What Is Dysphoric Milk Ejection Reflex?

Last Updated: January 5, 2023
Liesel Teen, RN-BSN

By Liesel Teen

BSN, RN, Practicing Labor and Delivery Nurse

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A big THANKS to Rachel from Soul Pioneer for her guest post about her challenges with Dysphoric Milk Ejection Reflex!

Here she discusses what Dysphoric Milk Ejection Reflex is, signs and symptoms, and what you can do to cope with this challenging condition.

Follow @mommy.labornurse on Instagram to join our community of over 640k for education, tips, and solidarity on all things pregnancy, birth, and postpartum!

What Is Dysphoric Milk Ejection Reflex?

I have a rare(ish) condition called D-MER (Dysphoric Milk Ejection Reflex). As time goes on and knowledge grows, I think we’ll determine it’s not so rare. But we don’t know much about this condition and no scientific studies have been completed yet.

What we do know is that some women experience a physiological change that occurs while breastfeeding that brings up negative emotions. This can be despondency, depression, anxiety, agitation and even aggression.

In addition to emotional responses, women usually have physical symptoms like dull ache in the stomach, mild nausea, antsy-ness, etc. Medical professionals think that a drop in dopamine causes these unpleasant emotions.   

I have just been through this. I’m a natural-living, earthy-mom who willingly weaned at 2 months. And although it initially felt like a betrayal to my vision of how I want to be a mother, it turned out to be the best thing I could do for myself.

Now, this isn’t like the time I was a vegetarian who ate bacon. That was a hypocritical time for me, but delicious nonetheless. No, I made this choice to get a grip on my budding postpartum anxiety. It’s so important to support who you can best be- I help moms do this and reclaim their happiness.

Related Reading: What Formula Is Best For My Baby?

D-MER signs/symptoms

I didn’t know that had D-MER until my second child. With my first, I simply assumed that I had postpartum depression. And yet, three days after I weaned my first child, I felt incredible.

Abso-flipping-lutely incredible. Walking on sunshine incredible. In contrast, all the other breastfeeding moms I knew were feeling sadness, deflation, and even mild grieving from weaning. And here I was jumping out of bed every morning, cooking pancakes on a weekday like it was Sunday morning. 

The next year a friend sent me an article about D-MER. I mentally filed this away, thinking that it didn’t sound exactly like me, but very similar and that I should remember it for when I became a mother again.

Two years later, I was at my six-week postpartum appointment with my second child. My nurse and midwife looked at me with serious expressions. “The fact that you’re still not sleeping well, even when the baby sleeps is not good. We’re concerned with how you’re handling postpartum.”

“Isn’t this how everyone handles it?” I shook my head. It was so hard.

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It may look similar to postpartum anxiety

I felt that I was doing everything in my power to make it as good as it could be. But there’s no doubt that this time is a challenging one. Who enjoys this? And yet, I’m typically the person who doesn’t complain much and finds the silver lining in the dark.

The midwife asked if I might have D-MER. I shook my head no because I didn’t actually feel depressed when I was breastfeeding. I didn’t feel depressed at all, just agitated, occasionally anxious, and annoyed with everyone.

I thought I had the beginnings of postpartum anxiety and was doing the best I could to treat it. I was exercising often, taking my supplements, connecting with loved ones, sleeping as much as possible with a baby around.

But still, I couldn’t shake the anxious tone that colored my days. If you are trying to improve your life through relieving anxiety or reclaiming happiness, you can sign up for the guide below that details an effective process.

When I started supplementing I could see a pattern in when my symptoms flared

Because I had a milk supply issue, we decided I was going to do 50/50 breastfeeding/formula. This would give my baby more food and allow me to get a break to get some rest while someone else fed the baby.

My baby was fond of cluster feeding all day long, and so one feeding bled into another constantly. When I moved to 50/50 feeding I was able to get some spaces between breastfeeding sessions.

Once I got some space, I noticed that my anxiety and a sick feeling in my stomach arose every time I started nursing. The more I began to track my symptoms, the clearer it became.

Every feeding brought on feelings of anxiety, desperation, and the unsettling desire to flee. My symptoms also became worse over the course of the day with night feedings being the most unsettling.

Related Reading: How and When To Stop Breastfeeding Your Baby

What to do if you think you have D-MER?

Treatment for this condition typically falls under 3 categories:

  1. Get support
  2. Eat a diet to raise your dopamine
  3. Take medication like Wellbutrin to control your dopamine levels.

I joined a Facebook group for D-MER for support and that made a huge difference. Here are some approaches to take.

Talk to medical professionals

If you think that you could have DMER or know someone who might, please talk to your doctor, midwife, or lactation consultant. Even if they have never heard of this condition (because it seems that awareness is growing, but some information travels slowly), be the one to bring it up. Getting help and support is critical.

Consider weaning and leave the guilt behind

I decided to stop breastfeeding because I wasn’t willing to risk my mental health or my personal relationships, which were definitely suffering from my bitchy attitude.

Same as the first time I weaned, within a few days, I felt amazing. Friends commented, “I can’t believe you’re 3 months postpartum. You look radiant! You are positively glowing!”

Here I was veering from the mainstream advice of ‘Breast is best,’ and my own desire to pursue the natural parenting approach. And yet, I knew that being true to myself and my mental health, this was the best way for me to be true to my vision of the type of mom I wanted to be.

By honoring my desire to care for myself at the deepest level, I am being the best mom that I can be. I had to fight against cultural conditioning- and perhaps instinctual wiring too- that says that I must sacrifice myself to serve my children and instead chose to honor and support myself and thus BETTER serve myself AND my children. Another way I support other moms is through my free guide- sign up below.

Honor yourself

Whether D-MER, anxiety, or well-meaning, yet misguided friends are your struggles, we’ve all got something that can impact the kind of mom we want to be. I encourage you to be ok with stepping away from your ideal vision of yourself as a mom. Accept who you actually are as a mom and be grateful for the unique woman that you are.  

At my site Soul Pioneer, I encourage moms to follow their inner knowing even when it conflicts with common advice or techniques. If you’d like to learn two tiny tweaks to reclaim your joy and increase your inner wisdom, click the link below to access the bonus guide. Here’s to you letting your light shine.

About the author

Hi, I’m Rachel Strivelli, Empowerment & Joy Coach for moms. I help you reclaim the happiness and excitement for life you used to have before you got swept up in the chaos of feeding, clothing, and housing hungry little people. Learn more about me here.

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Liesel Teen, RN-BSN

Liesel Teen

BSN, RN, Practicing Labor and Delivery Nurse

As a labor and delivery nurse, I’ve spent countless hours with women who felt anxious — even fearful — about giving birth. I want you to know it doesn’t have to be that way for you!

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