The Rare Problem That Makes Breastfeeding Disheartening And Painful

Read all about our founder Bianca's experience with D-MER, or Dysphoric Milk Ejection Reflex.

three-month breastfeeding crisis
Image: Bianca Cheah

Ever since I gave birth to Oliver, I would feel an intense sadness come over me whenever I sat down to breastfeed. I would always feel when I breastfed and when I wanted to pump. It was immensely heartbreaking to me because of everything you hear mothers say about how breastfeeding is how they truly bond with their child. I’ve never felt I was able to experience those loving moments as other moms do. Instead, all I’ve felt is an intense sadness, a feeling of homesickness, like my partner has left me alone to suffer through this alone. In trying to figure out what could be making me feel this way, I was referred to a psychologist. One who thought I might have postnatal depression or PND, but I know I don’t have it. I decided to do some research of my own, knowing it was something else instead.

does breastfeeding really help weight loss?
Image: Today’s Parent

The D-MER Or Dysphoric Milk Ejection Reflex

I’d read about D-MER before, but it didn’t click that was what was happening to me. Personally, I just kept hoping that the next feed would be better and that it was all in my head. But it didn’t ease up at all. It didn’t click for me until a handful of Instagram mamas shared the website, D-Mer.Org, with me that I realized what exactly what was going on with me. It was truly a relief to know that it wasn’t in my head and that there is an actual name for the condition I was feeling.

Dysphoric Milk Ejection Reflex is “a condition affecting lactating women that are often characterized by an abrupt dysphoria, or negative emotions, that occur just before milk release and continuing not more than a few minutes. Preliminary anecdotal evidence shows that D-MER is treatable if a severe and preliminary investigation shows that inappropriate dopamine activity at the time of the milk ejection reflex is the cause of D-MER. Dysphoria is defined as an unpleasant or uncomfortable mood, such as sadness, depressed mood, anxiety, irritability, or restlessness. Etymologically, it is the opposite of euphoria. D-MER is like a reflex. It is controlled by hormones and can not be controlled by the mother.”

What D-MER Is Not

  • D-MER is not a psychological response to breastfeeding. It is a physiological response to milk release.
  • It’s not nausea with letdown or any other isolated physical symptom or manifestation. D-MER has a negative emotional component above all else.
  • This is not postpartum depression nor is it classified as a postpartum mood disorder.
  • Not a general dislike of breastfeeding.  Impatience with baby at the breast, irritability from nipple pain, sadness during pumping because of separation from the baby; these things are not D-MER.
Bianca Cheah postpartum, baby blues
Image: Bianca Cheah

What Are The Symptoms Of D-MER?

According to D-MER.Org, the feeling of dysphoria a mother feels when D-MER comes on suddenly before letdown and leaves within 30 seconds to 2 minutes. She can feel the dysphoria before she feels the letdown sensation in her breasts (though not all mothers feel a physical letdown sensation). More often than not, by the end of the first letdown, she feels fine again, the dysphoria is gone. It can also happen for the first letdown of feeding or for all letdowns in a feeding, depending on the intensity of her D-MER.
She may or may not have dysphoria with letdowns when pumping and before spontaneous letdowns, this also is dependent on the intensity of her D-MER. D-MER has nothing to do with nipple contact or with irritation with the sensation of nipple tugging. The mother does not even have to be thinking about breastfeeding (for example with spontaneous letdowns) for the dysphoria to happen when a milk release is triggered.

What I’ve Decided To Do

D-MER is most likely found through Google search, with terms like “breastfeeding problems” or “sadness when breastfeeding”. The only unfortunate thing is that the only way for those feelings to disappear is to wean my precious Oliver off of breastfeeding. After consulting with my paediatrician, I’ve decided to ween Oliver slowly. It’s been 7.5 months and I’m so proud of myself for keeping up with it. I only did it for little Oliver. So that I’m always there for him, as my best self.

I hope that what I’m sharing today can help other mamas. Those who get the same feelings to help identify and know that it’s okay. Sometimes, we need to do what we have to do for our mental health. We cannot tear mothers down for choosing not to breastfeed or what they decide to do when raising their child. If you felt the same way I did, you are not alone. Know that this is not your fault.
I fed Oliver for 7.5 months and I’m so proud that I got that far. As for the bonding, Oliver and I have bonded in so many other ways. As much as it was a deep sadness, it was overcome with so much love in other ways. Truthfully, mothers do so much for their children other than breastfeeding. We care truly and deeply for our children, growing with them, and helping them learn to live life.

bianca's experience with d-mer, bianca and oliver
Image: Bianca May Cheah

To learn more about D-MER, visit D-Mer.Org.

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