Understanding D-MER: Navigating Negative Emotions During Breastfeeding

Breastfeeding/nursing can be a wonderful bonding experience, but for some parents, it comes with unexpected emotional challenges. Dysphoric milk ejection reflex (D-MER) is one such condition that can catch you off guard, leading to sudden waves of negative emotions during milk let-down. 

What is Dysphoric Milk Ejection Reflex (D-MER)?

“D-MER is a physiological response involving the abrupt onset of negative emotions during breastfeeding,” said Debbie Frye, BSN RN, an International Board-Certified Lactation Consultant at Inspira Medical Center Mullica Hill. “These emotions can range from sadness and anxiety to irritability and anger, all happening just before or during the release of breast milk.”

The release of milk during breastfeeding is known as let-down. This reflex gets triggered when your baby starts nursing, causing the hormone oxytocin to signal the milk ducts to release your stored milk. For many, let-down feels like a tingling or warmth in the breasts, but for those experiencing D-MER, this process can bring a wave of negative emotions linked to hormonal changes rather than physical sensations.

“D-MER affects a small number of breastfeeding parents and may get triggered by a rapid drop in dopamine, a chemical in the brain associated with pleasure and mood regulation, during milk ejection,” said Frye. “This drop can cause feelings of unease or dissatisfaction, known as dysphoria, which can make breastfeeding difficult, especially when these feelings are misunderstood or unrecognized.”

Potential causes and how to recognize D-MER

While the exact cause of D-MER is unknown, hormonal shifts during breastfeeding may play a key role. Unlike mood disorders like postpartum depression or anxiety, D-MER requires a unique care approach because it is linked directly to milk let-down and usually subsides within a few minutes. 

Recognizing D-MER symptoms early on is vital for managing this condition effectively. If you experience an unexpected flood of negative emotions during breastfeeding, particularly at the moment of milk ejection, it could be D-MER. These complicated emotions do not reflect your true feelings toward your baby or your breastfeeding journey.

Finding support and managing D-MER

“Navigating D-MER can be emotionally challenging, but it doesn’t have to derail your breastfeeding journey,” said Frye. “The first steps are acknowledging your experience and seeking support from those who understand this condition.” Lactation consultants can offer practical solutions, including strategies to manage your milk ejection reflex as well as emotional support to help you stay on track with your breastfeeding goals.

Other approaches include mindfulness techniques, lifestyle adjustments or, in some cases, medical interventions if your symptoms are severe. Most importantly, know that you are not alone and help is available. The emotional toll of D-MER can feel isolating, but with the right support, you can continue to nurture your baby while also taking care of your mental and emotional well-being.

Continuing a positive breastfeeding journey

By addressing D-MER’s emotional toll early on and seeking guidance from lactation consultants, you can continue your breastfeeding journey with greater confidence and peace of mind. Understanding that D-MER is a biological response, not a reflection of your parenting abilities or feelings toward your baby, can also bring comfort.

If you or someone you know is struggling with D-MER or any breastfeeding concerns, talk to a lactation consultant and your OB/GYN for support. Together, they can help you navigate this temporary yet challenging condition, ensuring a more positive experience for you and your baby.

Learn more about breastfeeding assistance options at Inspira.