Abstract：
Background: Dysphoric milk ejection reflex (D-MER) is a phenomenon that occurs before milk letdown and is described as a wave of negative or devastating emotions, ranging from mild to severe and lasting for seconds to minutes. To date, there has been little research regarding this phenomenon. This study aims to determine the prevalence of D-MER in our population as well as its association with postnatal depression scores and breastfeeding self-efficacy. Methods: Lactating persons between 4 and 12 weeks postpartum at our institution were invited to complete an anonymous 59-question survey via an online platform. Questions asked included patient demographics, presence of symptoms of dysphoria (including timing, duration, and frequency), the Edinburgh Postnatal Depression Scale (EPDS), and the Breastfeeding Self-Efficacy Scale Short Form (BSES-sf). Results: In total, 201 women completed the survey. Twelve women were classified as likely having D-MER (6%). Symptom resolution primarily occurred within a minute to 5 minutes (58%). Mean EPDS scores differed significantly between those with likely D-MER and those without (12.2 vs. 5.4, p = 0.002). BSES-sf scores differed significantly between the two groups (43.1 vs. 52.5, p = 0.009). Preexisting depression or anxiety was not associated with D-MER (p = 0.133), other reported mood disorders differed significantly between those with D-MER and those without (p = 0.004). Demographic characteristics of women with and without D-MER were similar. Conclusion: D-MER prevalence may be lower than previously reported. Patients with likely D-MER appear to have lower breastfeeding self-efficacy and higher depression scores. Those with preexisting mood disorders may be at higher risk of experiencing D-MER.
摘要：
背景：排奶反射障碍（D-MER）是一种在排奶之前发生的现象，被描述为负面或破坏性情绪的浪潮，从轻度到重度，持续数秒到数分钟。迄今为止,关于这种现象的研究很少。这项研究旨在确定我们人群中D-MER的患病率及其与产后抑郁评分和母乳喂养自我效能感的关系。方法：我们邀请在我们机构产后4至12周的哺乳期人员通过在线平台完成匿名59个问题的调查。询问的问题包括患者的人口统计，存在烦躁不安的症状(包括时机，持续时间,和频率)，爱丁堡产后抑郁量表(EPDS)，和母乳喂养自我效能感量表简表(BSES-sf)。结果：总的来说，201名妇女完成了调查。12名女性被归类为可能患有D-MER（6％）。症状缓解主要发生在1分钟至5分钟内(58%)。在那些可能有D-MER的人和没有D-MER的人之间，平均EPDS得分有显着差异（12.2与5.4，p=0.002）。两组之间的BSES-sf评分差异显着（43.1vs.52.5,p=0.009)。先前存在的抑郁或焦虑与D-MER无关（p=0.133），其他报告的情绪障碍在有D-MER的患者和没有D-MER的患者之间存在显著差异(p=0.004).有和没有D-MER的女性的人口统计学特征相似。结论：D-MER的患病率可能低于以前的报道。可能患有D-MER的患者似乎具有较低的母乳喂养自我效能感和较高的抑郁评分。那些先前存在情绪障碍的人可能面临更高的D-MER风险。
