Evidence map›Paper›PMID 40045338›Full record

ArticleInternational breastfeeding journal2025

Negative emotional experiences of breastfeeding and the milk ejection reflex: a scoping review.

Charlie Middleton, Elaine Lee, Alison McFadden

Abstract readScoping Review
In one paragraph

Article in International breastfeeding journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Charlie MiddletonSchool of Health Sciences, University of Dundee, 11 Airlie Place, Dundee, DD1-4HJ, UK. c.y.middleton@dundee.ac.uk.
Elaine LeeSchool of Health Sciences, University of Dundee, 11 Airlie Place, Dundee, DD1-4HJ, UK.
Alison McFaddenSchool of Health Sciences, University of Dundee, 11 Airlie Place, Dundee, DD1-4HJ, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBreastfeeding aversion response (BAR)and dysphoric milk ejection reflex (D-MER) are two examples of breastfeeding phenomena which present as negative emotional experiences of breastfeeding and lactation but are considered physiological in origin. D-MER presents as a sudden onset of dysphoria prior to and during milk ejection. BAR refers to unpleasant feelings and physical sensations during breastfeeding. Research suggests both phenomena are distinct from perinatal mood disorders. As awareness of D-MER and BAR is limited, this scoping review extended beyond the terms D-MER and BAR to describe the nature, extent and range of literature relating to negative emotional experiences of breastfeeding and the milk ejection reflex. The aim of this scoping review was to capture concepts, knowledge and experiences relating to D-MER and BAR.

methodsThis review followed standard scoping review methodology. Medline, CINAHL, MIDIRS, British Nursing Index, PsychInfo, EBSCO, EMBASE, Cochrane Database of Systematic Reviews, Web of Science, Google, Google Scholar, Open Grey, EThOS and PROSPERO were originally searched between March and July 2020 and April 2024, using predetermined keywords. After removing duplicates, records were screened for eligibility. Data were charted, then summarised and synthesised using numerical and thematic analysis.

resultsIn total, 116 academic and grey literature records were included in the scoping review and five main themes were identified. D-MER and BAR are associated with a range of negative emotions which impact breastfeeding. Awareness of D-MER and BAR is limited, thus, understanding the phenomena better is important for helping women achieve their personal breastfeeding goals.

conclusionThis review identified a wide range of literature which described the nature of D-MER and BAR episodes, suggested causes for both phenomena, the impact of D-MER and BAR on women's lives, strategies women use to cope and possible prevalence rates. Many health professionals remain unaware of D-MER and BAR, and so support provided may be inappropriate or inadequate. Much remains unknown about D-MER and BAR and further research is indicated.

Indexed as

Breast FeedingEmotionsMilk EjectionMothersFemaleHumans

Identifiers

PMID40045338
PMCPMC11881379

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.