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

Recognizing​ Postpartum Warnings

This has not been an easy post to write. I have wrestled with how to present this for almost two weeks now. This is such a sensitive topic that so few ever share about, being so raw and honest is hard especially about something so personal and tender. I was not so eager to share my story and struggled to find a way to share about a topic that I find to be SO important for new mothers, and even second or third timers. Most of the focus is on pregnancy and birth (and understandably so, it’s a major transitional event that happens to your body), that we almost never hear people talk about what the transition can actually be like once the excitement and the rush of a new baby is over. All the guests and visitors stop coming and reality sets in; negative feelings, depression, irritability, guilt, hopelessness…You feel like a bad parent like something’s wrong with you. You wonder what is happening, but everyone always tells you “It’s the best thing you’ll ever do!” So, of course, you better not screw it up! Every other new mother has always had smiles and perfect faces, never looking tired or miserable.  It may leave you wondering “What is wrong with me?!” “What am I doing differently?!” (because we all know the mom has complete control over a brand new baby, herself, sleeping perfectly, and everything that could possibly influence her emotions and baby! *Insert eye roll emoji here…)
So here it is! The best I could do to share information about the postpartum traumatic experience without bleeding my guts out… (inhale)

Recognizing the signs of postpartum complications is an important part of preparing for your new baby. We all think that we have to take birthing classes to be prepared and have everything in just the right spot, but the untold truth is that there is So much more to bringing home your new baby than just prepping for birth. Yes, this is a big part of it, and yes, birthing classes can help a great deal, but let’s not forget the importance of recognizing postpartum symptoms.

There are three different categories in the area of Postpartum Depression.
1. Baby Blues
Baby Blues is the most common and recognizable symptom of Post Pardom Depression. People may take this to mean depression is the biggest sign, and yes, that is one of them but, there are many other symptoms.

I think it may be important to state here that the Baby Blues is not a character flaw or a weakness. It can simply be a complication of giving birth. It does not mean you are incapable or failing. It simply means you had a baby and are experiencing side effects and may need some help. 

Other Symptoms of Baby Blues are:
Mood Swings, Anxiety, Sadness, Irritability, Feeling overwhelmed, Crying, Reduced Concentration, Appetite Problems, and Trouble Sleeping.
If you are experiencing these things more than normal, it might be a good idea to mention this to your healthcare provider.

In talking to a postpartum doula, a trained professional who assists new parents with the transition of becoming new parents, she said this about Baby Blues:
“Lots of new mothers experience what is known as the “baby blues” in the first couple of weeks postpartum (key phrase-lots of new mothers experience…).  This is perfectly normal and is caused by the extreme shift in hormones after giving birth, and milk production beginning. Baby blues should subside after a couple of weeks at most. Encapsulating your Placenta and taking it as a multivitamin can greatly assist in this. It may gross you out but if it helps you keep your sanity, it is worth the grossness and the money.” (Amen!)
I did not do this my first time and I actually Really regret this. There are a lot of other benefits to having this saved, it can help with cramps, menopause, and hormonal migraines. I even got my husband to take some. (I’ll talk more about this towards the end.) I lovingly refer to my stash as my “happy pill”, I take it and within 15 minutes I feel great and happy!

2. Post-Partum Depression
Some may think this is the same thing as the Baby Blues, but there are differences. The symptoms that are the same or similar usually are somewhat more severe.
Depression or severe Mood Swings, Excessive Crying, Difficulty Bonding with baby, Withdrawing from family and friends, Loss of appetite or eating much more than usual, Inability to sleep or sleeping too much, Overwhelming fatigue or loss of energy, Reduced interest and pleasure in activities once enjoyed, Intense irrealities and anger, Fear that you’re not a good mother, Feelings of worthlessness, Shame, Guilt, or inadequacy, Diminished ability to think clearly or concentrate or make decisions, Severe anxiety and panic attacks, Thoughts of harming self or baby, Recurrent thoughts of death or suicide.

adult art conceptual dark
Photo by Pixabay on Pexels.com

Here is a more extensive list of the Signs of Postpartum Depression:
1. Negative feelings
depression,
irritability
guilt
misery
self-consciousness
hopelessness
long-lasting
worsens over time with new moms
unable to focus on joys and positivity associated with motherhood

2. Anxiousness
linger aspect of PPD
worry about things you have no control over
more noticeable in women who were not that way before
hostility towards your baby
Shunning new baby
feeling trapped by responsibilities

3. Extreme guilt for hostility or sadness
Often leaves new mothers feeling unworthiness of being a mom and unable to care for this new life or the other responsibilities they had beforehand

4. Exhaustion
no surprise moms feel exhausted and irritable. Most are motivated by the joy of being a new mom and bonding with their new babies.
lack motivation and can’t see the Joy in motherhood.

