Dysphoric Milk Ejection Reflex (D-MER) is a unique condition experienced by lactating women, marked by a sudden onset of negative emotions just before the milk release, lasting only a few minutes. In the second edition of 'Before the Letdown: Dysphoric Milk Ejection Reflex and the Breastfeeding Mother,' Alia Macrina Heise, IBCLC, delves deeper into this phenomenon, offering eleven comprehensive chapters packed with valuable insights and support for mothers grappling with D-MER. This book not only serves as a vital resource for mothers seeking guidance and empathy but also equips healthcare providers with the knowledge needed to effectively assist their patients. Additionally, it provides partners and family members with essential tools to offer optimal support to mothers navigating the challenges of D-MER. With Alia Macrina Heise's expertise and pioneering work in the field since 2007, this edition promises to be an indispensable guide for understanding and managing D-MER.