As staunch advocates of breastfeeding, we’re wary of news which gives mothers a reason to stop nursing their babies, or which frightens women into believing that breastfeeding may somehow harm them or their newborns, when we know quite the opposite to be true: breast is best. However, we are also very aware of the reality of postpartum depression and the toll it takes on some new mothers, specifically with regard to thwarting their efforts to breastfeed. Navigating the deep, wide sea of postpartum hormones can be both terrifying and very isolating for women in their ‘fourth trimester’ as they tend to a newborn — which is why when we came across the news of a recently defined condition called “Dysphoric Milk Ejection Reflex” or “D-MER,” we felt compelled to write about it here to open up a forum of discussion for readers who may be suffering in silence or confusion.
Alia Macrina Heise, a mom of three, brought D-MER to light in 2008 when she experienced the condition while nursing her third child. She gave it a name, and started a blog with its regard, and soon found many other mothers who were having the same experience, that was yet to be pinpointed by the medical community or lactation consultants.
Described as a physiological, not a psychological experience, here is the explanation of D-MER:
“D-MER is linked to a drop in dopamine that seems to occur whenever milk is released. In a mother with D-MER at the time of letdown dopamine falls inappropriately, causing negative feelings. All of the suggestions made for treating D-MER are based on our belief that transiently inadequate dopamine is responsible. Milk release itself isn’t caused by dopamine dropping; it’s caused by oxytocin rising. In D-MER, the MER (milk ejection reflex) is a result of rising oxytocin (needed to move the milk out of the breast) but the D (dysphoria) is a result of inappropriately falling dopamine. Dopamine gets involved because it inhibits prolactin (which is what makes the milk,) so dopamine levels need to drop for prolactin levels to rise in order to make more milk. Normally, dopamine drops properly and breastfeeding mothers never knew it even happened, in D-MER mothers however, it doesn’t drop properly and causes a negative emotional reaction.”
Heise contacted several lactation consultants, one of whom is Diane Wiessinger, MS, IBCLC. Motivated to help care providers identify and diagnose D-MER, their first scientific study on Dysphoric Milk Ejection Reflex will be published in the coming months.
Personally, the spotlight on this condition resonates with me because after the birth of my now 5-month-old son, I experienced two months of postpartum depression, during which time I was overwhelmed by feelings of intense sadness and anxiety during many (but not every) nursing session. I also had two bouts of mastitis in a five week period, and was seriously wanting to throw in the towel on nursing entirely. I am so glad my son and I hung in there together though, because when my depression lifted and my mastitis was ultimately cured, these feelings of despair were lifted, and I now thankfully experience joy when breastfeeding. I know that I was wondering what in the world was wrong with me when I was in the throes of depression, which is why I felt it was important to give news of this condition credence here and let moms know they are not alone, no matter how isolated or overwhelmed they might be feeling.
Have you experienced feelings similar to what is known as D-MER? How did you overcome these issues? Please share in the comments below.