What is D-MER??
- bbdoulamt
- 19 hours ago
- 4 min read
D-MER or Dysphoric Milk Ejection Reflex is when a lactating mother experiences negative feelings with her let-down reflex. These negative feelings can last up to a couple minutes. They usually subside as her milk starts to flow. Some mothers experiencing D-MER only experience it during the first let-down of a feeding. Others experience it with every let-down, and some even when their let-down reflex is triggered between feedings.
D: Dysphoric (Dysphoria: A state of feeling very unhappy, uneasy, or dissatisfied (Mirriam-Webster))
MER: Milk Ejection Reflex (AKA Let-Down Reflex)
D-MER is an understudied breastfeeding phenomenon. D-MER was first identified in 2007 by Alia Macrina Heise who went on to educate and bring awareness to this issue. (You can check out her website at www.d-mer.org). It is thought that D-MER affects about 9% of mothers.
What does D-MER feel like?
Words women have used to describe what they feel with D-MER include (but are not limited to):
Sadness
Anxiousness
Hollow feeling in their stomach
Emotional upset
Angst
Irritability
D-MER symptoms range from mild to severe. Most mothers find that their D-MER symptoms get better as their baby gets older. Some say their symptoms disappear or greatly decrease by 3 months. Others say their symptoms didn’t disappear completely until their baby was weaned.
What Causes D-MER?
The theory is that D-MER is a result of the hormone dopamine dropping abruptly, causing a negative affect on mood and emotions. When a mother nurses her baby, her body releases prolactin and oxytocin. Prolactin is the hormone necessary for milk production, oxytocin is responsible for triggering the MER or Milk Ejection Reflex. Dopamine inhibits prolactin so it is necessary for it’s levels to decrease. In most cases dopamine levels decrease without the mother ever realizing they did. However, with D-MER, dopamine levels do not properly decrease causing an instant wave of negative feelings and emotions. This lasts until the dopamine levels stabilize again as prolactin levels rise.
D-MER is not something a mother can control any more than any other reflex. It’s just that: a reflex.
What is D-MER not?
D-MER is not a Postpartum Mood or Anxiety Disorder. Mothers struggling with PMADs may also struggle with D-MER but they are not in the same category of Postpartum struggles. The relationship between PMADs and breastfeeding can get complicated. “For example, breastfeeding is less prevalent among mothers with depression, it might help prevent postpartum depression, but it is still related to postpartum depression in some cases.” (PubMed Central) It is important to note that D-MER is not classified as a Postpartum Mood or Anxiety Disorder.
How are D-MER Symptoms Alleviated?
There are several helpful tools to help alleviate D-MER symptoms:
Education: Sometimes just knowing that you are dealing with something real that has a name can help you cope with the symptoms. You are not the only mama struggling with this.
Lifestyle Changes: Tracking what makes the symptoms worse (i.e. caffeine, stress, being dehydrated). Then try to avoid these things. Also tracking what seems to help alleviate symptoms (i.e. getting better rest, staying hydrated etc.) Then try to do these things.
Relaxation Techniques: Listening to calming music, deep breathing or other relaxation techniques may help reduce stress or anxiety caused by D-MER.
Increase Skin-to-Skin Contact: Skin-to-skin contact with your baby can help you relax and is always good for bonding with your baby!
Professional Help: Sometimes D-MER symptoms are severe, and a mother may feel the need to wean her baby because of the intensity of the symptoms. In these cases, consulting with a medical professional about medication or herbal remedies may prove helpful.
Distraction: Distraction, especially when you normally experience D-MER symptoms can help keep your mind off the negative feelings and help you cope through them.
Seek Support. Whether that’s from your husband, mom, best friend, a biblical counselor, or other moms struggling with D-MER as well. They can encourage you through encouraging words, prayer, and/or helping with chores around the house so you can rest or take time for yourself. When you are facing something challenging, having people to support you is super important!
Final Thoughts…
If you are a mama struggling with D-MER, you are not alone! You will not struggle with it forever and it does not mean you can’t still enjoy nursing your baby. Most moms who have walked this path before you have reported that symptoms lessen as their baby gets older. For now, seek out help and support. You don’t have to walk this path alone. Lastly, don’t forget to seek the Lord’s help through this. He will walk with you through every moment of your struggle with D-MER. He loves you and He hears you. He is faithful.
In my distress I called upon the LORD; to my God I cried for help. From his temple he heard my voice, and my cry to him reached his ears. ~Psalm 18:6
God is our refuge and strength, a very present help in trouble. ~Psalm 46:1
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Catharine is a birth doula and a stay-home/homeschool mama of 5. She has a passion for serving women on their motherhood journey. Catharine believes the memories surrounding birth are some of the most precious memories in a woman's life. How she is cared for during this precious and vulnerable time will make a big impact on her life. Each birth is unique and Catharine seeks to provide education and support so each mother can make informed decisions that are best for her. Her desire is that each mother can look back on her birth knowing she was loved and well cared for.
If you are looking for doula support for your birth journey please reach out!
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Disclaimer: The information on this website is intended solely for educational purposes. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always discuss any questions or concerns with your provider.
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