School of Health Sciences, Faculty of Medicine, Kagoshima university, 8-35-1 Sakuragaoka, Kagoshima-shi, Kagoshima, 890-8544, Japan.
Int Breastfeed J. 2024 Mar 27;19(1):21. doi: 10.1186/s13006-024-00625-0.
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.
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.
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.
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.
不愉快的奶喷反射（D-MER）是一种在奶喷时引起短暂不适的反射。D-MER 是由于参与哺乳的激素的影响而发展起来的，据报道，它是一种不同于产后抑郁症的生理症状，但在日本的实际情况尚不清楚。
本研究采用在鹿儿岛市的五家健康中心对三岁儿童进行健康检查的母亲进行的自我管理、匿名调查，旨在阐明母亲对 D-MER 的实际情况和认知。调查期间为 2022 年 5 月至 9 月。向 389 位母亲分发了问卷，收到了 216 份（回收率 55.5%），其中 202 份（有效应答率 93.5%）被纳入分析。
在研究人群中，202 位母亲总共生育了 403 位儿童，在母乳喂养 62 位儿童时经历了 D-MER（15.4%）。在纳入分析的 202 位母亲中，47 位（23.3%）在母乳喂养至少一位孩子时回答经历过 D-MER。66 位母亲（32.7%）知道 D-MER。与未经历过 D-MER 的母亲相比，经历过 D-MER 的母亲在与母乳喂养困难相关的项目上的得分明显更高（比值比（OR）：3.78；95%置信区间（CI）：1.57，9.09）和了解 D-MER（OR 2.41；95% CI 1.20，4.84）。关于症状，易怒（n=24，51.1%）、焦虑（n=22，46.8%）和悲伤（n=18，38.3%）排名较高。应对策略包括分散注意力、专注于孩子，以及在某些情况下停止母乳喂养。30 位母亲（63.8%）回答说她们没有咨询任何人，理由是她们认为没有人可能理解她们的症状，而且她们无法充分解释自己的症状。
D-MER 的低认知度表明有必要向母亲和公众宣传和教育 D-MER 的生理症状。此外，有必要倾听患有 D-MER 的母亲的感受，并支持她们应对症状。
