Pregnancy Information

D-Mer

I hated breastfeeding.

It didn’t hurt, I didn’t find it hard, I just hated it. As soon as my daughter latched on I would get a horrendous sinking feeling. I would be overcome with sadness. I would call my husband to get a drink to try and get the sick feeling in my stomach to pass.

As the feed went on, the dark cloud would pass. I would stop feeling quite so low.

I would often cry when I knew my daughter needed to be fed because I knew it would make me feel so sad. I had no idea what was happening and couldn’t explain it to anyone. Because breastfeeding physically came so easily I didn’t feel I could give up. I suffered for 5 months before weaning her.

3 years later the same thing happened with my son. I tried to explain it to my friend but it was so hard to explain how desperate it made me feel. After 3 months I couldnt take it anymore. I couldnt take the feeling at latch on and I couldn’t handle the dread when I knew a feed was coming up. I got the same feeling when expressing. I switched my son to bottles and instantly felt better.

About 2 years later my friend told me she had read something about a condition called D-Mer. I read up on it and BINGO! Suddenly everything made sense! I wasn’t going mad!

Dysphoric Milk Ejection Reflex (D-Mer) is a condition affecting lactating women that is characterized by an abrupt dysphoria, or negative emotions, that occur just before milk release and continuing not more than a few minutes. Dysphoria is defined as an unpleasant or uncomfortable mood, such as sadness, depressed mood, anxiety, irritability, or restlessness.

Janet Fyle, professional policy adviser with the Royal College of Midwives, says  “There needs to be more awareness that D-MER exists,” she says. “Some women may not admit to these feelings as they don’t want to be perceived as bad mothers for complaining.”

After birth, milk production starts when the hormone oxytocin contracts the new mother’s milk ducts. “Another hormone called prolactin is also needed to make the milk flow,” says Sharon George. “But dopamine blocks the production of prolactin so the body secretes lower levels of this hormone.”
Dr Nerina Ramlakhan, a neurophysiologist at Capio Nightingale Hospital in London, explains: “Dopamine is a hormone that releases endorphins and pushes ‘feel good’ chemicals around the brain. A sudden dip causes feelings of sadness.”

Classifyng 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.
  • D-MER is not a general dislike of breastfeeding.
  • D-MER is not the “breastfeeding aversion” that can happen to some mothers when nursing while pregnant or when nursing older toddlers.

What it is

  • The dysphoria a mother feels comes on suddenly before letdown and leaves within 30 seconds to 2 minutes.
  • She feels the dysphoria before she feels the letdown sensation in her breasts (though not all mothers feel a physical letdown sensation).
  • Often by the end of the first letdown she feels fine again, the dysphoria is gone.
  • It can happen for the first letdown of a feeding or for all letdowns in a feeding, depending on the intensity of her D-MER.
  • She may or may not have dysphoria with letdowns when pumping and before spontaneous letdowns, this also is dependent of the intensity of her D-MER.
  • D-MER is like a reflex. It is controlled by hormones and can not be controlled by the mother. She can not talk herself out of the dysphoria.

Not much can be done to ease symptoms of D-MER, apart from professional support. Although knowing what is going on can help a woman deal with her D-Mer. Janet Fyle says: “The most important thing is for us to believe a woman who says she experiences these feelings, to reassure her she doesn’t have a psychological illness, that the unpleasant feelings will pass and there is no need to feel guilty about them.”

For more information visit d-mer.org

About the author

Elizabeth