You’re finally settled in your comfy chair, your sweet baby nestled in your arms, ready for a feed. It’s supposed to be this peaceful, bonding moment, right? But then, just as you feel your milk starting to flow – that familiar tingle – a wave washes over you. Not a wave of warmth, but… something else. A sudden, sharp dip in your mood, maybe a pang of sadness, or even a weird sense of dread in the pit of your stomach. And then, just as quickly as it came, poof, it’s gone. If this sounds achingly familiar, please know you’re not imagining things, and you’re certainly not alone. This could be something we call Dysphoric Milk Ejection Reflex (D-MER). It’s a bit of a mouthful, I know.
Understanding Dysphoric Milk Ejection Reflex (D-MER)
So, what on earth is D-MER? Well, the name itself gives us clues. “Dysphoric” means a state of unease or general dissatisfaction. “Milk Ejection Reflex” is just the technical term for your milk “letting down.” Put them together, and it describes this fleeting but intense rush of negative feelings right before your milk releases. It usually lasts just a minute or two, sometimes even less. But oh, those moments can feel heavy.
I want to be really clear here: D-MER is a reflex. It’s something your body does automatically. It’s not about your feelings towards your baby or breastfeeding. It’s not a psychological issue; it’s thought to be driven by our amazing, and sometimes perplexing, hormones. It can happen when you’re breastfeeding, pumping, or even if your milk lets down unexpectedly – which, as many new moms know, can happen!
Some studies suggest that maybe 5% to 9% of breastfeeding moms experience this. It’s a separate thing from postpartum depression (PPD) or postpartum anxiety, though it’s certainly possible to have D-MER alongside those, which can make things feel extra tough.
What are the tell-tale signs of D-MER?
The feelings with D-MER hit fast and leave fast, usually sticking around for 30 seconds to maybe two minutes, always just before your milk starts to flow. Once the milk is flowing, the cloud lifts. Moms I’ve spoken with describe a range of emotions, things like:
- A sudden, deep sadness or a feeling of hopelessness.
- Feelings of self-hate or a real knock to your self-esteem.
- A sinking feeling in your stomach, like a wave of dread.
- Bursts of anger, agitation, or irritability.
- A spike of anxiety.
It’s important to know this isn’t about nipple pain or discomfort from engorgement. Those are different battles! But the feelings from D-MER can be so strong, so yucky, that some moms feel they just can’t continue breastfeeding or pumping. And that’s okay to feel.
A serious note: if these feelings are incredibly intense, or if you ever have thoughts of harming yourself or your baby, please, please reach out for medical help right away. That’s a different level of concern, and we need to address it immediately.
So, why does D-MER happen? What’s the cause?
We’re still learning a lot about D-MER, to be honest. But the leading idea is that it’s all about hormones, specifically a hormone called dopamine. Think of dopamine as one of your brain’s “feel-good” messengers; it’s involved in mood and pleasure.
Here’s the simplified version: When you breastfeed, your body releases prolactin (essential for making milk) and oxytocin. Oxytocin is the hormone that actually triggers your milk to let down. Now, oxytocin needs dopamine levels to drop a bit for it to do its job properly. In most women, this dopamine dip is smooth and unnoticed. But for some, for reasons we don’t fully get yet, that dopamine level might plummet too sharply, too suddenly. And that rapid drop is what’s thought to cause that brief, intense wave of negative emotion – that’s D-MER.
Once your hormones rebalance, usually within a couple of minutes, your mood should stabilize. It’s a physical response, not a reflection of your love for your baby or your desire to breastfeed. Weird, right? That something so natural can trigger this.
How Do We Know It’s D-MER?
There isn’t a specific blood test or scan for D-MER. It’s one of those things we usually identify by listening carefully to your experience. When I talk to a mom who thinks she might have D-MER, I’ll ask about:
- What exactly do you feel?
- When do these feelings start? Is it just before let-down?
- How long do they last?
- How intense are they?
Your story, your description of these very specific, timed emotions, is the most important clue.
What Can Help With D-MER?
Because we’re still in the learning phase about D-MER, there isn’t a specific “cure” or medication that’s a standard treatment. But that absolutely doesn’t mean you’re left to just suffer through it. Managing D-MER is often about finding coping strategies that work for you to help soften those brief, intense moments. Think of it as building a little toolkit.
