Dysphoric Milk Ejection Reflex: The Psychoneurobiology of the Breastfeeding Experience

Breastfeeding, given its biochemical and physiological basis, is known for its many benefits for both the lactating mother and the infant. Among the many challenges new breastfeeding mothers experience is the feeling of aversion in response to their newborn's suckling which has been termed dysphoric milk-ejection reflex (D-MER). Characterized by intense feelings of dysphoria which may eventually interfere with the mother's ability to breastfeed regularly, evidence suggests both the neurobiological and psychological basis of D-MER in an attempt to explain its complexity. Biologically, breastfeeding is expressed by the intracerebral release of oxytocin, an increased expression of oxytocin receptors in specific brain regions, increased mesocorticolimbic reward region activation, the secretion of prolactin and possibly the inhibition of dopamine. Hence, different theories explain D-MER in terms of disrupted neurotransmitter and hormonal activity. Breastfeeding has also proven to influence mood and stress reactivity in nursing mothers with a potential link with postpartum depression. Psychological theories attempt to explain D-MER from a sociopsychosexual lense shedding light on the significance of mother-infant attachment, the sexualization of the female body and the motherhood experience as a developmental stage in a woman's lifespan. The aim of this review is to provide a literature update of D-MER incorporating both neurobiological and psychological theories calling for raising awareness about the complexity of breastfeeding and for the need for mother-centered interventions for the management of D-MER and other postpartum-specific conditions.

Milk production process, quality and technological properties of milk for the use of various types of milking machines

Studies have been carried out to evaluate the efficiency of using easy-assembled cow houses in modern milk production technologies for the use of high-productive milking plants of the type ‘Parallel’ and ‘Carousel’ with 32 machines each. It has been established that new types of premises not only provide comfortable conditions for the maintenance of highly productive cows, but also reduce the labor costs for their maintenance and, most importantly, allow the use of modern high-productive milking installations of the type ‘Parallel’ and ‘Carousel’. It has been established that the technology of preparation of cows for milking and milking technology provides more complete display of the milk ejection reflex at the installation of the ‘Parallel’ type. The average intensity of cows’ milk flows at this plant is 30% higher compared to those of the installation of ‘Carousel’ type, which is confirmed by the intensity of milk flow production at the first minute of milking, which is at the level of 2.97 against 1.85 kg min.-1 per installation of ‘Carousel’ type. Milk obtained using a milking installation of the ‘Parallel’ type has higher values of the mass fraction of fat and protein that is associated with the genetic potential of animals. According to physical, chemical and technological properties, milk obtained from milking installations such as ‘Parallel’ and ‘Carousel’ is within the limits of the standards in force. Milk obtained from the use of milking equipment such as ‘Carousel’ has higher electrical conductivity at the level of 4.6 mS cm-3, which is confirmed by a higher level of mastitis disease of cows. Due to bacterial contamination, reductase test and milk clot characteristic, milk obtained using a milk installation of ‘Parallel’ type also has higher quality indicators than the installation of ‘Carousel’ type. But according to the complex of indicators, milk obtained from various technologies of milking refers to the desired cheese-making class.

Hypothalamic Neuropeptide Brain Protection: Focus on Oxytocin

Oxytocin (OXT) is hypothalamic neuropeptide synthetized in the brain by magnocellular and parvo cellular neurons of the paraventricular (PVN), supraoptic (SON) and accessory nuclei (AN) of the hypothalamus. OXT acts in the central and peripheral nervous systems via G-protein-coupled receptors. The classical physiological functions of OXT are uterine contractions, the milk ejection reflex during lactation, penile erection and sexual arousal, but recent studies have demonstrated that OXT may have anti-inflammatory and anti-oxidant properties and regulate immune and anti-inflammatory responses. In the pathogenesis of various neurodegenerative diseases, microglia are present in an active form and release high levels of pro-inflammatory cytokines and chemokines that are implicated in the process of neural injury. A promising treatment for neurodegenerative diseases involves new therapeutic approaches targeting activated microglia. Recent studies have reported that OXT exerts neuroprotective effects through the inhibition of production of pro-inflammatory mediators, and in the development of correct neural circuitry. The focus of this review is to attribute a new important role of OXT in neuroprotection through the microglia–OXT interaction of immature and adult brains. In addition, we analyzed the strategies that could enhance the delivery of OXT in the brain and amplify its positive effects.

