Understanding Dysphoric Milk Ejection Reflex & Breastfeeding

10% of women experience it. A stomach-churning, heart-stopping, panic-induced, sense of despair every time they attach their baby to their breast.

Dysphoric milk ejection reflex, or D-MER, is a condition classified by a spontaneous sense of dissatisfaction during the act of breastfeeding. A deep sense of anxiety, hopelessness, angst, self-loathing and even physical sickness, all while feeding your baby.

Most people have never heard of it.

Medical Health Professional and new mum, Allie Barnes, was one of them. In a dozen or so years in the industry, she’d never heard of anything like it. Until she experienced it.

Breastfeeding making you sick? You’re not alone

Allie shares her story with Scary Mommy and we found it so powerful and important. I experienced this same ’emotional drop’ many times myself but had no idea what it was. I also had no idea so many other breastfeeding mums were feeling it too.

According to the International Breastfeeding Journal,

Dysphoric Milk Ejection Reflex (D-MER) is an abrupt emotional “drop” that occurs in some women just before milk release and continues for not more than a few minutes.

The brief negative feelings range in severity from wistfulness to self-loathing, and appear to have a physiological cause.”

If you’ve ever been breastfeeding your baby and have been overcome with dread, anxiety or intense doom, then you have experienced D-Mer. Some women, including Allie, even got physically nauseous every time they fed.

‘Felt like I was getting bad news’

Allie explains it so perfectly. She tells Scary Mommy,

I remember the very first time really well. She latched, I got the pins and needles feeling you get when your milk lets down, and all of a sudden, I had this feeling of intense doom come over me.

The best way I can describe it is I felt like I was getting bad news. It was the kind of dread you get when you’re finding out someone you love has cancer, or that you’re getting fired from your job. Imagine you’re getting a call that you know is going to be really, really bad, and the pit in your stomach you get when that phone rings.

I had no idea what it was. I thought maybe I just had out-of-control anxiety about being a parent.

It seemed like something I shouldn’t be feeling, so I didn’t say anything. I didn’t know how to tell my husband, or how to describe what was going on.”

‘Suck the soul out of you’

Another mother on the Australian Breastfeeding Association website describes D-MER as this:

If you have read Harry Potter they talk about the creatures that suck the soul out of you and when they are around it makes you cold and you start to focus on negative things and fall into this abyss of negative thoughts — that is how D-MER was for me at times.”

However, other women may only experience mild symptoms, such as a strange feeling of sadness, mild irritability or hopelessness or a hollow feeling in their stomach. They may feel nervous or angst or a sense of discontent for a brief period of time.

D-MER and breastfeeding dread

D-MER comes and goes when you feed. What I mean by that is that, when you’re not feeding, you most likely don’t feel it. It’s only when you start to breastfeed that this intense doom returns. It may only last a minute or two, but it can make breastfeeding incredibly stressful and challenging.

You start to associate every feed with this feeling and, this makes the anxiety surrounding breastfeeding even worse. It’s one of the reasons many women decide they don’t want to do it anymore – the anxiety and the sickness is just too much.

However, because it’s not something openly discussed, many mums are not sure why they feel this way and often blame themselves.

While there is no definitive explanation for what causes D-MER, experts believe that it has something to do with the abrupt drop in dopamine when the milk release is triggered, resulting in a brief dopamine deficit for affected women.

Allie managed to breastfeed her first baby for seven months, despite having D-MER. She tried several ways to make the sickness stop but it just didn’t go away.

I tried everything — all the suggestions, all the things that other people said worked for them: drink cold water, watch TV, eat chocolate, stay really hydrated. Nothing really helped other than to focus on my baby and try to remember I was doing it for her, and it was all just temporary.”

Once she stopped feeding, the feelings went away. However, two years later she had her second baby and, as soon as she latched, the D-MER was back, this time even worse.

Not only was it the anxiety and dread and nervousness, but I would also get ridiculously nauseous. I’d feel like I might throw up, and then 15 seconds later I’d get the pins and needles of a letdown, and that’s when the anxiety would kick in.”

Allie knew it wasn’t going to get better. But she also knew her son loved breastfeeding. So she endured the multiple feeds a day, each time filled with nausea and dread. Every day she told herself it would be the last as she rode out the waves of sickness.

But then her son would fall asleep on the breast, snuggled so close, and the sickness would melt away. It’s the ultimate sacrifice that so many breastfeeding mums are doing right this second. But no one is talking about it!

Let’s talk about it.

For anyone who has experienced these symptoms while breastfeeding, there’s a good chance it’s D-MER and it might be worth bringing it up to your GP.

While it’s a relatively new diagnosis, there are some strategies that can help you cope.

And, please, if this is something you have experienced, let us know! We’d love to get some stories about D-Mer out there so breastfeeding mums are aware that this exists.