Imagine you are sound asleep, relaxed, comfortable, quiet mind and body – then all of a sudden you are startled awake by one of those awful vivid ‘falling dreams’. You can feel it in your body. Every cell is vibrating, every hair standing up.
In a matter of seconds, your physical and emotional state has gone from one extreme to the other. Now imagine getting that feeling every time you breastfeed your baby. THAT is what D-MER felt like for me.
Dysphoric Milk Ejection Reflex (D-MER) can occur with a Mama’s let down reflex, either whilst breastfeeding her babe, or during a spontaneous let-down… like when you’re standing in the shower and hosing the walls with milk.
Very few women and professionals have heard of D-MER. In fact, I’d bet money women have ended their breastfeeding journey due to the symptoms of D-MER without even knowing they had it.
Have you ever felt so agitated that you wanted to push your baby from your body whilst feeding? Well, unless you’re pregnant again, this nursing aversion could possibly be because of D-MER. So what on earth is it?
What D-MER Is
Dysphoric milk ejection reflex can be categorised by negative physical and/or emotional symptoms that occur with a Mama’s MER/let-down.
Now that’s not to say you have to physically feel the let-down occurring. Some women experience their MER as an uncomfortable electric shock, some as a tingly pins and needles feeling, and some don’t feel anything at all.
It is not the let-down itself that is the issue, rather inappropriate hormonal (dopamine) activity associated with the activation of the let-down.
To put it simply, D-MER is a chemical imbalance, triggered by the milk ejection reflex, which leads to unpleasant feelings.
What It Is Not
As previously mentioned, D-MER is NOT breastfeeding aversion, which is often seen when nursing mothers become pregnant again.
D-MER is NOT a psychological response to breastfeeding, but a physical/emotional response to the milk ejection reflex that lasts several minutes.
It is NOT characterised by an isolated symptom, but physical symptoms that elicit a negative emotional response.
D-MER must also not be confused with a general dislike of breastfeeding or negative experience of breastfeeding due to difficulties such as a painful latch, irritable baby, supply concerns etc.
D-MER is NOT postpartum depression or anxiety. If repetitive thoughts of harm to self or an infant are occurring, or you find you’re constantly having unpleasant thoughts, like worrying about ways your baby could die, then it is imperative to seek help.
The symptoms of D-MER, although very similar to those of postpartum depression and anxiety, are different. They are brief, temporary, usually of a more physical nature, and associated with a letdown.
That being said, D-MER can most certainly contribute to the psychological and physical effects of depression/anxiety.
If you think this may be the case for you, see our article about Perinatal Anxiety & Depression.
What D-MER Can Feel Like – Real Womens’ Experiences
The symptoms of D-MER can range from mild to moderate and severe. Several Mama’s have been kind enough to share their own experiences of D-MER with us.
Words used to describe the sensation include depression, sorrow, anxiety attack, disgust, anger, agitation, hollow dropping feeling in the gut, body tingling, waves of sadness, and butterflies in the stomach.
Personally, for me, it was a full body vibration. Like a physical panic, deep in my chest, radiating to my throat and making it difficult to breathe. It was a wave washing over me. My chest pounding with tension.
I was fortunate to recognise what it was early on, so mindfulness and slow breathing got me through those initial moments of a feed. There was also a lot of toe wiggling to distract myself. For some, it’s not so easy.
One Mama writes –
“My symptoms were a really strong sense of anxiety, like a pang in my gut. I experienced it for the first time with my third baby. Started a few days after birth and I was totally perplexed about why I was feeling it, didn’t seem related to how I was feeling emotionally.
I mentioned it to my midwife and partner and wondered if it could be a sign of PND (postnatal depression). After a little while, I realised it was related to my letdown so that helped a bit.
I described it in a Homebirth forum I was part of and someone mentioned D-MER. I Googled it and there was pretty much only one website! This was in 2009.
It was such a revelation to have a diagnosis. It really helped to understand what was happening.
With that baby, it lasted about 6-ish months. (D-MER) happened again when my next babe was born. I was tandem feeding so it’s interesting that it came up again. I can’t remember how long it lasted but it was a few months at least.
I didn’t feel it impacted my breastfeeding relationship so much. I do feel it increased my general anxiety though. Like having that feeling elicited so often wore a deep pathway – hard to describe.”
Another Mama who breastfed for 6+months says –
“I wanted to stop breastfeeding at 6 weeks because I actually hated it. My D-MER symptoms ranged from hunger, nausea, depression, sadness, doom and hopelessness.
The worst part is the random let downs in between feeds when I go from feeling great to (feeling like) I temporarily hate my kids.”
Many women don’t breastfeed because they feel ‘I don’t like it’ or ‘it feels wrong’, when they actually have this condition that no one knows about.
How To Cope With D-MER
The good news is, although we can’t just get rid of D-MER, we can manage its severity, and often, education plays a large role in coping with D-MER.
Mamas who understand the physiology of D-MER, or at least know that it even exists, are more likely to draw upon mindfulness strategies during the dysphoria, and successfully continue on their breastfeeding journey. They know it will pass, as awful as it is, and can utilise their own strategies to manage the anxiety that surrounds the overwhelming physical and emotional response.
For me, that was deep breaths and toe wiggling… mixed with the occasional emotional release with a few tears.
Based on mothers’ reports, D-MER often only lasts several weeks to 6 months. Knowing it will pass is often a reassurance and encouragement to keep at it.
Avoiding known triggers is another helpful strategy in coping with D-MER. Remembering every woman experiences it differently, what triggers it for some may not for you. This may take a few days of being really in tune with your diet, physical and emotional needs to understand your triggers. Caffeine, fatigue, and stress are a few of the main culprits.
When it comes to caffeine, I know first hand that even just ONE cup of tea or glass of cola would significantly increase the unpleasantness I experienced.
Unfortunately, there is no known pill or strategy to cure D-MER, though some women swear by magnesium supplementation.
Like anything, support from other D-MER mothers can make all the difference. Search web pages and social media groups and you are bound to come across women who can offer solidarity.
Finally, tell yourself you’ve got this, you can do this. When every inch of your body is screaming at you, and it feels like your mind is being tormented, remember, it’s a chemical imbalance causing unpleasant feelings. You are not broken, and it will pass.