{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T10:12:56Z","timestamp":1783764776398,"version":"3.55.0"},"reference-count":19,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Hum Lact"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>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\u2019s experiences of dysphoric D-MER remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research Aim:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A qualitative descriptive design was employed. Six women in T\u00fcrkiye 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Four main themes emerged: (a) valuing breastfeeding despite emotional discomfort\u2014breastfeeding was generally valued yet negatively affected by D-MER; (b) onset, duration, and nature of D-MER symptoms\u2014symptoms 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\u2014distraction techniques and social support were most frequently used; and (d) desire for recognition and nonjudgmental support\u2014women desired greater understanding, nonjudgmental support, and recognition of D-MER in healthcare settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>D-MER can undermine the emotional experience of breastfeeding despite women\u2019s 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08903344261451216","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T05:40:21Z","timestamp":1783575621000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Experiences of Women with Dysphoric Milk Ejection Reflex: A Qualitative Study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2917-1439","authenticated-orcid":false,"given":"Ayse Irem","family":"Gokcek","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences, Department of Midwifery, Istinye University, Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neslihan","family":"Keser Ozcan","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Department of Midwifery, Istanbul University\u2013Cerrahpa\u015fa, Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"crossref","unstructured":"Ahmed M. Mahmud A. Mughal S. Shah H. H. (2024). Dysphoric milk ejection reflex: Call for future trials. Archives of Gynecology and Obstetrics 310(1) 627\u2013630. https:\/\/doi.org\/10.1007\/s00404-024-07503-4","DOI":"10.1007\/s00404-024-07503-4"},{"issue":"2","key":"e_1_3_3_3_1","first-page":"368","article-title":"The qualitative research process: How to conduct a qualitative research?","volume":"5","author":"Baltac\u0131 A.","year":"2019","unstructured":"Baltac\u0131 A. (2019). The qualitative research process: How to conduct a qualitative research? Ahi Evran University Journal of Institute of Social Sciences, 5(2), 368\u2013388.","journal-title":"Ahi Evran University Journal of Institute of Social Sciences"},{"key":"e_1_3_3_4_1","unstructured":"Cox S. (2010). A case of dysphoric milk ejection reflex (D-MER). Breastfeeding Review 18(1) 16\u201318. https:\/\/doi.org\/10.3316\/informit.011888817276752"},{"key":"e_1_3_3_5_1","doi-asserted-by":"crossref","unstructured":"Deif R. (2024). Case report: Psychotherapy for enhancing psychological adjustment to dysphoric milk ejection reflex. Frontiers in Psychiatry 15 1333572. https:\/\/doi.org\/10.3389\/fpsyt.2024.1333572","DOI":"10.3389\/fpsyt.2024.1333572"},{"key":"e_1_3_3_6_1","doi-asserted-by":"crossref","unstructured":"Deif R. Burch E. M. Azar J. Yonis N. Abou Gabal M. El Kramani N. DakhlAllah D. (2021). Dysphoric milk ejection reflex: The psychoneurobiology of the breastfeeding experience. Frontiers in Global Women\u2019s Health 2 669826. https:\/\/doi.org\/10.3389\/fgwh.2021.669826","DOI":"10.3389\/fgwh.2021.669826"},{"key":"e_1_3_3_7_1","doi-asserted-by":"crossref","unstructured":"Frawley T. McGuinness D. (2023). Dysphoric milk ejection reflex (D-MER) and its implications for mental health nursing. 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Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine 19(7) 547\u2013553. https:\/\/doi.org\/10.1089\/bfm.2024.0055","DOI":"10.1089\/bfm.2024.0055"},{"key":"e_1_3_3_11_1","doi-asserted-by":"crossref","unstructured":"Kim H. Sefcik J. S. Bradway C. (2017). Characteristics of qualitative descriptive studies: A systematic review. Research in Nursing & Health 40(1) 23\u201342. https:\/\/doi.org\/10.1002\/nur.21768","DOI":"10.1002\/nur.21768"},{"key":"e_1_3_3_12_1","doi-asserted-by":"crossref","unstructured":"Liu H. Li J. Li X. Lu H. (2023). Dysphoric milk ejection reflex: Report of two cases and postulated mechanisms and treatment. Breastfeeding Medicine 18(5) 388\u2013394. https:\/\/doi.org\/10.1089\/bfm.2022.0206","DOI":"10.1089\/bfm.2022.0206"},{"key":"e_1_3_3_13_1","doi-asserted-by":"crossref","unstructured":"Lynn Herr S. Devido J. Zoucha R. Demirci J. R. (2024). Dysphoric milk ejection reflex in human lactation: An integrative literature review. 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