“Breast is best.”

We’ve all heard that or seen the memes plastered across social media. While none of us can argue that the nutrition that comes from colostrum and breast milk is second to none, it’s a lot more complicated than it sounds and any new mom can attest to this.

The reality is that you can purchase the best pump, nipple cream, and Boppy around to make breastfeeding more comfortable but that does not mean it will be easy! This reminds me of a line from my favorite movie, “The Notebook”: “I’m not telling you it’s going to be easy, I’m telling you it’s going to be worth it.”

I’ve been wanting to write an article on this topic for a while now. It’s not something I’ve personally experienced, but it’s something that two of my close friends have struggled with, and for that reason I wish to share some information about Dysphoric Milk Ejection Reflex, also known as D-MER.

I recall texting with my girlfriend after she had her son. We were doing what so many mom pals do, checking in with each other. “How’s your day today, you get out of those PJ’s yet?” (OK, lets be real, the texts went a little more like this: “I don’t know what I’m gonna do with him today, I can already tell he’s gonna give me a run for my money!”)

We talked a lot about breastfeeding and how to get the ever elusive breast milk supply up. I remember a particular conversation we had about whether or not I too had any sad or depressing thoughts during let down. I wracked my brain and told my friend that as much as I had trouble with postpartum depression, I don’t particularly remember struggling specifically when my milk would let down.

So like we all do, I pulled up Safari on my iPhone and began to Google “depressed feeling while breastfeeding only.” I was relieved and intrigued to find out that Google, like usual, was one step ahead of me.  I scoured mommy forums, and went back and forth with my friend. The main thing I wanted her to feel was supported. We all need that, and especially us new moms.

Even though I hadn’t experienced it myself did not mean I couldn’t sympathize. If I am recalling correctly, she had to educate her own doctor on the condition and her symptoms. While there is nothing wrong with this, it’s another gentle reminder that we are always our own best advocates and that doctors don’t know EVERYTHING.

Yesterday, another friend texted me and confided in me: “Britt, I get his yucky sad weird feeling when I’m pumping or breastfeeding. I know it’s weird, I honestly don’t know how much longer I’ll be doing it for.” While it made me sad for her that on top of the already grueling, time consuming, ALL consuming feat that is breastfeeding she was having to battle this too. I was happy to send her the information I had learned about D-MER, and it was no shock when she wrote back and said “That’s exactly what I have, but I want to keep breastfeeding because I know it’s best for him.”

While I completely understand her feeling this way, the pressure we put on ourselves is just too much. This is exactly what moms do. We guilt ourselves in to doing “the right thing” even when it’s taking a toll on us. I will be the first to admit that my journey exclusively pumping for 12 months was hard, the WHOLE time, and it took its toll at times. But a mom’s sanity is more important than breastmilk, homemade baby food, and all of the extras. Like we’ve all heard a thousand times before, you can’t pour from an empty cup.

Personally, I KNOW I wouldn’t have been able to pump for a year if I was experiencing sad feelings at every let down. Breastfeeding is extremely challenging, without this curve ball. In hopes of making other women aware of this and also to help normalize it, I want to share with you all that is Dysphoric Milk Ejection Reflex.

Symptoms may include:

  • A wave of negative or even devastating emotion just prior to let down. This emotional response is the consistent key component in D-MER.
  • The breastfeeding mother experiences this surge of negative emotions 30-90 seconds prior to milk release. Some women may feel the emotional response linger for quite a bit longer, and could possibly confuse the condition with PPD or the baby blues.
  • The feelings you may experience are different for every women but are most commonly described as overwhelming sadness, anxiety, a hollow feeling in the stomach, dread, emotional upset, angst, irritability, or hopelessness.
  • Most women feel completely fine except just before (or after) her milk starts to flow.
  • Some women will experience intense D-MER and others will have such a mild case they may never put two and two together.
  • Scientists believe that D-MER is triggered by a chemical change in dopamine levels in the brain during let down; differing from the dopamine levels breastfeeding mothers who do not experience D-MER experience.
  • Women who suffer from PPD or an ongoing anxiety disorder will suffer more intensely.
  • Many women will notice the effects of D-MER within the first few weeks of breastfeeding and some women’s D-MER will dissipate within three months.

D-MER Is Not:

  • Postpartum depression or any psychological mood disorder.
  • Breastfeeding aversion that can happen to nursing mothers who are pregnant.

Some women have found relief using acupuncture, Vitamin B12 or placenta incapsulation. You can find more information on this under recognized condition on d-mer.org.