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
Effective refractory period Effective refractory period In electrocardiography, during a cardiac cycle, once an action potential is initiated, there is a period of time that a new action potential cannot be initiated. This is termed the effective refractory period (ERP) of the tissue. This period is approximately equal to the absolute refractory period (ARP), it occurs because the fast sodium channels remain closed until the cell fully repolarizes. During this period, depolarization on adjacent cardiac muscles does not produce a new depolarization in the current cell as it has to refract back to phase 4 of the action potential before a new action