Preeclampsia-Like Features and Partial Lactation Failure in Mice Lacking Cystathionine γ-Lyase—An Animal Model of Cystathioninuria

Elevated plasma homocysteine levels are considered as a risk factor for cardiovascular diseases as well as preeclampsia—a pregnancy disorder characterized by hypertension and proteinuria. We previously generated mice lacking cystathionine γ-lyase (Cth) as cystathioninuria models and found them to be with cystathioninemia/homocysteinemia. We investigated whether Cth-deficient (Cth−/−) pregnant mice display any features of preeclampsia. Cth−/− females developed normally but showed mild hypertension (~10 mmHg systolic blood pressure elevation) in late pregnancy and mild proteinuria throughout development/pregnancy. Cth−/− dams had normal numbers of pups and exhibited normal maternal behavior except slightly lower breastfeeding activity. However, half of them could not raise their pups owing to defective lactation; they could produce/store the first milk in their mammary glands but not often provide milk to their pups after the first ejection. The serum oxytocin levels and oxytocin receptor expression in the mammary glands were comparable between wild-type and Cth−/− dams, but the contraction responses of mammary gland myoepithelial cells to oxytocin were significantly lower in Cth−/− dams. The contraction responses to oxytocin were lower in uteruses isolated from Cth−/− mice. Our results suggest that elevated homocysteine or other unknown factors in preeclampsia-like Cth−/− dams interfere with oxytocin that regulates milk ejection reflex.

PENGARUH TEKNIK MARMET TERHADAP KELANCARAN ASI PADA IBU MENYUSUI

Background: The marmet technique is removing the milk manually and assisting the milk exclusion reflex (Milk Ejection Reflex). Objective: Marmet technique influence to fluid breastfeeding in breastfeeding mothers.Method: design in this research is quasi experiment, population in this research are all postpartum gave birth with a normal gestational age with normal birth weight. Sampling using total sampling, with 24 samples, divided into 2 groups, 12 intervention groups and 12 control groups. Data collection using observation sheet and checklist. The data collected was then processed and analyzed using computer program of microsoft excel and statistic program (SPSS) version 20 with data bivariat analysis using chi-square analysis presented in table 2x2 form.Result: No effect of Marmet technique on breastfeeding in breastfeeding mothers before treatment, (ρ- Value = ,640 > 0,05), There is Marmet technique influence to fluid activity of breastfeeding mother after treatment (ρ-Value = 0,027 < 0,05).Conclusion: There is no effect of Marmet technique on breastfeeding in breastfeeding mothers before treatment is given and Marmet technique exists on the smoothness of breastfeeding in breastfeeding mothers after being given treatment. Keywords : PostPartum, Marmet Technique, Smoothness of Breast Milk

The Mystery of D-MER: What Can Hormonal Research Tell Us About Dysphoric Milk-Ejection Reflex?

The hormones that support breastfeeding also help mothers tolerate, or even enjoy it. But what happens when the hormones of breastfeeding turn against mothers? What if these very hormones make breastfeeding intolerable by biological mistake? That appears to be the case with D-MER. D-MER refers to Dysphoric Milk-Ejection Reflex, where mothers experience dysphoria during milk ejection. D-MER can range from mild to severe. It is a burst of negative emotions in the first few minutes of breastfeeding. In some cases, D-MER is so severe that mothers feel forced to wean. In this article, we examine the phenomenon of D-MER in the light of hormonal research, offer some hypotheses on the causes of D-MER, and suggest possible strategies mothers can use to help them cope.