Most mommies assume breastfeeding will make them feel warm and fuzzy inside as they bond with their baby. However, it is not always sunshine and rainbows for a small number of mommies. This can happen and it’s not making you a bad mom! It is a condition known as D-MER, which stands for dysphoric milk ejection reflex.

What is D-MER?

Dysphoric milk ejection reflex or D-MER for short, is a condition that can affect some breastfeeding women. It causes dysphoria, or a state of feeling sad, right before your breasts release milk. D-MER is very different from postpartum depression or anxiety disorder as it is only associated with negative emotions only when MER happens. And it only lasts not more than few minutes. While it is not harmful, it can cause you enough pain that you want to avoid nursing or give it up entirely. 

What causes D-MER?

There is no clear cut answer when it comes to D-MER, but it’s thought to involve the two known hormones, oxytocin and prolactin, that are emitted in response to breastfeeding. Prolactin is what causes your body to produce milk, whereas oxytocin causes it to release.

Oxytocin starts to be released almost right after your baby begins suckling (or you begin pumping) at the breast, and is released in small pulses for the first 10 minutes, while prolactin is released more gradually for about 20 minutes after you start nursing.

The emission of oxytocin causes dopamine to hinder, a brain hormone and neurotransmitter that helps boost and stabilize mood. Usually, dopamine drops properly and breastfeeding mommies never notice anything, but in mommies with D-MER, it drops faster than normal, which in return, causes a brief wave of negative emotions for a short while, as your dopamine levels bounce back after your prolactin goes up.

What are the D-MER symptoms?

Mommies with D-MER describe the symptoms as coming all of a sudden, like a wave, a few seconds after they begin a feeding or pumping session. They experience a whole roller coaster of negative feelings and they usually disappear — as quickly as they showed up — within 10 minutes of starting a feeding. However, the symptoms differ from mommy to mommy. Some mommies have only mild symptoms but some may experience severe symptoms, include self-harm or suicidal thoughts.

Feelings related with D-MER

There are many different words are used to describe the feelings when D-MER occurs. The most common ones are:

  • Sadness
  • Nervousness
  • Anxiety
  • Dread
  • Angst
  • Upset
  • Hopelessness
  • Irritability
  • Emotional churning in the stomach

How long does D-MER last?

D-MER symptoms may lessen by 3 months postpartum but they may also continue throughout the breastfeeding period. Nevertheless, most mommies do find that D-MER seems to be more manageable as their baby gets older.

How to manage D-MER?

Since D-MER is a relatively new condition, there are not many research had been done, therefore it’s hard to know what is the best treatment. On a happy note, D-MER doesn’t last forever. It will go away once you stop nursing or sometimes it will disappear even quicker, in the matter of days or weeks time.

Below are some ways that can help you cope with D-MER, so you don’t give up on your breastfeeding or pumping journey completely!

  • Surround yourself with a strong support system. Having D-MER, it’s the thought of breastfeeding itself will trigger your body’s fight-or-flight response. To help switching it off, you need to put yourself in a surrounding that makes you feel safe and peaceful. This includes surrounding yourself with friends and family members that you can trust. Or you can reach out to a support group of mommies with D-MER so you don’t feel alone!
  • Have skin-to-skin contact with baby while nursing. Research has shown that this can lower heart rates and cortisol levels in both mommy and their baby. If you practice this while breastfeeding, you can negate the negative emotions you get during D-MER, and possibly help repair it with positive emotions.
  • Try to make breastfeeding as enjoyable as you can. Get yourself a designated space to nurse — have a comfortable chair, put on a spa-like music, have your favourite snacks or drinks there. While breastfeeding, enjoy a good show on TV or read a good book to make you feel zen.

However, if D-MER is making breastfeeding too hard or leading you to consider to give up nursing earlier than you plan, please talk to your doctor or partner about things you can potentially try first. It is possible there are things in your life you could remove or add that may help lessen the severity of your symptoms.

Having D-Mer, does not mean you hate breastfeeding; you just hate how it makes you feel. You are not alone. You are not sick. And you are not a bad mom.

If you want help, please reach out. And if you need to be done nursing, that’s alright too. Whatever choices you need to make, we support you and know that you are a very good mommy! ❤