Diane Wiessinger has posted a couple times in recent months on Dysphoric Milk Ejection Reflex (D-MER), on the website about it, www.d-mer.org and about the video on youtube. I'm the woman she's been working with who gave this unusual breastfeeding problem a name and web presence. Usually a Lactnet lurker, I finally want to "speak up" because ***we've found a way to correct it***!
We defined D-MER as a condition affecting lactating women that is characterized by a brief surge of dysphoria, or negative emotions that peak before the milk ejection reflex, or letdown, and then dissipate quickly after the milk release. I've had online contact with nearing 200 other women now, who have this same issue.
The emotions mothers feel during D-MER fall along a spectrum ranging from dread to anxiety or anger. These emotions last anywhere from a few moments to 30-90 seconds, before every milk release. This leaves a mother confused as to why she is feeling these things while she nurses her baby. It also causes an exhausting emotional cycle, as mothers with D-MER generally feel just fine before and after they experience a D-MER.
I've been working with lactation consultants and other medical professionals to figure out the mechanism and treatment of D-MER and the evidence is pointing to an inappropriate drop in dopamine upon initiation of the milk ejection reflex. A dopamine increasing drug has been effective in treating my D-MER, and we've come up with several other possible drugs that also would probably work.
I'm not sure it's okay to name the drug on lactnet, since we have a sample size of one (it's perfectly mainstream and common and available by prescription) but if anyone wants to e-mail me privately, I'll be happy to tell you more about what's working for me and why we think it is. (If it's OK to publicly post that kind of info, somebody be sure to let me know, too)
A surprising number of breastfeeding mothers are affected by this phenomenon, and yet each and every one that I've been in touch with was silent about her feelings, thinking she was the only one who felt such horrific emotions while nursing her baby. Some professionals have gone as far as to call it "breastfeeding's best kept secret." But it's time to shed some light on Dysphoric Milk Ejection Reflex and let mothers know they are not alone and there are - finally - treatment options.
This is not some kind of abuse flashback. It follows the same pattern as any other reflex. You can tell yourself your knee isn't going to jerk when you hit it... but it does, just as much the hundredth time as it does the first, and it stops as soon as the stimulus stops. The D-MER reflex involves e-motion rather than motion because a hormone shift is triggered instead of having a muscle nerve triggered, that's all. Trust me. We've been up down and sideways on this issue, and it's clearly hormonal, not psychological. Within 24 hours on a dopamine-raising drug, I had one MER without the D, and within a week the emotional "drop" was gone. I'm finally able to nurse my one-year old just the way I nursed my two older children.
We'll be writing this up. In the meantime, you'll do your clients a **huge** service if you'll just mention to them that if they feel abruptly miserable and then abruptly fine while nursing their baby, they're not alone, it's not postpartum depression, and there's even a website with information on it, at www.d-mer.org
(but I, as well as Diane I am sure, would be happy to answer questions too!)
Genuinely,
Alia Macrina Heise, CLC, PCD(DONA)
www.d-mer.org
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