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Monday, April 15, 2013

Milk Ejection Reflex and Negative Emotions. What is going on?

You sit down to nurse. You're tired and looking forward to relaxing with your squishy new baby snuggled comfortably against your chest. You can't wait to hear those reassuring sounds as he sucks, swallows, and breathes.

You're ready.

Ready to soak up the warm touch of your baby's smooth skin, to stroke his back gently with one hand while supporting him with the other. You're ready to feel his tummy move in and out against yours as you enjoy the surge of oxytcin that will pulse through your veins telling your breasts it's time to nurture your baby.

You have your water, your snack, and a good book. Baby latches on, you lean back, you relax, and take a deep breath as you comfortably melt into your couch, but as you exhale you feel like something is not right; maybe you feel homesick, or even helpless. You don't know why or where this is coming from. These negative feelings, that can range from severe to mild, envelope you tightly as you struggle to understand how they could take up residence deep in the pit of your stomach while doing something you enjoy so much.


Baby begins gulping and you know your milk has let-down. A minute passes and everything feels right again. In fact you may even forget about these feelings but next time you sit down to nurse or even if your milk let-down occurs without a nursling at the breast you are reminded, yet again, of these passing emotions that you struggle to understand.

If this sounds familiar to you than you might have Dysphoric Milk Ejection Reflex or D-MER.


As a new mother with my first baby, a boy, the description above is my experience. After several months the symptoms improved greatly and pretty much disappeared as we nursed into toddler-hood. By the time I was pregnant with my second baby I had forgotten completely about these poorly understood emotions. Then she was born and the uncomfortable feelings were knocking at my breastfeeding door again.

Despite laying in my own bed or sitting on my own couch, every time I placed my brand new baby girl to the breast I felt homesick. It would fill me up with a mild sense of doom I just couldn't shake. The feelings were brief so I accepted them and moved on. I began to expect these feelings just as much as I expected to see my baby start gulping. I knew they would visit just before I felt the familiar sensation of a milk release (note: not all women feel a milk ejection reflex) and expected them to leave within a minute or less. These unexplained, poorly understood feelings were consistent and predictable. In fact, they were so predictable, even when baby wasn't at the breast, I could tell if I was going to have a let-down because I would suddenly feel that all too frequent "ickiness" that started in the pit of my stomach and consumed my body like a virus.

Just as they slowly left me with my first baby they faded with my second. It wasn't until one of the breastfeeding facebook pages I "like" posted an article about D-MER did I know that what I was experiencing had a name, or even that it existed beyond my own experience. It was my "aha moment!" A physiological reaction to a drop in dopamine!


So what is Dysphoric Milk Ejection Reflex?

According to "'Dysphoric Milk Ejection Reflex is a condition affecting lactating women that is characterized by an abrupt dysphoria, or negative emotions, that occur just before milk release and continuing not more than a few minutes.' This is a physiological response (not a psychological response) that appears to be tied to a sudden decrease in the brain chemical dopamine immediately before milk let-down."

For more information read this article by Alia Macrina Heise, from Breastfeeding Today, Issue 4 (November 2010), pp. 18-20.
D-MER (Dysphoric Milk Ejection Reflex): What is it?

~ Meghan