International Board of Certified Lactation Consultant (IBCLC) Practice Exam

What condition is characterized by negative emotions just before the milk ejection reflex?

1. D-MER (dysphoric milk ejection reflex)

2. Breastfeeding aversion

3. Pre-lactation anxiety

4. Postpartum depression

The correct answer is: D-MER (dysphoric milk ejection reflex)

The condition characterized by negative emotions just before the milk ejection reflex is known as D-MER, or dysphoric milk ejection reflex. This phenomenon involves the experience of feelings of sadness, anxiety, or general unease that occur just prior to the letdown of milk during breastfeeding. The key aspect of D-MER is its timing; the negative emotions arise specifically in relation to the physiological process of milk ejection, rather than being associated with breastfeeding or motherhood as a whole. Research suggests that this response is linked to hormonal changes that take place during letdown and is distinct from other emotional or psychological experiences associated with breastfeeding. Understanding D-MER is important for lactation consultants and healthcare providers, as it helps them to recognize and support mothers who may experience this condition. It can affect a mother's willingness or ability to continue breastfeeding despite wanting to do so, which emphasizes the need for providing empathetic care and resources to affected individuals. In contrast, other options like breastfeeding aversion or postpartum depression encompass broader or different emotional experiences not specifically tied to the milk ejection reflex. Pre-lactation anxiety refers more specifically to anticipatory feelings about breastfeeding rather than the acute emotional response that characterizes D-MER.