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You’re not crazy, mama: This “rare” breastfeeding condition isn’t uncommon



Anna O'Neil - published on 10/05/19

If you know about Dysphoric Milk Ejection Reflex (DMER), then you can make it through a difficult time.

I’ve you’ve ever even heard of Dysphoric Milk Ejection Reflex (DMER), then you already have a head start on a lot of certified lactation consultants. The head Lactation Consultant at a hospital where I’d given birth told me that in her many years there, I was the first woman to call her with the condition. 

Wow, I thought. DMER must be insanely rare. 

DMER has only had a name since 2007, when mother and lactation consultant Alia Macrina Heise identified the condition and started raising awareness. There is not yet much hard data about what causes it, or how you can ease the symptoms.

People with DMER feel a wave of anxiety, agitation, or depression, just prior to their milk letdown reflex. A woman might feel it when she’s nursing or pumping, or spontaneously throughout the day, as her body replenishes its supply. It comes on suddenly, and lasts less than five minutes. I used to be able to tell, just by the sense of dread and depression I was feeling, that in 45 seconds, my milk would come in — and I was always right.

My mother had this condition, and so did her mother, but neither of them ever knew what to call it or how common it was.

Well, they finally did a study to determine how many breastfeeding women might have this condition. Although the study had plenty of its own limitations, including a relatively small sample size of 164 mothers, they found that more than 9% of the women they questioned at their first postpartum checkup were experiencing DMER. 

For context, about 10% of breastfeeding women experience mastitis. Everyone’s heard about mastitis. Every article I’ve ever read about breastfeeding complications talks about what it might look like, and what can be done for it. Mastitis is a big problem, because if you get it too frequently, it can interfere with your breastfeeding relationship.

I was looking at these numbers, and my heart just broke. I had DMER for a few months before I discovered that I wasn’t crazy, that I wasn’t imagining the symptoms, and that they had a name. It was months before I realized I wasn’t alone in a confusing, frightening experience. Months before I learned that those feelings didn’t mean I was a bad mother, or a bad person, or that I didn’t love my second baby as much as I’d loved my first.

I carried that burden around for so long, because how would I have put those feelings into words? How can we, when all we hear about the postpartum time is that it’s an unpredictable time characterized by “hormones,” and we need to just accept that?

Maybe as many as 10% of breastfeeding moms are living life feeling totally alone, because nobody ever told them that what they are going through is not all that unusual. Who could say how many women aren’t able to continue breastfeeding, and feel like they’ve failed, all because they couldn’t put into words the intense feelings of dread, of anger, or sadness, every time they sat down to feed their babies? 

When mothers do manage to describe the condition to their doctors, it’s often misdiagnosed as postpartum depression, but the prescribed antidepressants that are offered don’t help, because SSRIs don’t target the actual problem. 

We need to tell more moms about the possibility of this condition — but more than that, we need to tell moms to trust themselves. If you’re feeling “off,” please don’t be so quick to blame yourself. If something doesn’t feel right, it’s not a sign that you’re a bad mother. If you feel that you’re totally alone in what you’re going through, don’t let that stop you from googling everything you can think of, and reaching out to every mom and medical professional you know. 

Especially postpartum, try to approach your experiences with acceptance and non-judgment — because if you have DMER, you’re not crazy, you’re not alone, and what you’re feeling is real and physical. And a little education and support might be all you need to make it through this difficult time.


Read more:
Why you should disregard comments about your pregnancy weight


Read more:
A letter of encouragement to all breastfeeding mothers

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