D-MER, or Dysphoric Milk Eject Reflex

     If you are like me, you have NEVER heard of D-MER. D-MER is a condition that can affect breastfeeding mothers causing them to have what has been defined as uncomfortable and unpleasant mood swings such as sadness, depression, anxiety, irritability, or restlessness. This is controlled by… you guessed it… Hormones… and is uncontrollable by the mother.  What happens when a woman has a letdown of breastmilk is a release of both oxytocin and dopamine. You need both to make breastmilk, but in women who experience D-MER, the dopamine falls to an inappropriate level causing sometimes extreme negative reactions. Milk release itself is not caused by dopamine dropping, it’s caused by oxytocin rising. Dopamine inhibits prolactin, stopping the production of milk. Dopamine levels need to drop for prolactin levels to rise in order to make more milk. Normally, dopamine drops properly and breastfeeding mothers never know it even happened. In D-MER mothers, it doesn’t drop properly and causes an instant wave of negative emotions.

     How do women find this information if they don’t know what it is?? Google. They google it. This irritates me! It makes me angry that women do not have the human resources and knowledge they need and have to use a computer because their health care provider does not even mention the possibility of this condition. Or because the community around us doesn’t offer the Real support new mothers need! If you have been a mother for any length of time, you know it is hard and scary, and you feel like you have NO Clue what you’re doing. Why is it that we leave new mothers in the dark? Why do we not share what we have learned and pass it on or even just say “I don’t know what/why, but I’ve been there!” Why are we too afraid to be vulnerable about our experiences leaving generation after generation in the dark, letting them fall farther into loneliness and lack of education.

In all fairness, there has not been a lot of awareness about this subject until recently; it has started to expand through increased online content. There is now preliminary anecdotal evidence that D-MER is treatable.
I have personally not experienced this, so there is no personal connection story, however, if there are so many women out there suffering from D-MER and would not otherwise hear about it, it deserves to be brought to light as part of my mission to help bring healing and health to all mothers everywhere.
So how did I hear about it if I didnt have it? I had it brought to my attention by listening to the story of my friend’s journey through parenthood. One of my favorite things to do is talk to new mothers about their experiences. I have been a mother for almost three years come January 2019. I always find that I can learn new things almost every time or gain a new perspective. It was during one of these conversations that I first heard about D-MER and after learning more about it and how little it is talked about, I decided to share it with you.

Let’s take a minute and talk about what D-MER ISN’T.

It is not classified as a mood disorder or Postpartum Depression. (See my recent post  Recognizing Postpartum Warnings for more information about that.)

It is not nausea with letdown, or any other isolated physical symptom because it is emotionally based.

It is not a psychological response to breastfeeding but a response to milk release.

It is not a general dislike, or impatience with the baby while breastfeeding.

It is not  “breastfeeding aversion” that can happen to some mothers when nursing while pregnant or nursing older toddlers.

     There are slight variations but it all has one common characteristic, negative or even devastating emotion just prior to a letdown. THIS is the key element of D-MER. The mother will feel a surge of negative emotions about 30-90 seconds before the release of milk and by the time the baby is actually swallowing, the feelings have dissolved but will return just before another letdown.
There is a three-level spectrum:
1. despondency
2. anxiety
3. agitation
If you find yourself describing your experience as hollow feeling in the stomach, anxiety, sadness, dread, introspective, nervous, emotionally upset, angst, irritable, hopeless and a general negative emotion, you may be experiencing D-MER and should bring this up to your healthcare provider.

D-MER is defined on something like a color spectrum due to the variable experiences a mother may have; example, red does not look like blue, but they are both colors. Like this, D-MER can present with different “colors” of emotion for different mothers; despondency, anxiety or anger. Each of the three spectrums has three intensities of D-MER that include mild, moderate and severe. These are determined by the mother’s description of intensity, length of time the D-MER takes to correct itself, how many letdowns per feeding she feels the dysphoria and other specifications. Mild cases often can correct themselves in the first 3 months. Moderate can take up to 9 months while severe cases can take up to the first year or longer.

This may feel like a bit of a hopeless situation even for the mild cases, yet, there is hope for helping even the more severe cases. Often once a woman knows that it is not just her but an actual medical condition and not just an emotional problem, she can manage her symptoms more easily. Even educating the moderate cases can often be the helping edge they need to continue breastfeeding. And if this is not enough, mothers with D-MER are encouraged to keep a log so they can become more aware of things that intensify the reactions, things like stress, dehydration, caffeine; and things that might help them feel better, such as plenty of sleep and exercise. Certain lifestyle changes and natural remedies can also help control the symptoms of D-MER in the mild to moderate cases.
Mothers experiencing more severe cases may need a prescription to help them control their symptoms better if they are feeling like they may quit breastfeeding. So far, it seems that simply taking a prescription that increases her levels of dopamine are effective in reducing D-MER symptoms to a more manageable way of living.

And THIS, ladies (and any gentlemen) is why I want to share this with you; because education is often what helps mothers manage their D-MER. It is a simple solution, share your stories, share your experience and help others who are going through the same thing so they don’t have to suffer alone! Share your story with me so we can change the culture in which we live; no one should have to go through parenting alone. Let’s be a community that helps one another because as they say…

IT TAKES A VILLAGE TO RAISE A CHILD. 

six boys standing near trees and houses photo taken
Photo by Fancycrave.com on Pexels.com

6 thoughts on “D-MER, or Dysphoric Milk Eject Reflex”

  1. This is so interesting, it’s definitely something I went through, although I thought there was something wrong with *me* so it never occurred to me to talk to the Dr about it. Thank you for sharing this information, I pinned it and I hope all [relevant] women have a chance to see and understand this issue!

  2. Your story is not uncommon. Many times patients, men and women, have to go outside of their doctors to find answers to the things that are ailing them. It’s a good thing we live in the information age– just think of what our parents and grandparents had to go through!

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