Breastfeeding (or chestfeeding) is often depicted as a warm, happy, and fulfilling experience — but not everyone finds it that way.
In fact, for some parents, breastfeeding fills them with intensely negative feelings. When these negative feelings correspond with your milk letting down during a feeding, you might be going through something called dysphoric milk ejection reflex, or D-MER.
Parents who have dysphoric milk ejection reflex usually feel a rush of negative, depressing feelings right before their milk lets down. Often, parents don’t know what’s happening, are quick to blame themselves for feeling this way, and may feel that they’re the only ones going through this.
If you’re having symptoms of dysphoric milk ejection reflex, first and foremost, know this: You’re not alone.
Although research is still evolving, one study found that as many as 9 percent of breastfeeding women experience dysphoric milk ejection. What’s more, researchers are still learning about why some parents experience dysphoric milk ejection and how to treat it.
Dysphoric milk ejection reflex is described as a flood of negative emotions during breastfeeding that corresponds specifically to milk letdown (milk ejection).
D-MER is thought to be a physiological reaction and not a psychological reaction. In other words, dysphoric milk ejection is not “all in your head.” It’s a real medical condition, and nursing parents who have it didn’t do anything to cause it.
D-MER usually includes feelings of depression, anger, and anxiety. Everyone experiences it a little differently, but the main characteristics are negative, unwanted feelings.
Some of the other feelings described by breastfeeding parents
- hopelessness
- feeling homesick or wistful
- feeling panic or paranoia
- self-loathing
- feelings of dread or a sense of impending doom
- anger or irritability
- thoughts of suicide
The symptoms of dysphoric milk ejection reflex can range from mild to severe. They usually begin within a few minutes of breastfeeding, and can last up to 10 minutes.
Some breastfeeding parents are able to manage the feelings, especially once they understand what’s happening. However, for some parents, the feelings are so intense and unmanageable that they feel no choice but to wean.
D-MER shares many of the same symptoms as postpartum depression and postpartum anxiety. However, the symptoms of D-MER are limited to the act of breastfeeding. Once the milk lets down and breastfeeding is underway for a few minutes, symptoms usually disappear.
On the other hand, parents who experience a postpartum mood disorder often have these feelings most of the time, and find that their emotional state interferes with their ability to function on a day-to-day basis, or properly care for their baby.
Although D-MER can be very intense, these feelings go away after the feeding itself.
But here’s a hard truth: It’s possible to experience a postpartum mood disorder and dysphoric milk ejection reflex at the same time.
Parents who have both may have trouble understanding what’s happening, and may find it hard to pinpoint the distinct symptoms of dysphoric milk ejection reflex.
If you’re having symptoms of a postpartum mood disorder — which is characterized by 2 or more weeks of overwhelming shifts in mood, an inability to concentrate or complete daily tasks, and feelings of guilt and hopelessness — don’t hesitate to reach out to your doctor or midwife.
Just as the name suggests, dysphoric milk ejection is considered a “reflex” — a physiological and hormonal reaction to the act of breastfeeding.
There’s no agreed upon causes as of now, but the
Other researchers theorize that it occurs because of an exaggerated “fight or flight” response triggered by the oxytocin that’s released during letdown. This response may be further aggravated by stress and trauma experienced by the breastfeeding parent.
Dysphoric milk ejection reflex isn’t an official diagnosis as of now, and it’s not considered a postpartum mood disorder.
There are no diagnostic tests to determine if you have it. Usually, your symptoms and symptom occurrence will tell you if you’re experiencing it.
If you think you might have D-MER, talk with your doctor or midwife. You can also speak with a lactation consultant, who may have more experience treating the syndrome.
There are currently no approved medications to treat dysphoric milk ejection reflex, but there are some coping techniques that many parents find helpful.
Often, just learning that you’re experiencing D-MER makes it easier to keep what’s happening in perspective and cope with the experience.
Clinicians who believe that stress and trauma exacerbate dysphoric milk ejection reflex recommend de-stressing techniques to help manage the syndrome. Usually these things are done while you’re feeding your baby.
Techniques include:
- being skin-to-skin with your baby
- getting a massage
- listening to relaxing music
- putting a hot pack around your shoulders
- soaking your feet in warm water
- practicing mindfulness and meditation techniques to decrease negative thoughts
- using breathing techniques to relax the body and mind
- surrounding yourself with kind, supportive helpers
Some parents have found improvement while taking Wellbutrin (bupropion). But it’s not approved to treat D-MER. If you’re interested in this as a possible treatment, talk with your doctor.
Dysphoric milk ejection reflex is usually most pronounced in the early weeks of breastfeeding.
Many parents notice that instances of it decrease as their baby gets older. For some, there’s a decrease at the 3-month mark. Others only get relief when their baby is older and their milk supply begins to decrease.
Still, some parents report that weaning is the only way their symptoms disappear.
Support is key when you’re dealing with D-MER, and some researchers believe that getting proper support can make the symptoms less intense.
Understanding what’s happening to you — and knowing there are others going through it too! — can help you manage symptoms better.
Reaching out to a lactation consultant or breastfeeding counselor is a great first step.
Online support groups are great ways to connect with other parents experiencing dysphoric milk ejection reflex, too. For example, you may consider joining the Facebook group started by Alia Macrina Heise, a parent and lactation consultant who’s considered an authority on D-MER and first brought it to light in 2007.
If you’re having feelings of sadness, depression, anxiety, or anger while breastfeeding or chestfeeding, you aren’t the only one. And you did absolutely nothing wrong.
Dysphoric milk ejection reflex isn’t caused by bad parenting, something you’re eating, or something that’s wrong with your body.
D-MER is simply a physiological response that some parents experience while nursing. Most people get some relief as their babies get older. In the meantime, there are some techniques you can use to make the experience less intense.
If you need help understanding or managing your symptoms — and especially if the feelings are severe or making you feel out of control — reach out to your doctor, your midwife, or a lactation consultant for support.
