Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
7/11/2011
7/11/2011
Definition
Little evidence to adequately define! Dysphoria:
a state of feeling acutely hopeless uncomfortable unhappy
Opposite to Euphoria
7/11/2011
Characterised
Surge of negative emotional responses Described as
waves of sadness anger anxiety
7/11/2011
D-MER Is Not
Psychological response An isolated physical manifestation
Nausea or itching with MER
Postpartum depression or postpartum mood disorder General dislike of breastfeeding Breastfeeding aversion"
7/11/2011
Prolactin Rise
Oxytocin Spike
Log symptoms
May be aggravated by
stress, dehydration, caffeine.
MODERATE
Usually will self correct between 3-9 months
SEVERE
Does not seem to self correct within the first year or more.
Somewhat bothersome to mothers even after education as treatment. Some risk to shorter duration.
High risk of weaning. Mothers often want treatment options. Very disruptive to nursing enjoyment.
7/11/2011
www.D-MER.org
Pharmacological Management
Aim to increase dopamine levels NorepinephrineNorepinephrine-dopamine reuptake inhibitors i.e: Bupropion (Wellbutrin)
Hale suggests caution with its use due to persistent reports that it may suppress breast milk supply
7/11/2011 Marissa McDonald - IBCLC
Counter productive
Avoid dopamine antagonists: Antipsychotics: clozapine, risperidone, olanzapine, quetiapine,
ziprasidone, aripiprazole
7/11/2011
Fava beans Omega 3s Some herbal supplements Music therapy Hypnosis Counselling Vit B complex
Resources
www.Dwww.D-MER.org Media presentation on above web site Breastfeeding: A guide for the Medical Professional, 7th ed. Lawrence and Lawrence Breastfeeding Answers Made Simple, N. Mohrbacher (2010) The Womanly Art of Breastfeeding, 8th ed. (La Leche League International Book), D. Wiessinger, D. West, and T. Pitman (2010)
7/11/2011 Marissa McDonald - IBCLC
References
Cox,S, 2010, A Case of Dsyphoric Milk Ejection Reflex, Breastfeeding Review, 18(1), 16-18 16Facebook online support web page D-MER. www.D-MER.org www.D-
7/11/2011