Dysphoric Milk Ejection Reflex (D-MER)

Dysphoric Milk Ejection Reflex, D-MER, is a condition that affects breastfeeding mothers. It is a lesser known but certainly impactful issue that can make the breastfeeding experience difficult and distressing.

What is D-MER?

D-MER is characterized by a sudden feeling of intense negative emotions like sadness, anxiety, or irritability that occur just before or during the let-down reflex while breastfeeding. These negative emotions can last a few seconds to a few minutes and can greatly interfere with the bonding experience between mother and baby. Some women may feel overwhelmed by these emotions and may even develop feelings of guilt or confusion about why they are feeling this way.

What causes D-MER?

The current theory is that an abrupt decrease in a hormone called dopamine causes D-MER. When you breastfeed, your body releases prolactin (a hormone necessary for milk production) and oxytocin. Oxytocin is the hormone that triggers the flow or ejection of milk from your breasts when your baby suckles (or you begin pumping). Oxytocin suppresses dopamine, which means your dopamine levels decrease. For reasons researchers don’t completely understand, some people’s dopamine levels drop very quickly and cause a sudden feeling of unhappiness and other negative emotions. This is D-MER.

Treatment for D-MER

There are currently no treatment options for D-MER, but many women find the below minor life-style changes helpful to cope with the symptoms.

• Increase skin-to-skin contact while breastfeeding. This can help to lower your cortisol levels and decrease your heart rate causing a calming effect.
• Distract yourself during the let down with things like eating or watching TV.
• Try practicing meditation or deep breathing. Take a deep breath in through your mouth and out through your nose.
• Find other ways to relax just before feedings like soaking in a warm bath or getting a massage.
• Prioritize sleep over less important activities. Lack of sleep makes symptoms of D-MER worse for some women.
• Find support. Whether it is a friend, your partner, a therapist, your doctor, or support group. It is important for women experiencing D-MER to know that they are not alone and that there is support available.

How long does D-MER last?

It can vary. For most, D-MER resolves within about 3 months becoming less severe as their child grows older. For some, D-MER lasts until the person is done breastfeeding.

D-MER is a very real and valid condition that can impact the breastfeeding journey for some women. By raising awareness and offering appropriate support, we can help mothers navigate the challenges of breastfeeding with D-MER and ultimately enhance the breastfeeding experience for both mother and baby. If you or someone you know is experiencing D-MER, remember that help is available and you are not alone.

It is an honor to support you on this journey. Please do not hesitate to call us with questions about the information we are providing. Our consultations are always free.

It is an honor to support you on this journey. Please do not hesitate to call us with questions about the information we are providing.