Here are some things that other moms have found helpful:
- Extra skin-to-skin contact: If you’re breastfeeding, snuggling your baby close can sometimes lower stress hormones and have a calming effect. It’s like a warm, reassuring hug for your nervous system.
- Mindful breathing or meditation: Even a few deep, slow breaths can make a difference. In through your nose, out through your mouth. Focusing on your breath can help anchor you when those feelings hit.
- Relaxation techniques: Maybe a warm bath or shower before feeding, listening to calming music, or even a quick massage from your partner if that’s an option. Anything that helps you feel a bit more relaxed overall.
- Gentle distraction: Some moms find that having something else to focus on during that initial let-down period helps – maybe watching a favorite show, scrolling through something lighthearted on your phone, or eating a snack.
- Finding your village: This is so important. Talk to your partner, a trusted friend, or look for online support groups for moms with D-MER. Just knowing you’re not the only one, and having people who understand (or at least try to!), can be incredibly validating.
How long will this D-MER last?
This is a “it varies” kind of answer, I’m afraid. For many moms, D-MER tends to lessen in intensity over time and often resolves within about three months postpartum. As your baby gets older, it might just… fade away. However, some women do experience it for as long as they breastfeed or pump. Everyone’s journey is a bit different.
Is D-MER a Sign of Postpartum Depression?
This is a common worry, and it’s a good question. No, D-MER is not a sign that you have postpartum depression (PPD) or another postpartum mood disorder. While some of the feelings might sound similar (like sadness), D-MER is very specific: it hits suddenly just before your milk lets down and then disappears quickly. PPD, on the other hand, involves more persistent low mood, loss of interest, and other symptoms that affect you more broadly and for longer periods.
However, it is possible to experience both D-MER and a postpartum mood disorder at the same time. If those negative feelings start to hang around longer, pop up at times unrelated to feeding, or become more intense, it’s really important to chat with your doctor or midwife.
Can I Stop D-MER From Happening?
Unfortunately, because it seems to be a physiological reflex, there’s no known way to prevent D-MER from occurring in the first place if you’re susceptible to it. You didn’t do anything to cause this. But knowing what it is, and knowing that support is available, can make a huge difference in how you cope with it.
Taking Care of Yourself with D-MER
Living with D-MER can be tough. It’s a real condition, even if not everyone understands it. The good news? It’s usually temporary, and those coping strategies we talked about can really help. Sometimes, just having a name for what you’re experiencing and knowing other moms go through it too can bring a sense of relief.
D-MER might make you want to stop breastfeeding or pumping. And you know what? If this condition is taking a serious toll on your mental health and well-being, it might be the best decision for both you and your baby to explore other feeding options, like formula. That is absolutely okay. There should be no shame in that choice. A healthy, happy mom and a thriving baby – that’s always the goal.
When should I see my healthcare provider?
Please, never hesitate to ask for help. If these feelings are intense, if you’re struggling to cope, or if you’re just feeling overwhelmed by it all, talking to your doctor, midwife, or a lactation consultant can be a lifeline. It helps to be open and honest. Sometimes just writing down how you feel and when it happens can make it easier to share with us. You are not alone in this.
And I’ll say it again because it’s so important: if you ever have thoughts of hurting yourself or anyone else, please seek medical attention immediately. We are here to help.
Key Things to Remember About D-MER
Alright, let’s quickly recap the main points about Dysphoric Milk Ejection Reflex (D-MER):
- D-MER causes sudden, brief, negative emotions (like sadness, anxiety, or dread) just before your milk lets down.
- It’s a physiological reflex, likely due to a rapid drop in dopamine, not a psychological issue or your feelings about breastfeeding.
- Symptoms last only a minute or two and disappear once milk flows.
- It’s different from postpartum depression (PPD), but you can experience both.
- There’s no “cure,” but coping strategies like relaxation, distraction, and support can help manage it.
- It often improves or resolves within a few months, but can last longer for some.
- You’re not alone, and it’s okay to seek help or consider other feeding options if needed.
You’re Doing Great, Mama
Navigating new parenthood is a journey with lots of ups and downs, and sometimes unexpected bumps like D-MER. Remember, you’re doing an amazing job, even when it feels incredibly tough. Please reach out if you need support. You’re not alone in this.