Imagine settling down into your favorite rocker, a big glass of water at the ready, getting your baby situated, and as you feel the sharp pull of her latch and your milk letting down a wave of utter sadness and despair washes over you. Imagine this happened every time you nursed your baby and every time your milk let down. It might make nursing intolerable for you. It might make you feel like a horrible person, wondering why you feel so sad when you nurse your baby. This is what it is like for women with Dysphoric Milk Ejection Reflex (D-MER).
D-MER is not a very well understood condition. But what is clear is that it is a physiological response to milk letdown and not a psychological response to breastfeeding. In the little research that has been done, it appears that an inappropriate drop in dopamine levels during milk letdown causes the dysphoric feelings. Dopamine is a hormone involved in our reward-motivated behavior: it is what gives us a little rush of good feelings when we win something. Dopamine usually drops while nursing so that prolactin – the hormone that causes milk letdown – can rise. But for people who experience D-MER, dopamine drops too much, too fast.
Just as a hammer tapping below your knee causes your leg to bounce unconsciously, there is nothing a woman can do about the reflex causing her to feel sad. However, depending on the severity of her condition, just knowing that it is not a problem with her can be extremely helpful. Those with severe D-MER may need a prescription for dopamine-enhancing drugs to help. As with many aspects of parenting, a woman can feel ashamed or embarrassed by these feelings and not want to share with her care providers or friends that she is experiencing this. But it is important for women to understand that it is not some failing on their part; it just happens to some women and there is nothing to be ashamed about. For more information, check out d-mer.org.