Picture this Mamas: you’ve set yourself up for a comfortable breastfeeding session. You’ve got your cushion, your favourite TV show cued up, snacks and water within reach and your baby in your arms. You’re feeling okay – I mean, sure you could use a few more Zzz’s and you’d love to have a long hot shower and wash your hair, but generally you’re feeling okay about life and this whole parenting gig. You get into position, then your baby latches on and begins furiously sucking to trigger your letdown.

And your heart sinks. Your stomach drops. You suddenly feel a complete loss of appetite, perhaps even nauseous. An overwhelming sense of depression washes over you. It lasts a few seconds, maybe even a couple of minutes and you’re shocked by the intensity of the emotions. Then, almost as suddenly as it came, it’s gone and you’re left wondering what the hell was that?

Well that, Mamas, is D-MER – Dysphoric Milk Ejection Reflex.

D-What Now?

I only found out about this maybe a month or two into my breastfeeding journey. The first two weeks after giving birth I was an emotional mess from the adjusting hormones, crying over everything and nothing. Once this startled to settle and my C-section recovery was coming along nicely, I started noticing these intense negative feelings that would wash over me during my breastfeeding sessions. Sometimes the strength of these emotions would bring me to tears. I wondered why this was happening only when I breastfed, when I didn’t think that I was experiencing postpartum depression otherwise. So I did what any millennial mum would do in this situation – I turned to Dr. Google. Why do I feel depressed when I breastfeed? I typed into my laptop.

Dr. Google answered: D-MER. So I did some reading.

D-MER is a little known condition affecting some women who breastfeed, causing intense negative emotions just before the milk letdown occurs. It can feel like anxiety, sadness, anger, panic, hopelessness or even the whole range of negative emotions, and may make you feel an aversion to food. It lasts only for a few minutes and is not the same as postpartum depression or ‘baby blues’, although they can co-exist. Some women experience it only mildly, while others find it very intense. It might even be the reason that some women stop breastfeeding.

A lactation consultant named Alia Macrina Heis was the first one to look into this in 2007, once she realised she was having these negative feelings while breastfeeding her third baby. Although D-MER has likely been around a lot longer than that, there wasn’t much research to go on besides other women’s experiences. To this day, there aren’t many published research papers about this, and many people are not aware that this condition exists. Perhaps one of the reasons this condition can go undiagnosed is that many people might mistake it for postpartum depression/anxiety. However, while the symptoms might be similar, D-MER only occurs during breastfeeding and only lasts a few minutes when it happens.

Why Does It Happen?

While there hasn’t been enough research to conclude what causes D-MER, it is thought to be related to the hormone activity that occurs during breastfeeding. Prolactin is the hormone responsible for producing milk, and oxytocin helps push the milk out. The current theory is that dopamine, the hormone that helps boost and stabilise mood, behaves abnormally in relation to the former two, causing a temporary dip in mood.

There is no official way of diagnosing D-MER, but if you notice that these symptoms occur only while breastfeeding, it is quite likely that you have it. It can last for a few days, a few months or throughout your breastfeeding journey. But don’t worry, you’re not alone. An article discussing D-MER on the What To Expect website states that some research suggests nine percent of new mothers experience this.

How Can I Manage Symptoms?

The good news is that it doesn’t last forever. The maximum it will go for is the duration of your breastfeeding journey, but symptoms will likely get milder as time passes. I personally experienced quite severe symptoms during the first three months but found that they eased off after that. Here are some strategies that I used to help me cope.

  • Breathe: Just knowing about D-MER helped put it into perspective for me. Understand that your body and brain are having a physiological reaction to breastfeeding, and it’s not all in your head. Focus on your breathing and know that it will be over soon.
  • Have support: It’s very important to surround yourself with support and I would often talk to my husband and close friends about it.
  • Make breastfeeding as enjoyable as possible: Find your favourite breastfeeding position, put on your favourite show, make sure you have snacks and drinks on hand.
  • Stay hydrated: It’s especially important for breastfeeding mamas to drink lots of water as your body works hard to keep your baby nourished.
  • Mind the caffeine: I know, I know! It’s hard to give up caffeine when we’re already barely functioning on so little sleep. However, I found that coffee really exacerbated my anxiety and made my symptoms worse, so I switched to matcha lattes for a smoother, milder caffeine hit throughout the day. It’s been a gamechanger as I no longer get the intense caffeine comedown.

If these tips don’t help and you still experience intense symptoms of D-MER, consult your GP, who might be able to suggest medication that can help. And if you need some things to help make your breastfeeding journey easier, I hear Boss Mama has a range of super comfortable nursing and pumping bras and tops! *wink*

In all seriousness though, please know that you are not alone in this journey. Chat with other Mamas who can share similar experiences by joining our 24/7 Telegram Mommy Hotline on Telegram, where we seek to support and empower mothers daily through love and knowledge sharing.