Many times being a new mother can feel isolating. There are certain situations you might find yourself in and not know if what you are experiencing is normal. I hope the story below will shed some light around DMER, Dysphoric Milk Ejection Reflex. I had never heard of the condition and now feel like I would be able to identify the condition if I had a friend going through this. The more educated we all are around certain postpartum conditions the more likely we will be able to be a resource for other moms. We all need to look out for each other, during this fragile time. So read on.
Jess Hohman will take it from here.
Breastfeeding has always been a hard subject for me.
Let me start from the beginning – the birth of my first son, Brooks.
During pregnancy and after delivery, breastfeeding exclusively was the plan. I was fine with deviations from that plan. In my mind, fed is best.
I was ecstatic that Brooks took to nursing like a pro. While nursing him in the hospital, I noticed that I would get nauseous every time that I fed Brooks. I suspected it was the pain meds or other side effects after having an unplanned C-section, so I let it go.
To my displeasure, the feeling continued after we settled in at home. In addition to the nausea, I started having intense emotional reactions when breastfeeding. Not in the soothing, basking in the sunlight rocking your precious newborn way. Rather, I felt terrible unhappiness and irritability, but only when breastfeeding.
For the 30-45 minutes that Brooks nursed I was unpleasant to be around. I snapped at anyone who came into the room or dared to speak to me. It became known that if I was nursing, I was in my room alone to save everyone the pain of being around the monster that I became. And then, once Brooks was done eating, I morphed back into my normal, albeit tired, self.
I had brought up the nausea with my OBGYN, which had been a nonissue to them. I figured this new emotional development would be the same, so I toughened up and powered through…for months.
Once I made it to 6 months nursing my son, which was the goal that I had set for myself, I decided to wean and introduce formula. I was thrilled. I had associated this insurmountable heaviness with nursing, and that feeling was almost gone.
We successfully weaned, and I didn’t think about it again until I got pregnant with my second son when Brooks was just 9 months old. After another relatively uneventful pregnancy, breastfeeding was the goal again. The anticipation of sitting in that darkness for months nursing haunted me.
This time around, my second son, Vance, struggled to nurse a little, eventually figuring it out on his own within a few days. Once again that gloom came every time I popped Vance on my chest for a meal.
I dreaded nursing. I dreaded working through the negativity. I dreaded holding my perfect newborn and feeling anything but pure glee. I felt a terrible guilt associated with my fleeting mental state while nursing. Why could I not feel the way I was “supposed” to feel when I was given the gift of a healthy baby and a body physically capable of feeding him?
One morning 3 months later when I was skimming Instagram stories, I heard someone mention D-MER. A blogger was discussing her breastfeeding triumphs and failures, and mentioned that she knows that there are some women who feel intense negative emotions when their milk lets down. Her message was that breastfeeding shouldn’t be something that you dread, hate, or that makes you feel any less than.
My ears perked up. She was talking about me. Breastfeeding had made me feel less than the perfect mother. During each feeding, I was filled with an irritation that would later fill me with guilt.
After some power-googling that morning, I discovered that D-MER stood for Dysphoric Milk Ejection Reflex. It is an anomaly that affects a very small percentage of breastfeeding mothers with irregular dopamine activity. This means that this condition is 100% hormonal. It is neither a mental illness nor any sort of psychological issue.
I should have talked to my doctor once these symptoms became the norm. However, there is such stigma associated with any sort of mental manifestations that I was instantly shameful. I had already begun to wean Vance because I felt hopeless. I knew that having a happy momma was more important than having an exclusively breastfed child. It devastated me though – I (irrationally) felt like I was starting Vance out in the world with an instant disadvantage.
I learned from my research that this stigma is a large part of why D-MER is not well known even amongst medical professionals. Women are ashamed to speak up about unpleasant things in general, too often opting to appear polite and quiet.
In addition to stigma, every sign in the hospital, OBGYN, and pediatrician’s offices clearly delineate the benefits of breastfeeding for mother and child – decreased risk of certain cancers for mother and decreased risk of allergies and future infections for baby, and passing along antibodies made specifically for your child. What kind of selfish person wouldn’t want to give all that to their child when they are physically able?
I felt an overwhelming guilt. I was so lucky to be able to produce milk efficiently and to have a child who was a good eater. With all that being the case, in my mind I should nurse regardless of the mental toll it takes on me. I should have been strong enough to overcome my side effects in favor of feeding my children.
In reality, I should do what is best for my family as a whole. I am not an island alone whose needs are disregarded now that there are more mouths to feed. I now realize that my well-being contributes to the wellness of the family. And that is something that is not on signs in the hospital.
I hope that this admission of D-MER and all the nasty symptoms that come along with it encourages others to talk to their doctor’s openly. Bring this, or any other condition that makes your well being take a backseat, to your doctor’s attention. Once more people come forward; there will be a stronger justification for research into this condition.
And finally, to the mom struggling through D-MER:
You are doing your best – trying to breastfeed your child and give him the milk that your body perfectly made for him. But if you are feeling depressed, angry, anxious, or generally unhappy ONLY when you’re nursing him, don’t overwhelm yourself by ignoring those warning signs.
Speak to a doctor, and develop a plan for your family. If that means medicine, good! If that means weaning, good! Prioritize yourself so that you are capable of giving that beautiful child all he needs.
This is your journey, and it is beautiful no matter what. I know you’re trying your best, and so does that sweet baby staring up at you.
Some more information around DMER
“Dysphoric Milk Ejection Reflex, or DMER, is a condition marked by an abnormal chemical and hormonal reaction that causes a brief but abrupt emotional response at milk letdown. “It seems to be a small chemical reaction that causes a huge emotional reaction,” Alia Macrina Heise, anInternational Board Certified Lactation Consultant in Naples, New York, who pioneered research on the condition.
For milk letdown to occur, the hormone dopamine — which controls the secretion of the hormone prolactin — must fall so levels of prolactin can rise. Yet for mothers with DMER, a chemical imbalance or dysfunction of dopamine prevents that from happening.
Symptoms of DMER vary, but they typically include anxiety, irritability and sadness. Some women may even have suicidal ideations. “This is like being zapped by a dark cloud — it can be very overwhelming and scary,” Diana West, an internationally board-certified lactation consultant and director of media relations for La Leche League.” FN