When you become a new mother, your body and mind go through a lot of changes, don't they? Sometimes, when you're ready to breastfeed your baby, or just before your milk starts to come out of your breasts, do you suddenly feel very sad, angry, or upset for no reason? This is not unique to you. Today, we're going to talk about this strange feeling.
What is D-MER (Dysphoric Milk Ejection Reflex)?
Simply put, D-MER is a condition that affects breastfeeding mothers, or mothers who pump milk. It is a sudden, unpleasant feeling that comes to your mind just before your milk comes out (milk let down). This lasts for a short time, about a minute or two, but it can be very distressing (dysphoria) and frustrating. Sometimes, you can also feel this way when your milk comes out unexpectedly (accidental let down). This is normal during lactation.
The important thing is that this is a reflex , which means it is not something you can control. It is not a problem in your mind, it is not because you do not want to breastfeed your baby, it is not because your nipples are sore. It is completely physical . According to current research, it is caused by a sudden change in the chemicals in your body, namely hormones .
Research is still ongoing into how common D-MER is. One study suggests that between 5% and 9% of breastfeeding mothers may experience it. It is not directly related to postpartum depression (PPD) or postpartum anxiety . However, some mothers may experience D-MER along with PPD or anxiety.
What do you feel during D-MER? (Symptoms)
The main thing you feel during D-MER is the sudden onset of bad thoughts and feelings. These come on very quickly and disappear within half a minute to two minutes. Most importantly, these feelings only come when your breasts are about to let down. Once the milk starts coming in, all those bad feelings disappear.
You may experience these feelings with D-MER:
- A feeling of great sadness and disappointment.
- Dislike of oneself, low self-esteem.
- A sinking feeling/dread , as if something is stuck in the stomach, or something bad is going to happen.
- Anger , sadness, or restlessness for no reason.
- Anxiety or irritability.
Remember, D-MER is not related to other physical discomforts associated with breastfeeding, such as nipple pain or breast engorgement. However, these feelings can be so intense that some mothers may feel the need to stop breastfeeding or pumping.
Very important: Sometimes these symptoms can be very severe and can lead to suicidal thoughts . If you ever have thoughts of harming yourself or someone else, please seek medical advice immediately. D-MER symptoms can be even more difficult to manage for mothers with postpartum depression (PPD).
Why does this happen? (Causes of D-MER)
Although this condition is not yet fully understood, many studies suggest that hormones are the main cause. Specifically, it is caused by a sudden decrease in the body's levels of a hormone called dopamine . Dopamine is a hormone that is associated with feelings of happiness and satisfaction. Numerous studies have shown that low levels of dopamine can negatively affect our mood and emotions.
Think of it this way: when you breastfeed your baby, your body releases hormones called prolactin (a hormone essential for milk production) and oxytocin . When your baby sucks (or you start pumping), it is this hormone called oxytocin that causes milk to come out of your breasts (milk ejection/let-down). This hormone, oxytocin, works by lowering dopamine levels. That means your dopamine levels drop.
For reasons that researchers still don't fully understand, some mothers' dopamine levels drop very rapidly . That's when they suddenly feel sad and other negative emotions. This is called D-MER.
But these bad feelings are temporary . Many mothers report that once your prolactin and oxytocin levels return to normal, your mood will stabilize within a few minutes.
Remember, D-MER is a physical reaction, not a mental one. It doesn't mean you're depressed, angry at your baby, or reluctant to breastfeed. If you think you may have D-MER, it can be very helpful to talk to your doctor, midwife, or lactation consultant.
How does a doctor know for sure that this is D-MER? (Diagnosis)
Because there isn't a lot of research on D-MER, there's no official diagnosis for it yet. Your doctor will talk to you about your symptoms, when they occur, and how severe they are. Remember, D-MER only occurs when you're breastfeeding or pumping, and it goes away after a while. A clear description of your symptoms and when they occur will help your doctor understand what's going on.