5. Panic attacks
rapid heartbeat
Sweating
nausea
or fainting

6. Appetite changes
constant worry, anxiety, guilt is enough to leave most moms feeling nauseated fatigued, migraine headaches, suffer from loss of appetites or stress eating and severer stomach pains and digestive problems.

7. Lack of Sex drive
due to weight gain, bloating, body image issues. Let’s face it; the extreme fatigue and physical attention required to carry, breastfeed, rock, soothe, and diaper your new baby won’t put you in the mood.  However, if this lasts past a few months of getting used to new motherhood, you may be suffering from PPD.

8. Worsening depression
each case is characterized by feelings and actions that are out of character for that particular woman.
loss of motivation
hostility
Guilt
the extreme hopelessness that remains constant and gets worse over time.

Increase in Omega-3 levels may help lower risk of PPD

Please note that experiencing any of these does not define you or your parenting skills. No one should think you are less than you are by admitting you have had thoughts of harming yourself, baby, or thoughts of suicide. If they do, they are not the right person to talk to and I encourage you to keep searching for the right one until you find someone who will help you. And if someone has thought ill of you, I apologize.

3. Postpartum Psychosis
I had personally never heard or knew some of these were possible. If you or someone you know is suffering from Postpartum Psychosis, please get help as soon as possible.
Confusion and disorientation, Obsessive thoughts about your baby, Hallucinations and Delusions, Sleep disturbances, Paranoia, Attempts to harm self or baby.

When to see a Dr.
It’s important to call your doctor as soon as possible if the signs and symptoms of depression have any of these features:
Don’t fade after two weeks
Are getting worse
Make it hard for you to care for your baby
Make it hard to complete everyday tasks
Include thoughts of harming yourself or your baby

If feelings of depression occur after the birth of your baby, don’t’ feel reluctant or embarrassed to admit it. It does not mean you have failed or are a bad mother. It simply means you had a baby and have a lot of hormonal changes going on in your body right now. Many people suffer from this and never get help. These first few months of your baby’s life should be joyful and enjoyable, experiencing these symptoms make it hard to do so. Please don’t miss out on making beautiful memories.

There is one other type of Postpartum I would like to mention, Postpartum Trauma. I may have made up this category. But I still think it is something worth mentioning. Honestly, there may be a better name for it and it may be a real thing, I just can’t think of it right now! Experiencing Trauma during labor can have a large impact on your postpartum recovery (in my opinion). It can inhibit bonding with your baby and make the thought of ever having a baby again terrifying, or even the thought of having sex seem impossible. When you have a birth plan and it goes awry in any way, the effects can be long lasting even after all symptoms seem to be gone. Processing those emotions with a safe person can help provide healing.

One final thought I would like to leave you with is this; even less talked about is the fact that men can also suffer from postpartum complications the can experience a number of these same complications as the mothers do. They may be traumatized by seeing someone they love in pain, they can feel helpless and like they can’t Do anything, which is a big deal for a man. A man can also experience trauma by seeing a baby come out of a place he associates with pleasure and enjoyment. He may find it difficult to be intimate. It can be hard for a man to body with a baby as it is but they can even have a harder time bonding if they experience trauma in some other form of the process.

And on a happier note! Restoration and healing can be possible for anyone who may have experienced a traumatic birth, or postpartum complications. My first birth and postpartum experience with my daughter was not all sunshine and roses, and now that she is almost three years old, we have been able to slowly build a healthier, happier relationship by building different ways to bond with each other. The process has been slow and there is still healing to take place, but I am continuing to see our relationship grow and become a blessing every day! After the birth of my son, I now have a more positive outlook on birthing and post birth and even hope to become a birthing doula someday because I want to experience the magic of births and help give others positive experiences. If you have experienced any of these, just know there is hope for healing and you are not alone. I speak as one who has been down both roads, I know the pain and the joy of giving life. I have seen my experiences help others avoid pitfalls and provide a person who understands.

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