For many new mothers, the oxytocin rush that comes with breastfeeding is just short of heaven. But when you're dealing with a little-known condition called DMER, milk letdown is anything but short of torture.
I've only encountered a few women with this medical condition, but let's just say that this lactation-related mood disorder is far from a minor inconvenience. DMER stands for Dysphoric Milk Ejection Reflex, whose hallmark symptom is a sudden, brief onset of hormone-controlled depressive feelings associated with the breast milk ejection reflex.
Dysphoria describes an uncomfortable mood that may encompass sadness, anxiety, irritability, and/or restlessness. Many moms describe it as intense baby blues at the point of letdown. Imagine these symptoms coming every time you breastfeed!
Depending on the severity of each DMER case, some women only experience dysphoria during the first letdown or they may continue feeling these symptoms with all subsequent letdowns in a feeding. Others feel the effects of DMER when pumping, too, but not everyone.
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DMER has nothing to do with nipple pain or what a mom is thinking. The dysphoric symptoms are wholly related to a physical process and happen regardless of whatever feelings an affected mom might have toward how breastfeeding is going, her baby, upcoming separation due to work, irritability toward low milk supply, fear of nipple pain, or any of the other myriad parts of nursing that aren't always pleasant.
The mood change with DMER only happens during letdown, usually starting immediately before the milk ejection reflex has occured and lasting for about 30 seconds to 2 minutes. So its short-lived, but don't let that fool you into thinking this is a minor thing. The dread that women who suffer with DMER have toward these negative feelings can be just as scary as trying to nurse with cracked and bleeding nipples. It may be uncomfortable for only a short time, but it is REALLY uncomfortable!
And depending on the severity, DMER can make breastfeeding such an unpleasant experience that the affected moms feel there's no other alternative than to avoid it.
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DMER is a very newly recognized condition, and as such, resources are very limited. This includes finding professionals to help treat it. Lactation helpers should always refer clients with DMER to a lactation consultant, who will refer onto a professional who treats mood disorders. Even then, treatment consists of trial and error, meaning that relief may not be quick and quiet.
However, it's important that moms and breastfeeding helpers, professionals, family, and friends understand that DMER is not a psychological reaction to breastfeeding -- she may love it or hate it -- but a biological response to the letdown process. DMER is not part of postpartum depression or another mood disorder. The condition is also present right from the start and does not develop later, such as when nursing toddlers or while pregnant.
This is far from a "its all in her head" medical condition, and she can't talk herself out of it. It's real, and it can be serious. But hopefully with getting more awareness out there about DMER, moms who deal with it will be more encouraged to talk about it and know they're not alone. And then professionals and researchers will be more motivated to find treatments that work so that these moms are able to breastfeed in peace.
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