Breastfeeding Challenges

Dysphoric Milk Ejection Reflex (D-MER): What It Is and How to Treat It

Time to read: 2 min.

Dysphoric milk ejection reflex, also commonly referred to as D-MER, can be an uncomfortable and oftentimes frightening experience for a new breastfeeding mom. Learn what it is and how you can overcome this condition.

If you’re like a lot of moms, you likely expected the time you spend nursing your new baby to be sweet and full of happy bonding moments —an opportunity for closeness with your new little one. But what if, instead, you’ve experienced feelings of negativity, unhappiness, and even self-loathing that occur right before your milk lets down?

First and most importantly, you must know that what you’re experiencing is a very real condition called Dysphoric Milk Ejection Reflex, or D-MER.

What is D-MER?

The decision to nurse your baby is an excellent one that provides myriad benefits to baby and you. Besides the obvious nutritional benefits for your baby, it is often seen as a unique time of closeness that helps forge a crucial bond between you and your newborn while setting a foundation for your little one’s emotional development. But it can also be a challenging time of transition for you, especially if you’re a first time parent. We understand, mama. That’s why on top of the often sleep-deprived nights, everyday adjustments to having a newborn, and learning to feed, diaper, bathe, and care for your baby, we know the last thing you need is breastfeeding anxiety!

Yet, millions of women experience the symptoms of D-MER and mistakenly feel as if there’s something wrong with them. We want you to know without a doubt that just isn’t the case! In fact, D-MER is a very real physiological condition. This is not something that’s “all in your head.”

While the exact cause of D-MER is unclear, many medical professionals believe there is a correlation between the hormone oxytocin and breastfeeding.

You might already know that oxytocin is what facilitates your body’s ability to express your milk and that this hormone is released as soon as your baby begins nursing. At the same time, it inhibits dopamine, the hormone in your brain that lifts your mood and allows you to feel pleasure. Many moms don’t even notice this dopamine drop. Unfortunately, for moms with D-MER, the drop seems to happen more quickly and they experience a temporary wave of unsettling emotions that can last up to 10 minutes.

Symptoms of Dysphoric Milk Ejection Reflex

Diagnosing D-MER is not always easy. There’s no way to test for it, and it can sometimes be confused with postpartum depression. However, D-MER typically only occurs around breastfeeding time, whereas moms with postpartum depression exhibit symptoms most of the time.

Symptoms of D-MER can range from mild to severe and include feelings of:

Depression or hopelessness
Wistfulness
Panic
Self-loathing
Dread
Paranoia
Anger
Suicidal thoughts

Know that it is possible to experience both D-MER and postpartum depression simultaneously. If you feel that your feelings are overwhelming or you’re struggling to cope with them, it’s crucial to immediately speak with your physician, midwife, or lactation specialist. Remember, it is always okay to ask for help! The safety of you and your baby is paramount.

Overcoming D-MER

If you think you may be experiencing symptoms of D-MER, there are several things you can try to find relief:

Increase the skin-to-skin contact with your little one while breastfeeding. The positive sensations that doing so yields can help to lower your heart rate and your cortisol levels.
Ask your partner for a massage. Again, physical contact works to counteract stress.
Practice deep breathing and meditation techniques. This lowers your heart rate and reduces anxiety.
Soak your feet in warm water to encourage relaxation and reduce stress.
Ask for support and encouragement from loved ones and talk to your healthcare providers about how you're feeling and what you're experiencing.

Take heart, mama. Many mothers report that D-MER is most noticeable in the early weeks of nursing, and symptoms seem to gradually decrease as their baby gets older. Finally, keep in mind that D-MER is real, it isn’t your fault, there is nothing “wrong” with you, and you are not alone. You’ve got this!

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