Dysphoric milk ejection reflex sense of depression and this feeling can range from mild homesickness or wistfulness to more intense feelings of hopelessness and self-loathing. Similarly, anxiety may range from restlessness to more intense panic and dread. Anger, the least likely of the three, may range from tension and agitation to more intense feelings of hostility and aggression. The mechanism is not clear. In a mother with D-MER, dopamine may fall inappropriately with milk release, causing the negative feelings. Among the hormones involved in milk production and release are oxytocin, prolactin, and dopamine. Oxytocin, released in pulsatile "spikes" from the posterior pituitary in response
Low milk supply baby drink more milk. Making the mother comfortable, particularly by resolving nipple pain, is essential. Breast self-massage is recommended to stimulate the milk ejection reflex and to physically promote the flow of milk. Some experts recommend using a breast pump after each breastfeeding session. If the baby cannot nurse effectively, frequent drainage of milk from the breasts through hand expression and/or an electric double breast pump is recommended. The mother's use of medications and herbs should be evaluated, as some substance suppress lactation. The Academy of Breastfeeding Medicine protocol for low milk supply recommends that the mother be evaluated for