How To Cope With D-MER If You Want To Keep Breastfeeding

When Marna Mortimore, a mom of two, first started experiencing D-MER (dysphoric milk ejection reflex) with her first baby, she truly had no idea what was going on – which in itself was terrifying.

“I didn’t know what it was in the beginning, which made it worse,” Mortimore tells Scary Mommy. “I would be hysterically bawling while nursing my sweet baby, and couldn’t understand why it was making me feel so sad.”

D-MER is an uncomfortable and sometimes debilitating medical condition that a minority of mothers experience while breastfeeding. Symptoms are experienced right before and during the letdown of breastmilk; mothers describe feelings of depression, panic, aversion, nausea, and a host of other unpleasant emotional and physical sensations.

Though D-MER can be very intense, the experience is brief – usually only a minute or two – and symptoms completely vanish after the milk lets down. D-MER has only recently been named and discovered so our understanding of it continues to evolve. But what researchers know so far is that it’s likely caused by an abrupt drop in dopamine that occurs concurrently with letdown.

But even though it’s a brief and passing experience, for the moms who experience it, it can be incapacitating, especially at first when you don’t know what the heck is happening. D-MER is not the same as postpartum depression, but some moms have described falling into a depression or noticing an uptick in panic attacks because of their experience with D-MER.

“It took months for me to learn what was going on,” wrote Lea Grover on Scary Mommy. “I’d become so depressed, it bordered on suicidal, and even though my daughter was only nursing a few times a day, the panic attacks lasted longer.”

Many moms continue to breastfeed despite their experience with D-MER, but some moms find that weaning is the only way to experience relief. Still, it shouldn’t really be a choice of either/or – because although D-MER can be downright awful, there are things you can do to lessen the symptoms, and to continue to meet your breastfeeding goals.

Here are some tips:

1. Name it.

When most mother experience D-MER for the first time, they have no idea what is happening, which only makes their experience of it that much more troubling and unpleasant. If you are experiencing any signs of D-MER, talk to your doctor or a lactation consultant. Getting a diagnosis – being able to name what is happening to you – will help alleviate some of your fears and stress.

2. Educate yourself.

Mortimore said that once she began to research the condition and learn everything she could about it, she began to feel a whole lot better.

“After posting about it once on Facebook, someone brought up the name,” she told Scary Mommy. “I did some research, and was finally able to come to terms with it. I would still feel sad, and still cry, but I was able to realize it was something that I couldn’t help, but I could get through. I would still be able to enjoy the times I nursed, even though I was fighting the tears.”

3. Remember that D-MER is a medical condition.

We mothers are quick to blame ourselves or think we are overreacting when we have a strong emotional experience. It’s important to keep in mind that D-MER is a real medical condition, and what you are experiencing is not “all in your head.”

When Rita Templeton — who experienced D-MER to some extent with all of her children — realized this, it was a game-changer. “What helped me most was knowing that it was just a physiological response,” she tells Scary Mommy. “It was my body reacting, not my brain. This was very important because until I understood that it was my body, I thought I was nuts, and it was scary. I was comforted by reminding myself that it was just a bodily response, something that would go away like goose bumps or hiccups.”

4. Rest, stay hydrated, and eat well.

Resting and eating well aren’t exactly things that come easily to new moms, but many moms attest to the fact that when they are tired, depleted, and dehydrated, their symptoms of D-MER are worse. Have a glass of water and a healthy snack with you each time you sit down to nurse. If you haven’t learned how to lie down while breastfeeding, now’s your time to master the skill (here’s a helpful video tutorial on the side-lying position).

5. Reduce caffeine and stress … but eat chocolate!

Again, certainly more research is needed on D-MER, but a study published in the International Breastfeeding Journal found that caffeine and stress exacerbated D-MER symptoms in moms. But chocolate (“a chocolate ice cream binge” specifically!) reduced symptoms. Now that’s my kind of advice. Yum.

6. Talk to your doctor about meds.

Although treatment with medication is usually only reserved for severe cases of D-MER, there have been mothers who’ve been successfully treated with medications that increase their dopamine levels. This would be something to talk to your doctor about, but it’s definitely worth looking into. Remember, too, that most common medications are compatible with breastfeeding.

7. Connect to other D-MER moms.

Knowing you are not alone in this is SO important. Consider joining your local La Leche League group or other breastfeeding support group. If you don’t know any other real-life moms who have D-MER, there is a wonderful Facebook support group run by D-MER.org where D-MER moms offer tips, encouragement, and solidarity.

Maybe the best advice for coping with D-MER is “this too shall pass.” D-MER will most likely will get better in time – most mothers notice improvements in symptoms at about three months postpartum, and many moms find that symptoms improve or go away altogether as nursing progresses.

That said, D-MER is definitely not something you should just have to “grin and bear.” Nursing your sweet baby has the potential to be one of the most lovely and fulfilling experiences you’ll ever have, and you deserve to have all the help, support, and resources out there to make it as comfortable and peaceful as possible.