You've heard this before. A painful breastfeeding experience can push a mom to give it up. But for one nursing mom, the physical pain was not the problem. It was the slew of negative emotions she felt that overwhelmed her.
"To be blunt, breastfeeding made me want to curl up and die," Teagan Gambin-Johnson wrote on her blog, Two Kids Raising Kids. "Not because it was painful (although the first few weeks of engorged, hot boobs and cracked nipples were hell!) but because I suffered D-MER."
Teagan, mom of two from Australia, said she didn't understand why she felt sad when breastfeeding. "Instead of feeling all of those beautiful, loving and bonding emotions, I instantly felt like I had been hit by a truckload of depression," Teagan wrote. When she finally understood what was happening to her, she could only wish her body worked differently and even wished to experience the "normal" struggles of nursing.
What was the "D-MER" that Teagan was experiencing? It stands for Dysphoric Milk Ejection Reflex, a condition where a lactating mother experiences a wave of negative emotions just a few seconds before the release of breast milk or "let down." The dysphoria or negative feelings (it's the opposite of euphoria) can last from 30 seconds to two minutes or longer but not for the whole duration of nursing your baby.
The negative emotions can range from a feeling of sadness to something severe like suicidal thoughts. Nursing moms may notice having fewer symptoms after the first three months after childbirth, but it may persist as long as the mom breastfeeds. The Australian Breastfeeding Association (ABA) lists the many emotions associated with D-MER:
Hollow feelings in the stomach
Something in the pit of the stomach
Sylvia Malabanan, a lactation counselor from L.A.T.C.H Philippines, said D-MER was quite rare. "You can differentiate it from postpartum depression and normal exhaustion. [With D-MER] the feelings coincide very specifically when you are breastfeeding and experiencing milk ejection reflex and not any other time."
Lactation counselor and postpartum doula, Alia Macrina Heise, was perhaps the first to describe the feelings associated with D-MER, which she experienced when she breastfed her third child. In 2011, she and Dianne Weissinger, an International Board Certified Lactation Consultant (IBCLC), did a study that found D-MER may be due to a chemical process that happens in a lactating woman's body.
According to D-MER.org, a website Heise created to spread awareness about the condition, D-MER is a reflex, an automatic response of the body triggered by the sudden shift of hormones. It has been linked to an abrupt and significant drop of the hormone dopamine in the mother's system during breast milk letdown. Furthermore, the organization stated D-MER is not a psychological condition or a mood disorder. A woman may dislike breastfeeding or feel anxious about the challenges that come with it but not have D-MER.
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The good news is you don't have to give up breastfeeding if you think you have D-MER. The first step is to acknowledge you have it. Teagan says it was a relief to know she wasn't crazy.
Second, track and log your episodes: Does it happen when your direct breastfeed and express breast milk? How often or how long? What other things (i.e., stress) trigger your episodes? You might not be able to prevent or stop them from happening, but it can help you anticipate and prepare.
Most of the treatment options concentrate on increasing dopamine levels in the body, but there is little research that proves it is effective. Mild D-MER usually goes away after a few weeks. But severe cases one may need interventions such as:
1. Distraction. Find something to distract you during the start of feedings, such as a book or a conversation. It can be a simple as that.
2. Healthy lifestyle. Exercise naturally increases dopamine levels and receptors in the brain. The ABA states that stress, dehydration, and caffeine may worsen symptoms of D-MER.
3. Diet changes. Foods rich in vitamin B6 and B12 (e.g., chicken, turkey, almonds, oats, dark chocolate, yogurt, bananas) help improve brain functions and increase dopamine activity in the brain. Certified nurse-midwife Penny Lane of Believe Midwifery Services recommends taking nutritional supplements such as DHA, vitamin B6, and amino acids tyrosine and phenylalanine.
4. Herbal supplements. According to Birth Without Fear, Rhodiola or golden root can help increase dopamine naturally in the body. Roseroot, chaste berry, cowhage, and evening primrose oil are said to help increase levels of levodopa, which is converted to dopamine in the body. Ginkgo helps by improving blood circulation in the body.
5. Placenta encapsulation. Doula Irina Otmakhova explains to SmartParenting.com.ph that placenta capsules are said to balance and even increase the production of certain hormones. She says consuming one's placenta may help regulate the drop of dopamine in the body.
6. Acupuncture. Waconia Women's Health in Minnesota lists acupuncture as one of their services to help moms who experience D-MER. Acupuncture can help increase milk supply, so it's one of the potential natural therapy options.
7. Prescription medication. These are often recommended for extreme cases. Consult your doctor first before taking any medication.
D-MER is relatively new. A new mom who's suffering from the condition can easily feel guilty and even depressed when she decides to give up breastfeeding. Getting help is important. Talk to a doctor if you feel any symptoms.