
title_full_unstemmed Dysphoric milk ejection reflex among Japanese mothers: a self-administered survey
title_short Dysphoric milk ejection reflex among Japanese mothers: a self-administered survey
title_sort dysphoric milk ejection reflex among japanese mothers a self administered survey
topic Dysphoric milk ejection reflex
Breastfeeding trouble
Breastfeeding support
url https://doi.org/10.1186/s13006-024-00625-0
work_keys_str_mv AT yukakomoriyama dysphoricmilkejectionreflexamongjapanesemothersaselfadministeredsurvey
AT yukonakao dysphoricmilkejectionreflexamongjapanesemothersaselfadministeredsurvey
AT naokoyamamoto dysphoricmilkejectionreflexamongjapanesemothersaselfadministeredsurvey
AT toshimichioki dysphoricmilkejectionreflexamongjapanesemothersaselfadministeredsurvey