"The sudden sense of disgust and rage was so shocking, I felt like I was going crazy!"
Dysphoric Milk Ejection Reflex (D-MER) is a condition that affects some breastfeeding individuals. It's characterized by sudden feelings of sadness, anxiety, irritability, or agitation that occur right before or during milk letdown.
Now, I know what you're thinking, "Everyone says breastfeeding is a time for bonding and connecting with your new baby, but these feelings have me second guessing breastfeeding at all." D-MER can be such a distressing experience for those who experience it.
Imagine, you're cuddled up with your little one, ready to feed them some nourishing breast milk, and then out of nowhere, you're hit with a wave of sadness or disgust. You might feel like crying or running away and you don't know why. It's a confusing and upsetting experience.
But don't worry, you're not alone. D-MER affects up to 10% of breastfeeding individuals, and it's not a reflection of your ability to be a good parent or your love for your little one. Women who have experienced D-MER, have shared it does not necessarily happen every time they breastfeed. Indicating it can be intermittent and unpredictable.
So, what causes D-MER? Well, the exact cause is still unknown, but researchers believe it may be due to a sudden drop in dopamine levels during milk letdown. Dopamine is a neurotransmitter that's involved in regulating mood, and when its levels drop suddenly, it can cause a dysphoric response.
The symptoms of D-MER can vary in severity and duration but usually start suddenly and last for a few minutes. Some common symptoms include:
Feelings of sadness, anxiety, or depression
A sense of impending doom
Irritability or restlessness
Thoughts of self-harm (rare)
Physical symptoms such as nausea, dizziness, or a rapid heartbeat
The good news is that D-MER is a temporary condition and typically resolves on its own as your breastfeeding journey progresses. However, if you're experiencing severe or persistent symptoms, it's essential to talk to your healthcare provider or therapist, who can provide support and guidance on managing your symptoms.
In the meantime, here are a couple of strategies you can utilize if you have symptoms of D-MER.
Breathe: Pay attention to your breathing while latching. Focus and count. Inhale using your diaphragm to the count of four, and exhale slowly to the count of eight; pausing at the top and bottom of each breath.
Distract: the thing with D-MER is you know when it will likely occur. You can prepare yourself with a distraction. A TV show, conversation, or book can help take your mind off of the discomfort of D-MER.
Remind yourself that D-MER is a time limited experience. It is unlikely to last through the entirety of your breast feeding experience.
Know that you're not alone, and there's no shame in seeking help.
Breastfeeding can be a beautiful and rewarding experience, but it's not always easy. Hang in there momma! You got this!
*Article originally written by Dr. Jessica Kaffer, PsyD on DocMomPsyD.com and has been crossposted.
Magnani, S., De Leo, V., & Ferrari, S. (2010). Dysphoric Milk Ejection Reflex: A Case Study. International Breastfeeding Journal, 5(1), 5. https://doi.org/10.1186/1746-4358-5-5
Young, E. (2011). D-MER: The Elephant in the Room. Journal of Human Lactation, 27(3), 248–251. https://doi.org/10.1177/0890334411404415
D-MER.org. (2023). https://www.d-mer.org/
Mayo Clinic. (2020, September 8). D-MER: When Breastfeeding Makes You Depressed. https://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/d-mer/art-20283081
La Leche League International. (2023). Dysphoric Milk Ejection Reflex. https://www.llli.org/breastfeeding-info/dysphoric-milk-ejection-reflex/