D-MER Dysphoric milk ejection reflex

What is D-MER?

D-MER, short for Dysphoric Milk Ejection Reflex, is a condition where a breastfeeding mother experiences negative emotions just before or during their milk let-down. It is characterised by feelings of dissatisfaction, anxiety, restlessness, and fidgeting that come suddenly right before the let-down and tend to last for around 30 seconds to two minutes. After that, the mother feels fine again. Typically, the let-down may not even be felt when it happens.

Unlike Postnatal Depression or an anxiety disorder, D-MER is specifically linked to the let-down reflex during breastfeeding or expressing milk. Women may use various terms to describe their D-MER experience, such as hollow feelings in the stomach, anxiety, sadness, dread, introspectiveness, nervousness, emotional upset, irritability, angst, and hopelessness.

Severity of D-MER

The severity of D-MER can vary from mild to severe and is determined by factors such as the intensity of negative emotions, the duration it takes for the mother to feel better, and the frequency of let-downs per feeding. Women experiencing D-MER may have different levels of emotional distress and may require varying levels of support and management strategies based on the severity of their symptoms.

While some mothers may have mild symptoms, others may experience severe effects like suicidal thoughts. Symptoms of D-MER may improve within three months after childbirth or continue as long as breastfeeding, with many finding it easier to manage as their baby grows older.

Why does D-MER happen?

During the milk ejection reflex, which is the process that releases milk from the breasts, there is an increase in the hormone oxytocin. This rise in oxytocin is accompanied by a decrease in dopamine, another hormone in the body. The exact cause of D-MER is not fully understood. Still, one theory suggests that mothers experiencing D-MER may have a more pronounced dopamine drop compared to those who do not, while another theory proposes that those with D-MER may experience a more significant spike in oxytocin.

It is essential to recognise that D-MER is a physiological response to hormonal changes in the body rather than a psychological issue. Therefore, methods such as psychotherapy or positive thinking are not likely to prevent or alleviate D-MER symptoms, as they are rooted in the body's hormonal fluctuations.

Treatment

Treatment options include seeking advice from a doctor, making lifestyle changes, such as avoiding stress and caffeine, prioritising sleep, and using distraction techniques while breastfeeding. In severe cases, a healthcare provider may recommend medication or herbal remedies.

Currently, there is no standardised treatment for D-MER. However, individuals experiencing D-MER may find the following suggestions from other mothers helpful:

• Educate yourself about D-MER to better understand the condition.

• Inform and involve your family members, seeking their support and encouragement.

• Prioritise self-care and ensure you are meeting your own needs.

• Connect with others who also experience D-MER for support.

• Practice deep breathing techniques during a let-down to help manage negative emotions.

• Engage in distractions to divert your attention from negative feelings when they arise.

• Consider taking supplements like vitamin D, B-complex, and probiotics after consulting with your healthcare provider.

• Drink cold water during a let-down as a coping mechanism.

Does anything make D-MER worse?

It is important to be aware of factors that may exacerbate D-MER symptom so, such as:

• Lack of knowledge about D-MER.

• Feelings of isolation.

• Following low-carb diets.

• Inadequate self-care practices.

• Sensitivity to touch.

• Use of birth control methods.

• Consumption of caffeine.

• High levels of stress.

• Breastfeeding in the presence of others.

• Use of galactagogues.

• Extended intervals between feedings.

• Menstruation.

• Chaotic or disorderly environments.

By being mindful of these triggers and implementing self-care strategies, mothers with D-MER may be able to manage their symptoms better and improve their overall well-being.

The resolution of D-MER can vary in duration, with some breastfeeding mothers finding relief within three months, while others may experience symptoms for over a year or all through their breastfeeding journey. It is essential to understand that these negative emotions are hormone-driven and do not reflect your genuine feelings of motherhood.

By knowing about D-MER and implementing helpful strategies, you can navigate these challenges and continue to enjoy breastfeeding your baby for as long as you desire. Remember, with the correct information and support, you can overcome the difficulties associated with D-MER and focus on the rewarding aspects of nurturing your infant.