D-MER: When Breastfeeding Really is the Worst

Breastfeeding often doesn't come naturally. It can take time to work out and get into a comfortable rhythm (often with the help of a good lactation consultant). But for some mothers, the act of breastfeeding stimulates feelings of sadness, anxiety, or anger. When this happens in relation to the milk ejection reflex and is not related to other conditions, such as post-partum depression, it may be the result of dysphoric milk ejection reflex — commonly referred to as D-MER. 

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Image via Flickr/ Mothering Touch

What is D-MER?

At its most basic, D-MER is an identifiable influx of negative emotions right before and during the milk ejection reflex in a breastfeeding mother. It can be mild, moderate, or even severe. Mothers experience devastating and overwhelming negative emotions. How D-MER presents depends greatly on the individual. Some women may only experience it with letdowns during nursing sessions. Others may find the feelings happen even with spontaneous letdowns. The emotions usually come on about 30 to 90 seconds before the milk ejection reflex. And mothers can experience multiple episodes during a nursing session if there is more than one letdown. The sensation also depends on the individual, but common feelings associated with D-MER include but are not limited to:

  • Anxiety
  • Hopelessness
  • Dread
  • Sadness
  • Agitation
  • Anger
  • Angst
  • Irritability
  • A general feeling of unease

Why does it happen?

It's important to understand that this is a physiological response in the body rather than a psychological one. You are not crazy, and D-MER is not associated with past negative experiences. Researchers believe that it occurs when something goes wrong with the dopamine levels that must lower for prolactin levels to rise and the milk ejection reflex to occur. It seems that in mothers with D-MER, the dopamine levels may drop too quickly or go too low, triggering the negative feelings. 

What can you do about it?

Weaning used to be seen as the only answer to D-MER. However, advances in research and how we understand D-MER to occur has brought about alternative treatments. In mild cases, the mother may not be bothered enough to seek treatment or may be able to keep it under control with lifestyle changes. But for those with moderate to severe cases, prescription medications can offer some relief. 

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Have you suffered from these types of symptoms in relation to breastfeeding? 

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D-MER: When Breastfeeding Really is the Worst

Katelynne has been trying to get the hang of this raising kids thing since 2007 but spends most of her time wondering who stole her copy of Parenting 101. When she’s not playing referee for her two children or writing all the words, she fantasizes about a full night’s sleep, uninterrupted showers, and triple venti caramel macchiatos with coconut milk. ... More

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