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Breastfeeding is supposed to be one big joy-fest, where babies and moms bond. It’s supposed to be the best gift moms can give their newborns. But the truth is that for some, breastfeeding brings uncontrollable negative feelings — and can be the polar opposite of a positive experience — because of a condition known as D-MER.

We always hear the good things about breastfeeding: how breast is best for baby, how it benefits in so many ways, how it can speed that weight loss and help you bond with your baby. But what we don’t hear about is the hard parts of breastfeeding. It can be painful. It’s hard. And for some women, it leads to intense sadness during letdown.

What? You never heard that last one before? It’s true, and the rarely discussed reality for some women is now recognized in the medical community.

Dysphoric Milk Ejection Reflex, or D-MER, is a condition where women feel negative emotions or sadness just before their milk begins to release during breastfeeding. It continues for no more than just a few minutes. And for the moms who have this condition, breastfeeding can be a dreaded experience.

What is it?

Still in relatively early stages of research, there’s a lot more to be discovered about D-MER — but we do know that it impacts only some breastfeeding moms. It’s not a form of postpartum depression, though. According to D-Mer.org, the D-MER condition is believed to be connected to an unusual drop in dopamine levels (often called the “feel good hormone”) during milk letdown. The feelings associated with D-MER can include hopelessness, apprehension, helplessness, and pessimism, among others. Also, it’s a physiological condition, not a psychological one. The symptoms come and go, tied to when a mother’s milk lets down.

Three intensities of D-MER have been identified: Mild, Moderate and Severe. It’s largely under-diagnosed or misdiagnosed because the symptoms can sound like depression, but the fact that it comes and goes is a distinctive characteristic. La Leche League has a fantastic explainer that you can find here.

Treatment?

The good news? D-MER appears to be treatable and a treatment is under development. According to the D-MER website, most antidepressants don’t work for the treatment because they are Selective Serotonin Reuptake Inhibitors and don’t treat the specific issues that D-MER-afflicted mothers have. However, the use of Bupropion could alleviate the symptoms. Bupropion is a dopamine reuptake inhibitor. Researchers are also looking to track women who, with their doctors, use this treatment method.

D-MER.org has a wealth of wonderful resources — research articles, handouts, podcast episodes and more — for those experiencing this condition (or just looking to understand it a little bit better).

 

A version of this post was originally published in March 2011

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