Dysphoric milk ejection reflex to nipple/areolar stimulation, thoughts of the baby or of breastfeeding, or overfull breasts, travels through both brain and bloodstream, causing emotional changes in the brain and the release of milk in the breast. Prolactin, released in a gradual wave that peaks after the beginning of a feeding, is responsible for continued milk production. Dopamine inhibits the release of prolactin, so dopamine levels must drop in order for prolactin levels to rise. Some speculate that the necessary dopamine drop is similar to (and timed with) the oxytocin spike – a sort of negative image – but that in D-MER mothers it
Breast milk of milk of similar quality to that of mothers in developed countries. There are many reasons a mother may not produce enough breast milk. Some of the most common reasons are an improper latch (i.e., the baby does not connect efficiently with the nipple), not nursing or pumping enough to meet supply, certain medications (including estrogen-containing hormonal contraceptives), illness, and dehydration. A rarer reason is Sheehan's syndrome, also known as postpartum hypopituitarism, which is associated with prolactin deficiency and may require hormone replacement. The amount of milk produced depends on how often the mother is nursing and/or pumping: the more