What can we do if we have D-MER? (Treatment and Management)
Because researchers still don't fully understand the condition, there is no specific 'treatment' for D-MER. However, there are several ways to help you manage your symptoms and cope with the condition.
Here are some of the most commonly used methods to manage D-MER symptoms:
- Increase skin-to-skin contact with your baby: If you are breastfeeding, try to hold your baby close to you as much as possible. This touch can reduce your cortisol levels (a hormone associated with stress), lower your heart rate, and make you feel a sense of calm. Just like the comfort we feel when we hold a small baby.
- Meditation or deep breathing: The main thing is to try to calm the mind. This reduces anxiety and stress. Take deep breaths through your nose and exhale slowly through your mouth. Doing this for a few minutes a day can make a big difference.
- Find other ways to relax: Get a gentle massage before breastfeeding, listen to your favorite song, or soak in a warm tub. These things can help you relax and cope better when D-MER arrives.
- Distract yourself: When you're feeling nauseous, try to focus your attention on something else. Maybe you can eat a snack, watch something on TV, or read a book while you think about what's on your mind. Basically, it's about keeping your mind occupied with something else when that bad feeling comes.
- Find support: Support is very important for you to cope with D-MER. It could be your spouse, a best friend, or an online D-MER support group. Find people who will listen to you, talk to you, and care about you. It's also a great strength to know that you are not alone.
How long will this situation last?
This varies from person to person. For most people, D-MER gradually subsides after about three months. It becomes less severe as the baby gets older. However, there have been some who have experienced D-MER until they stop breastfeeding altogether. So, it's hard to say exactly how long you'll have it. But keep in mind, it's not something that's permanent in most cases.
Can this be prevented?
No, you can't prevent D-MER. But it's important to know that there are people who can help you and that this situation is not caused by anything you did. You don't have to take responsibility for it.
Is D-MER a sign of postpartum depression (PPD)?
No, D-MER is not a sign that you have postpartum depression (PPD) or another postpartum mood disorder. Although some of the symptoms are similar, D-MER only occurs when your milk supply is about to come in and goes away quickly. However, it is possible to have a condition like PPD while you have D-MER. If the negative thoughts and feelings you are experiencing are more intense outside of breastfeeding, or if they seem to be getting worse day by day, please talk to your doctor.
It is very important that you take care of yourself!
Although some people don't realize it, D-MER is a real condition. Fortunately, it's often temporary, and there are ways to help you cope. Try to manage your D-MER symptoms using the methods mentioned above. Sometimes, it can be a great relief to know that you have a real condition and that other mothers experience similar things.
D-MER may make you want to stop breastfeeding. If this is having an unbearable impact on your mental health and well-being, switching to formula may be the best option for both you and your baby. That's okay. Don't be ashamed of it. If breastfeeding doesn't work for you, it's not your fault.
When should you definitely see a doctor?
There is nothing wrong with asking for help. If your feelings are very strong and you are having a hard time coping with them, it can be very helpful to talk to your doctor or a lactation specialist. It is important to talk openly and honestly about your feelings. It can also be helpful to write down your feelings on a piece of paper and show it to your doctor. Please know that there are people who can help you, and you are not alone.
If, at any time, you have thoughts of harming yourself or someone else, please seek medical advice immediately.
Things to remember to take home
Breastfeeding isn't a pleasant experience for everyone. If you experience negative emotions like anger or sadness when you let down your milk, you may have D-MER, or Dysphoric Milk Ejection Reflex.
- You are not alone. This happens to other mothers too.
- This is not your fault. You haven't done anything wrong.
- There is nothing "wrong" with you. This is a physical response.
- Tell your doctor about how you're feeling. They'll tell you the best ways to cope with what you're experiencing.
- Sometimes, just knowing that there's a name for what you're feeling can help you feel like you're not alone. Don't worry, there's help.
` D-MER, Dysphoric Milk Ejection Reflex, breastfeeding, milk let-down, sadness, anger, anxiety, hormones, dopamine, postpartum, mental health
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