What is D-MER?
Breastfeeding Mental Health Parenting

What is D-MER? (Sadness Whilst Breastfeeding)

What is D-MER?

D-MER (Dysphoric Milk Ejection Reflex) is a condition affecting lactating women. It is characterized by an abrupt dysphoria, or negative emotions, that occur just before milk release and continuing not more than a few minutes. If you have D-MER, you will find yourself stricken by a sudden sadness, depression, anxiety or other negative emotion just before your milk lets down.

I wanted to write about D-MER as I know that there are many women out there who suffer from this, who do not know that it is a recognised condition with a name. I suffered from this for months, not knowing what was going on. Eventually I Googled it and discovered that I wasn’t alone!

Credit: alfcermed

What causes it?

D-MER isn’t a psychological condition, it is a physiological one, caused by the mother’s hormone activity going a bit wrong. Women with D-MER experience a quicker than normal drop in dopamine levels just before a let down, which is what causes the emotional response.

According to d-mer.org; ‘Milk release itself isn’t caused by dopamine dropping; it’s caused by oxytocin rising. In D-MER, the MER (milk ejection reflex) is a result of rising oxytocin (needed to move the milk out of the breast) but the D (dysphoria) is a result of inappropriately falling dopamine. Dopamine gets involved because it inhibits prolactin (which is what makes the milk) so dopamine levels need to drop for prolactin levels to rise in order to make more milk. Normally, dopamine drops properly and breastfeeding mothers never knew it even happened, in D-MER mothers however, it doesn’t drop properly and causes an instant and brief wave of  a negative emotional reaction that lasts until the dopamine levels restabilize after prolactin has begun it’s rise.’

D-MER is not postnatal depression, nor does it mean you dislike breastfeeding or have any negative feelings towards your baby. It is also not the commonly experienced ‘breastfeeding aversion’.

Credit: Petra-foto

My Experience

As I stated earlier, it took many months before I finally figured out that what I was experiencing had a name. I didn’t get symptoms of D-MER during every feed, only some of them, so it may have taken me longer than usual to make the connection. My own experience with D-MER was quite a mild one compared to some of the stories I’ve heard.

Sometimes, I experienced the normal rush of love/oxyticin during letdown. But sometimes, I didn’t feel that love. Instead, I was engulfed by an extreme sense of anxiety and panic. This was comparable to a panic attack. I’d feel scared, terrified of the responsibility I had as a mother. Scared that my daughter was entirely reliant on me, scared that I was failing her – scared of everything. Everything suddenly felt so terrifying that I often had the intense urge to stop breastfeeding and run away, leaving my life behind.

But then, as quickly as it started, it stopped again, leaving me overwhelmed, and confused as to what the feelings meant. Were they my real feelings, deep down? Why did they suddenly come out of the blue like that? I kept them to myself for a long time, scared of what they meant. Scared that they meant that I didn’t want to be a mother.

Does It Get Better?

I can personally attest to the fact that having D-MER feelings doesn’t mean that you don’t love breastfeeding. Breastfeeding was one of my favourite things about motherhood. I breastfed my daughter until she was 2 and a half, and I wouldn’t trade the bond it gave us for the world. Thankfully, as she got older, the D-MER did get less frequent, eventually stopping altogether. So there is hope that the feelings will lessen or disappear entirely the further into your breastfeeding journey you go.

If you want to know more about D-MER, you can visit d-mer.org or llli.org/what-is-d-mer

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