Dysphoric Milk Ejection Reflex is an understudied condition of lactation involving emotional dysregulation during letdown or milk ejection. Affected individuals may experience transient feelings of helplessness, melancholy, and general unhappiness.
To evaluate the scope of published literature on Dysphoric Milk Ejection Reflex.
Whittemore and Knafl\'s methodology guided this integrative review. Five databases were searched for primary research, summaries, and editorials on Dysphoric Milk Ejection Reflex in lactating individuals. Literature searched also included websites, pamphlets, and conference proceedings via Google and Google Scholar. A total of 11 articles, from five different countries, met inclusion criteria for review.
Studies on Dysphoric Milk Ejection Reflex and negative emotional sensations during lactation were synthesized under five conceptual umbrellas: (1) Experiences, Sensations, and Symptom Management; (2) Biological Underpinnings; (3) Influence on Maternal Role and Breastfeeding Self-Efficacy; (4) Support, Understanding, and Awareness; and (5) Reduction and Cessation of Breastfeeding.
Dysphoric Milk Ejection Reflex is a neurobiological condition characterized by low mood and negative feelings during milk ejection throughout lactation. Dysphoric Milk Ejection Reflex is linked to maternal psychological distress and breastfeeding discontinuation. Priority areas for future research include biological origins and interventions aimed at prevention, symptom control, and greater awareness of the condition on a more international scope.

Changes in milk composition during a milking are well characterized, but variation in milk fatty acid (FA) profile is not well described and may affect the accuracy of in-line milk composition analyzers and could potentially be used for selective segregation of milk. Within-milking samples were collected from 8 multiparous high-producing Holstein cows (54.86 ± 6.8 kg of milk/d; mean ± standard deviation). A milk-sampling device was designed to allow collection of multiple samples during a milking without loss of vacuum or interruption of milk subsampling. Milk was collected during consecutive morning and afternoon milkings (12-h intervals) and was replicated 1 wk later. Each sample represented approximately 20% of the milking and was analyzed for fat, true protein, and lactose concentration and FA profile. Milk fat concentration markedly increased over the course of milk let down (4.4 and 4.2 percentage units at the a.m. and p.m. milking, respectively), whereas milk fat globule size did not change. Milk protein and lactose concentration decreased slightly during milking. Modest changes in milk FA profile were also observed, as milk de novo and 16-C FA concentrations increased approximately 10 and 8%, respectively, whereas the concentration of preformed FA decreased about 7% during the milking. In agreement, mean milk FA chain length and unsaturation modestly decreased during milking (0.59 and 0.014 U, respectively). The observed changes in milk fat concentration during a milking are consistent with previous reports and reflect the dynamic nature of milk fat secretion from the mammary gland. Changes in milk FA profile are not expected to practically affect the accuracy of spectroscopy methods for determination of milk fat concentration. Furthermore, the small variation in FA profile during a milking limits the use of within-milking milk segregation to tailor milk FA profile.