Dysphoric Milk Ejection Reflex Might Be the Cause
If you are experiencing extreme, sudden sadness when you breastfeed your baby, you might be worried that something is terribly wrong. It can be confusing and upsetting to experience such a strong feeling of sadness related to something that you have heard others speak about with fondness. However, you are definitely not alone! This issue is experienced by as many as nine percent of breastfeeding women, according to this study.
（Dysphoric Milk Ejection Reflex: A Descriptive Study | Breastfeeding Medicine (liebertpub.com).
Dysphoric Milk Ejection Reflex, or D-MER, might be to blame for your sadness when breastfeeding. In this article, you’ll find the answers to some common questions about D-MER, as well as some of the ways in which it is treated.
What is D-MER?
Dysphoric Milk Ejection Reflex is described as a sudden rush of negative feelings that comes immediately before your milk lets down when breastfeeding or pumping. These feelings will last for a few minutes following the milk ejection reflex.
D-MER is not a psychological problem, but a physical response to the milk letting down. This makes it different than other postpartum mood disorders such as postpartum depression or postpartum anxiety.
Other postpartum mood disorders cause persistent negative feelings that last for weeks to months after giving birth. The feelings related to D-MER only last for a few minutes and are related to the hormonal shifts that cause your milk to release. However, they can feel intense and lead to further anxiety as you might wonder what is wrong.
What causes D-MER?
While research is still being done about the condition, most signs point to dopamine being a key component. A small drop in dopamine is a normal, healthy part of the hormonal reflex that triggers your milk to release.
For some women, this dip in dopamine happens at an abnormal rate, causing a sudden, negative drop in emotional experience. Because it is a reflex, it is not something that you can control or stop from happening through willpower or planning.
What are the symptoms?
Many mothers have reported experiencing some or all of these feelings in the 30-90 seconds leading up to a let-down, and they may persist for several minutes afterward:
- Hopelessness
- Panic
- Dread
- Wistfulness
- Sadness
- Anger
Because these symptoms have similarities to other postpartum mood disorders, it can be tricky for some breastfeeding parents to know what is causing the feelings. If you are only experiencing these emotions directly before and during feeding sessions, you may be experiencing D-MER.
Some parents are able to better manage the symptoms after understanding where they come from and recognizing that they are based on a physical response, not a phycological one. For other parents, the feelings may be so overwhelming or intense that they decide to seek treatment or wean their baby before they had planned to.
The symptons of D-MER
- Hopelessness
- Panic
- Dread
- Wistfulness
- Sadness
- Anger
Did I do something wrong?
If you are experiencing D-MER, it is not your fault! There is no evidence that certain activities increase your chance of developing it. There is not anything you could have done differently in order to prevent it from occurring. Some mothers have even experienced it with one or more of their babies, and not with others!
While you cannot know if you will experience symptoms of D-MER before you begin breastfeeding, you can keep track of your symptoms in order to determine if there are any activities that make the symptoms better or worse.
How long will it last?
Most breastfeeding parents experience a gradual reduction in the intensity of the symptoms over time as their bodies adjust to the milk ejection reflect. Symptoms can vary in intensity from parent to parent. Often mild symptoms will resolve in about 3 months, while more severe symptoms may persist for upwards of a year.
Can D-MER be treated?
One of the most effective treatments for D-MER is education. When you understand that what you are experiencing is common and why it is occurring, it can be easier to handle the intense feelings at the moment.
When education alone is not enough to help you manage the symptoms, you might be encouraged to track your symptoms and see what things exacerbate them. Sometimes, lowering stressors in your daily life or increasing your rest and nourishment might help lessen the severity.
When symptoms of D-MER are very severe, your healthcare provider might offer prescription treatments or suggest weaning. If you have questions or concerns about symptoms, you should always contact your care provider and give them an honest account of what you are feeling so they can help you determine the best course of action.
Because D-MER is sometimes believed to be related to heightened states of stress, there are a few things that you could try while breastfeeding to help lower your body’s negative response to the milk let-down:
Ways to lower your body’s negative response to the milk let-down
- Skin-to-skin contact with your baby
- Calm music
- A massage from your partner or friend
- Warm foot soak
- Meditation, mindfulness, or breathing exercises
While none of these activities will stop the physical reflex, they might help you move through the negative feelings without too much impact on the rest of your day.
Ways to lower your body’s negative response to the milk let-down
- Skin-to-skin contact with your baby
- Calm music
- A massage from your partner or friend
- Warm foot soak
- Meditation, mindfulness, or breathing exercises
Who can I talk to about my symptoms?
Reach out to your doctor or midwife if you are experiencing strong negative emotions after giving birth. It is important to surround yourself with people who will listen to your worries and validate your experience! Being supported through the negative emotions that result from D-MER is a key component of keeping yourself healthy and well throughout your postpartum experience.
If you are experiencing D-MER, it is important to remember that it does not mean you are doing anything wrong! If you are experiencing heightened anxiety or feelings of isolation due to your experience, ask your care provider about therapy as an option for ongoing mental health care.
Remember, you are not alone! Your experience is valid, and you are doing a great job taking care of your little one.
