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D-MER: When breastfeeding makes you feel crazy

When Dr. Dara first asked me to write about D-MER I was like, “I need to research this. I have NO idea what I’m about to write about.” So I started reading. And the more I read, the more I realized that I had more to add than I thought!

I am a mama of two boys. With my first, breastfeeding was a breeze! I always had more than enough milk and he was always perfectly plump and squishy. We continued until he was 2.5 and I cherished those years. Fast forward to baby boy number two. The moment he first latched I gulped and said, “WOAH!” He was born with a lip and tongue tie which had to be revised by laser and then required bodywork for aftercare to relieve the tensions established in his jaw and neck. Nursing has been a little more trying and his new teeth have been horrible. When he was around two or three months old, I noticed that I started feeling anxious, panicky, and jittery when he first latched. Almost like I’d just downed a big glass of cold brew and hadn’t had any breakfast to go with it. And then it would pass. I thought it was odd, but it didn’t seem like a “big enough” deal to complain about or mention so I pushed the thought of it out of my mind. Or, I tried. But the anxiety and jittery feelings intensified into anger at times; and what about those warm cuddly feelings I was supposed to get? Why wasn’t I gazing joyfully into my baby’s eyes, full of love and affection for my little babe? Instead I was feeling panicky and anxious for what seemed like no reason! “What’s WRONG with me?” I wondered; but I kept all those thoughts to myself.

That Mama/Baby Bond <3

When it comes to breastfeeding we hear mostly about the Joy – the connection, the bond, all those love hormones, and of course the glorious extra calorie burn! We sometimes hear about the struggles – latching, supply, and definitely those tiny little teeth. But one thing you’ve maybe never heard of – I certainly hadn’t – is D-MER: Dysphoric Milk Ejection Reflex.

What is D-MER?
Simply, you get a feeling of dysphoria (a range of unpleasant or uncomfortable emotions) just before or as your milk “ejects” (known more commonly as a let down) and it is a reflex – meaning there is absolutely nothing you can do to control it.

The dysphoria of D-MER feels different for all women who experience it. For some the dysphoria might manifest as a bad mood, sadness, or depression, for others (like myself) it might come on as anxiety, irritability, restlessness, or even anger.

What causes D-MER?
A “let-down” is triggered by a rise in prolactin – also known as luteotropic hormone, a protein associated with all things mothering in mammals. However, in order for prolactin to rise, dopamine must temporarily decrease; normally dopamine acts as an inhibitor to prolactin. Authors of a preliminary study suggest that a larger than usual, abrupt drop in dopamine may occur when milk release is triggered, resulting in a brief dopamine deficit for D-MER affected women, causing a slew of dysphoric feelings.

d-mer.org clarifies a few things about D-MER

CLARIFYING what D-MER is NOT:
D-MER is NOT a psychological response to breastfeeding.
D-MER is NOT nausea with letdown or any other isolated physical manifestation.
D-MER is NOT postpartum depression or a postpartum mood disorder.
D-MER is NOT a general dislike of breastfeeding.
D-MER is NOT the “breastfeeding aversion” that can happen to some mothers when nursing while pregnant or when nursing older toddlers.

Although just a small percentage of women experience these symptoms, you can probably ask around in your Facebook mommy groups or other social networks and find at least one or two mums who can give you a rundown of her own experience with D-MER.

For many moms with mild to moderate dysphoria, just knowing that THIS IS A REAL THING – that YOU’RE NOT GOING CRAZY! – is enough to help get through the dysphoria. For most moms, it is relatively short lived, lasting only 3-6 months.

Therefore, Education about D-MER is a logical first step.

Tracking your episodes may also be helpful. How often do you have them? What were you doing before the feeding or let down? Does pumping effect you the same as feeding at the breast? Things like stress or dehydration can also aggravate the condition, so note these in your log as well.

For some moms, the dysphoria is significantly more intense. But THERE IS TREATMENT, both natural and medical. These might include:

CranioSacral or Chiropractic Therapy
Talk to your care provider about a hormonal balancing therapy. Most providers know ways to help restore the normal function of the mesolimbic system to help your body release dopamine.
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Flower essences
Flower essences are herbal infusions or decoctions, made from the flowering part of the plant, which uniquely address emotional and mental aspects of wellness.

Rescue Remedy is a popular and readily available option (you can find it at most drug stores or natural grocers) and can help ease the emotional symptoms associated with dysphoria. Or you can have a special bouquet made specifically for your personal emotional symptoms by a trained naturopath.

Diet
Dopamine is made from the amino acids Tyrosine and Phenylalanine. Foods that increase these amino acids are eggs, turkey, chicken, pork, whole milk dairy, granola, oats, wheat germ, dark chocolate, fish, peanuts, almonds, avocados, bananas, lima beans, pumpkin seeds, and sesame seeds. Young green Fava Beans contain 50-100 grams levodopa in just 3 ounces of canned beans, which could mean significant improvement for a mother with D-MER.

Supplements
DHA is the Omega 3 that has the most effect on dopamine; it may increase endogenous dopamine levels by as much as 40-75%.

Music Therapy
Research in both music therapy and in neuroscience have shown that certain types of music stimulate the production of dopamine. Something with a definite rhythm but not a commanding one. Reggae (Cas Haley, Bob Marley, Buju Banton) Latin (Ozomatli, Los Lobos, Ricky Martin) Jazz (Micheal Buble, Harry Connick Jr, Frank Sinatra) would be  appropriate choices.

Herbs
Herbs such as Rhodiola or Golden Root, Evening Primrose Oil, or Ginkgo have been used to treat D-MER as a method of increasing dopamine (ALWAYS consult with your care provider first!)

Counseling or Therapy
D-MER is not a psychological issue, but that doesn’t mean that a mother won’t find some healing through talking about it. Having someone to talk to (professional or friend) about how you feel, your frustrations about not having a “normal” nursing experience, your fears of not being able to get through it, etc. can be very freeing, healing and helpful thing.

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If you think you might have experienced D-MER in the past, or if you can relate to these symptoms, tell us about it in the comments below! Don’t be afraid to talk to other mamas about your experiences, you may find that others are going through the same thing as you. <3

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