BACKGROUND: Dysphoric milk ejection reflex (D-MER) is characterized by an abrupt 
dysphoria, or undesirable feeling that occurs with the MER and continues for no 
more than a few minutes. After milk ejection, the dysphoria vanishes.
CASE SERIES: This case series provides a report of three women who have 
experienced D-MER. All three women described the sudden onset of negative 
feelings at the initiation of each breastfeeding session. The dysphoria vanished 
after each milk ejection.
DISCUSSION: Literature on D-MER is limited to one published qualitative research 
study and two published case reports. As a result, lactation professionals and 
other providers in the healthcare setting rarely recognize this condition.
CONCLUSIONS: The case studies presented here provide evidence for the presence 
of D-MER. Research is needed to better understand its pathophysiology, 
incidence, and treatment options.