What to Know About Dysphoric Milk Ejection Reflex (D-MER)

Anne Wanlund
August 23, 2022
4 min read

Do you feel sad upon let-down when pumping or breastfeeding? You may have D-MER.

You've heard about the benefits of breastfeeding (from the antibody boost for baby to the oxytocin surge for mom, as well as the bonding enhancement for the mother-infant dyad but nursing, albeit natural, does not come easily for many moms. Most often, these challenges stem from trouble latching to managing milk supply. While lactation classes and counselors can help to overcome these challenges, there is one often overlooked & underdiagnosed condition that is not as easily resolved with traditional lactation support and tools. It’s called D-MER, Dysphoric Milk Ejection Reflex.

What is D-MER?

Dysphoric Milk Ejection Reflex, also called D-MER, is a condition that affects 10% of new moms. It is characterized by a massive surge of negative emotions just before let-down or milk ejection. Rather than the typical mood boost that comes with let-down from the release of oxytocin, moms are filled with dread, panic, and even nausea.

Although it is not conclusive, some research suggests this happens as a result of a drop in dopamine when milk is ejected. It is thought to be a physiological reflex rather than a psychological response and differs from postpartum depression.

How Does D-MER Present in New Moms?

Here are a few of the most common symptoms of D-MER in new moms:

  • A rush of negative emotions just before let-down (i.e. when milk is released), lasting a few minutes and up to 10 minutes.
  • Because it happens during let-down, it happens during breastfeeding & pumping.
  • Feelings are characterized by restlessness, general unease, sadness, anxiety, panic, anger, or agitation.
  • For some women, it happens with every milk release, whereas with others it’s just for some feedings.
  • D-MER tends to be strongest during the initial breastfeeding period, however, some moms experience it during the entirety of their breastfeeding/pumping journeys.

While the negative surge associated with D-MER is temporary and intense, there are often longer-term consequences on a new mom’s mental and emotional well-being. Feelings of guilt, inadequacy, and shame can persist throughout (and even beyond) the breastfeeding period. Below, you can hear from a patient who suffered from D-MER after the birth of her two sons.

This piece was originally published on Aeroflow.com. Read the full article here.

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