D-MER: The Breastfeeding Disorder That Makes You Miserable

by Lea Grover
Originally Published: 
A young mother holding and breastfeeding her baby
claudiodivizia / iStock

A few weeks after bringing my third child home from the hospital, things felt like they were starting to become routine. She hadn’t been a great nurser up until then, and I’d dreaded feeding her, but I was determined to do it. We found a position she liked, and she nursed that way exclusively no matter how sore I was, but we were finally doing it, I thought.

I remember the day everything changed so clearly. It’s burned into my memory forever. It was a Saturday morning. The baby was rocking in her swing. The twins were playing on the carpet. I was reading a book, an amazing luxury. And suddenly, I couldn’t breathe. My vision blurred, a rushing sound filled my ears, and it felt like I my whole body was trembling. I dropped my Kindle and screamed.

My husband rushed to my side while I hyperventilated and cried, with no answer to give as he yelled, “What’s happening? What’s wrong?” And then, as suddenly as quickly as it had come over me, the feeling was gone. I was shaky and weak and confused, my mouth was dry, and I felt like I’d just gotten off the world’s fastest roller coaster, but I was okay. Before I could say any of that, my milk let down.

“I think I had a panic attack,” I said, and then I nursed the baby.

A few hours later, it happened again. I was in the kitchen this time, and I dropped the plate of food in my hands. I didn’t scream this time; instead, I collapsed onto the floor, sobbing. My husband came running again, and again, the feeling passed and the familiar feeling of my milk letting down followed.

By the end of the weekend, I’d had a dozen panic attacks, each lasting only a minute or so, each followed by a letdown. I had no clue what was happening.

It took months for me to learn what was going on. 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. But my supply was fine, and my daughter wouldn’t take a bottle, so I went on nursing.

I was suffering from an incredibly severe case of a condition called D-MER (dysphoric milk ejection reflex).

Most of the time breastfeeding makes people feel happy, and that’s what it should do. What happens in a healthy letdown is this: The lactating brain produces prolactin, which it releases at the same time as oxytocin. Oxytocin usually makes you feel happy and loved, and that helps you bond with the baby. You feel affection and satisfaction and contentment, and most of all, love. It’s a feeling most nursing mothers are familiar with. It’s the feeling I had when I nursed my twins only a few years earlier.

Dopamine inhibits prolactin though. With too much dopamine present, prolactin can’t reach levels high enough to cause a letdown, and that means the lactating brain reduces the amount of dopamine it produces. Low dopamine levels can cause anxiety, confusion, attention deficits, fatigue, and depression. And oxytocin isn’t a one-sided hormone. In levels too high, it can cause fear.

This can start a nasty chemical and emotional spiral. First, the lack of dopamine causes anxiety and confusion. Then, due to high amounts of oxytocin, the brain holds onto this memory, strengthening the panic reaction to those feelings during the next letdown. The drop in dopamine causes anxiety and confusion, now recalling short-term fear memories, and oxytocin causes the ensuing feelings to register deeply in short-term memory, and so on.

Most cases of D-MER are mild: feelings of unease with nursing, of confusion or emotional discomfort. But some, like mine, can be debilitating.

It’s not known how common D-MER is. It has only been medically recognized for a few years, but while research is limited, it’s moving fast. Already, so much more is known about this condition than when I suffered from it in 2012. And the biggest difference is that now there are actually treatments.

When I was suffering, nobody knew if it was safe to prescribe medications for me. Nobody knew if they would help, or why. The best advice medical professionals had to give was, “Now that you know what it is, you don’t have to feel like you’re crazy,” which was nice but did nothing to stop the panic attacks. Their most common advice was, “Stop nursing.”

Feeding my twins had never given me the problems I had with my third, and I couldn’t imagine giving up simply because I was unhappy. For five months, I struggled without having a clue what was wrong with me. I nursed another four months after I had a name for it, but having a name isn’t the same as having a treatment. I thought I had to suffer to give my daughter the best nutrition. I thought that breastfeeding a second time had made me go insane, and I would have to wait out nursing my daughter to regain my sanity.

Now I know D-MER is not a psychiatric disorder. It’s a hormonal imbalance, and one that can be corrected with medication. People suffering from D-MER don’t have to “wait it out. They can get help immediately. They can continue nursing their babies, literally without fear.

If you suffer from D-MER, don’t hesitate to talk to your doctor. As D-MER is still so new in medical literature, your doctor might not know about it yet, but that’s okay. Just because it’s new, that doesn’t mean it’s not real. Bring some articles about D-MER, and tell your doctor to look it up if they don’t know much about it. It’s rising rapidly in visibility, and it’s not nearly as hard to learn about it now as it was back in 2012.

You don’t need to be experiencing severe D-MER, like me, to get help. Nobody should have to feel miserable and confused while feeding their child. Nobody should have to sacrifice their emotional help to do what they believe is best for their child.

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