I always thought that successful breastfeeding was just a matter of pushing through and having dedication to making it work, no matter what. But after my first was born and I saw two mom friends struggling with breastfeeding, I realized that wasn’t so.
I decided that as important as breastfeeding was to me, it wasn’t going to be the factor by which I determined whether or not I was a “good mom.” I decided that my opinion of myself and acknowledgment that I was doing valuable, important things would take precedence over how I fed and cared for my baby.
So I knew that making breastfeeding work wasn’t all roses and cuddles, but I didn’t know that there was even more to the story. This is before I learned about D-MER.
When I weaned my first child, I suddenly felt so happy. I wanted to stop strangers in the street and ask them if they knew that the hills were actually alive with the sound of music. My daughter self-weaned before one year and I had fully intended to breastfed to 12 months and this earlier weaning came as a bit of shock to me. But aside from the shock, I felt like the sun had burst forth from behind the clouds. This dramatic emotional shift seemed odd to me (although very welcome), because all I heard all the other breastfeeding moms saying on and offline was that they felt sadness and a grieving when they stopped breastfeeding.
Two years later, my friend Colette sent me an article about a rare condition whereby breastfeeding makes the mother feel depressed called D-MER. It is not postpartum depression. D-MER stands for Dysphoric Milk Ejection Reflex, and is a reflex by which the letdown of milk makes the mom feel depressed. Huh, this sounds similar to what I experienced, although not exact. I filed it away for future reference and two years later, revisited it again when I had my second child.
Labor and recovery for my second child went so much better than my first. I had lots of support in postpartum. I hoped that aside from some pesky sleep deprivation that I would just enter into new motherhood again like a beatific angel.
Even though I knew that I was prone to postpartum depression (which exhibits itself mostly as anxiety for me) and I was doing ALL THE THINGS to guard against being anxious and depressed, something was still off. At this point, I didn’t think I had D-MER because I didn’t feel depressed.
Around the clock my baby was cluster feeding (which my husband thought I made up to laugh at how the feedings felt like a cluster f*ck). My doctors and my baby’s docs felt that I had a supply issue. We decided to supplement with formula to give me a break and give the baby some more food. As I got space in between the feedings, I realized that I felt incredibly anxious and agitated every time right as I started breastfeeding my son. Wait a minute! Depression and anxiety are linked.
I realized that feeling anxious while breastfeeding might mean I had D-MER after all. I did a quick web search on D-MER and learned that the symptoms of D-MER can exhibit as depression, agitation, and/or anxiety.
D-MER is a physiological change (not psychological), meaning that it originates in the body and not the mind. Medical professionals think that a drop in dopamine causes women to experience these unpleasant emotions while breastfeeding. The negative reactions can range from mild to severe. They typically fall under the categories of either depression, anxiety or agitation. For me, the symptoms were extreme, almost constant and mostly exhibited as anxiety, antsy-ness, and anger. Women can also feel despondency, apathy, and even aggression.
In addition to emotional responses, women often feel symptoms in the stomach, like a dull ache in the stomach or mild nausea. For most women (though not me), the feelings diminish after the milk letdown, which means anywhere from 90-120 seconds after initiating breastfeeding, the mom feels better. My emotions did not dissipate after the initial letdown and continued as long as I was in the act of breastfeeding.
What to Do if You Think You Have D-MER
If you feel you might have D-MER or know a mom who this sounds like, please talk to your doctor, midwife, or lactation consultant. Awareness about D-MER is growing, but it is nowhere near in the public consciousness like postpartum depression is. Please talk to someone because getting help and support is crucial.
D-MER can be treated via three main methods: medication, lifestyle changes (like eating a diet rich in foods with high dopamine levels), and/or support and counseling. Many mothers chose a combination of these three. Similar to other health concerns, it might take some testing until you find the right combination of factors to help you. You can join a support group.
I decided to stop breastfeeding completely because I knew from child #1 that ceasing breastfeeding would probably fix the issue. Same as the first time I weaned, within a few days I felt abso-flipping-lutely incredible! Friends exclaimed to me, “You are glowing! I can’t believe you have a three-month-old. You look positively radiant!”
Many women with D-MER may chose to try a different approach to address this condition. Because I was feeling so low, I wasn’t willing to troubleshoot any longer to try to fix the issue (not to mention I had been doing the supplements, exercise, and healthy food route that I normally take to address my anxiety). I wanted to do something to immediately improve my situation, because my personal relationships were definitely suffering from my bitchy attitude.
I believe that by being true to myself and my mental health, I’m being true to the type of mom I want to be, whether or not I’m adhering to the norms of natural parenting or not.
I encourage you to decide that you are allowed to put aside cultural conditioning and the expectations of yourself or others — and just be the type of mom that is best for you to be. Because I don’t want to sacrifice myself to serve my children (my stomach and pelvic floor were sacrifice enough!). When we can commit to honor being grateful and accepting of who we truly are now, then we can even better serve and provide for our children.
Here’s to moms rocking it by caring for ourselves and our mental health first.