D-MER: The Little Known Condition That Causes You to Feel Intense Sadness Before You Lactate

I didn't know why I'd become consumed by negative emotions every time I started breastfeeding. After doing some research, I learned I have D-MER—and I'm not the only mom who does.

graphic/abstract illustration of breast, milk drops and rain clouds
Illustration by Caitlin-Marie Miner Ong.

When I gave birth to my son, I knew what to expect. I considered myself an experienced Mama, which is to say I had already carried and delivered one child—a smart, sassy, and beautiful little girl. And while my pregnancy was harder the second time around—I was depressed, uncomfortable, and beyond exhausted—I felt relatively confident in the hours and days that followed after giving birth.

My boy slept well, made the appropriate number of diapers, and latched on quickly. It seemed breastfeeding him would be a breeze. But after a few weeks, I noticed every time I started to feed him, I was consumed by emotions. I didn't know who was more upset: me or the red-faced baby in my arms.

Of course, I know what you're thinking—it is normal to be overwhelmed; parenthood is hard; breastfeeding is hard; and sleep deprivation is brutal. And you're right. Science has proven sleep deprivation can negatively impact your cognitive abilities and physical health. But my emotional struggle was something deeper, and soon I discovered I was right: I was suffering from something called D-MER, or dysphoric milk ejection reflex.

I could (and still can) tell when I am about to let-down. My breasts tingle and get hard. My chest grows heavy. I can feel the milk rushing forward, but then an acute wave of depression washes over my body. I experience a rush of negative emotions: about myself, my daughter, my son, and my life. I am also terrified, afraid of a monster I cannot see, and a threat which I know does not exist.

The good news is the anxiety and sadness only last a few moments. The feelings disappear as abruptly as they come on. But for two or three minutes, I am stuck on flight mode. I feel desperate and the sense of dread and despair is unreal.

Having breastfed before, I knew this feeling isn’t typical. I had a love/hate relationship with the act when my daughter was born because, let's face it, breastfeeding can be painful and tiring. But this sudden, intense, and visceral reaction was foreign. I didn't know what was wrong with me and became afraid of what I was experiencing.

And then one night, while scouring the internet with my wee one on my breast, I came across a group of women who expressed the same feelings. I learned there were others with these thoughts, and that's when I discovered there was a name for my condition.

What is D-MER?

D-MER is an "abrupt emotional 'drop' that occurs in some women just before milk release," according to the International Breastfeeding Journal. Those who experience it commonly report feelings of sadness, anxiety, hollow feelings in the stomach, introspectiveness, irritability, or angst, explains the Australian Breastfeeding Association.

That said, there isn't a lot of research on D-MER, a fairly rare condition, probably because it doesn’t “occur a lot with mothers or mothers don’t report it,” says Deedra Franke, a registered nurse and certified lactation consultant at Mercy Medical Center in Baltimore. In turn, diagnosing and treating D-MER is difficult and currently there are no known medications or therapies.

What causes it also remains unclear. Lactation consultants Alia Heise and Diane Wiessinge released a case report in 2011 explaining a correlation between the condition and an excessive drop in dopamine, the hormone which must fall for prolactin (the hormone promoting breast milk production) to rise.

Luckily, many find D-MER goes away after the baby is a few months old, which could be due to a variety of factors, including hormones levels steadying, the duration and quality of sleep improving (for both Mom and Baby), and many parents gaining their footing. Franke says “rest, hydration, proper nutrition, exercise, and a decreased intake in caffeine may help.”

D-MER awareness can be key to helping those going through it. “Many women with D-MER can improve mild to moderate symptoms with…education of the disorder and support from other moms who experience it,” adds Franke.

How I get through D-MER

As for me, I do my best to cope by breathing through each attack. I let my eyes well, and the tears flow, and then I count to 100. My milk usually lets down sometime between 60 and 80, and then I wait. Within minutes, I feel relief.

Will I continue breastfeeding? I'm not sure. My son is 5 months old now, and I am already supplementing. He takes two formula-filled bottles each day. And while I initially felt an immense amount of guilt over that decision, I know I need to be a happy Mama and a healthy Mama—and you do, too. So whether you struggle with supply issues, latch issues, or experiencing D-MER, know you are you are not alone, and opting for other options is totally OK.

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