Dysphoric Milk Ejection Reflex

D-MER, or dysphoric milk ejection reflex, is a physiological, hormonal response to breastfeeding that causes a mother to feel anything from just a "pang" or a "sigh" to suicidal.  There are three levels of D-MER starting at mild, progressing to moderate, and then severe.  The symptoms vary from mother to mother, but any woman who feels she may need help should call a lactation consultant and/or seek help. 

"Defining D-MER:
What It Is

Dysphoric Milk Ejection Reflex is a newly recognized condition affecting lactating women that is characterized by an abrupt dysphoria, or negative emotions that occur just before milk release and continuing not more then a few minutes.

Preliminary testing tells us that D-MER is treatable and preliminary research tells us that inappropriate dopamine activity at the time of the milk ejection reflex is the cause of D-MER.

Clarifying D-MER:
What It Is Not

D-MER is not a psychological response to breastfeeding.

D-MER is not nausea with letdown or any other isolated physical manifestation.

D-MER is not postpartum depression or a postpartum mood disorder.

Lastly, D-MER is not the "breastfeeding aversion" that can happen to some mothers when nursing while pregnant.

How D-MER Presents:
What Mothers Feel

The negative emotions, or dysphoria, that a mother with D-MER experiences often manifest "in the mother's stomach" - a hollow feeling, a feeling like there is something in the pit of the stomach, or an emotional churning in the stomach. Mothers report varying types of emotions with D-MER ranging from dread to anxiety to anger, these emotions fall on the D-MER spectrum which has three different levels. The common thread between these levels, is the wave of negative emotions or dysphoria, prior to letdown, when nursing, expressing and with spontaneous letdowns, that then lifts within another 30-90 seconds, and then usually repeats with each letdown.

A key piece of D-MER is that a mother with D-MER feels absolutely fine except just before her milk starts to flow. D-MER is a brief feeling, not more than 30 seconds to 2 minutes, only and always beginning before let-down. This is not postpartum depression and most of these mothers feel perfectly fine except for that pre-milk moment. A brief interval after the negative feelings appear, the milk begins to flow.

D-MER can easily go unrecognized since 1) some mothers have so many closely spaced letdowns per feeding that the feelings do not have a chance to dissipate before the next D-MER is upon her, making her feel that she experiences on long D-MER through most of, if not all of, the feeding 2) many mothers do not physically feel a letdown in their breasts and so does not connect the feeling as to being just prior to letdown and 3) given the fact that D-MER happens with spontaneous letdowns as well, a mother may not immediately connect the way she is feeling to being a breastfeeding phenomenon."  - From D-MER.org

 

For more information, including a list of symptoms and helpful resources, click here.