For some, whether or not to breastfeed their baby is a decision to be made after much thought and discussion. For me, there was never a question. From the moment I knew I was pregnant, I also knew that I would nourish my child the way God intended: with breastmilk. I also had every intention of breastfeeding for at least a year, longer if all was going well.
Like many first time moms, I thought breastfeeding would be easy. It’s natural, after all, so we’d both have an instinct on how to do it right. Besides, how hard could it be: baby opens mouth, mom inserts nipple, baby happily sucks until her tummy is full. Easy peasy, right?
Not so much, it turns out. Although my daughter successfully latched minutes after birth (with a lot of help and guidance from our midwife), the going got tough after we came home. Munchkin had a lot of latching issues for which we sought help from two different Lactation Consultants, a physical therapist and a chiropractor. It took two months of cracked, bleeding nipples and a screaming baby for Munchkin and I to finally get the hang of things. Many moms would have given up by then, and I would not have blamed them, but I was determined to feed my child the most nutritious food I could give her.
Then the PPD set in. Actually, it knocked me on my ass. It took another couple of dark months for me to finally admit to myself that I could not control the way I was feeling and that I needed help. I researched the hell out of all the medications that I could safely take while breastfeeding. Even though I was intensely depressed and would often sob inconsolably while feeding my child, I still couldn’t let myself give up on breastfeeding.
Being put on medication for the PPD has made a world of difference. I was finally able to bond with my baby and feel joy about being a mom. Things have been much easier for me and Munchkin in the feeding department and I thought we were in the clear. But then I started having strange new symptoms.
At every feed I have always been desperately thirsty right about the time I have a let down. My mom told me this happened to her and I’ve heard other women discuss it happening to them so I wasn’t concerned. But then I started to notice that along with the thirst came a deep and overwhelming sense of sadness. Like a huge surge in the depression that I thought was finally behind me (or at least under control). The sadness would linger for the first few minutes of each feed and then slowly dissipate. After a little while, I felt normal again. It was the oddest thing and I thought it was just a fluke occurrence the first few times. But it kept happening with every let down.
After several weeks of this overwhelming sadness I decided to talk to my midwife. I asked her if she had heard of this kind of thing happening to others. I fully expected her to say no. I really thought I was just a freak with weird depression issues. To my surprise, she responded that I had a little known condition called Dysphoric Milk Ejection Reflex (or D-MER). While I was relieved to know that I was not, in fact, nuts, it was also disheartening to discover yet another obstacle for me to overcome. So I did what I always do and I did some research. Here is what I found through a great website called D-MER.org:
What is D-MER?
It is a newly recognized condition affecting lactating women that is characterized by abrupt negative emotions that occur just before milk release and continue not more than a few minutes. Some of the most frequent feelings experienced are: hollow feelings in the stomach, anxiety, sadness, dread, anxiousness, irritability, hopelessness.
What causes D-MER?
D-MER is a physiological reaction caused as a result of inappropriate dopamine activity when the milk ejection reflex is activated.
Are there different levels of D-MER?
Yes, D-MER can be very mild, often described as a “sigh” or a “pang.” On the other end of the spectrum, some mothers feel extremely intense emotions resulting is suicidal thoughts, thoughts of self-harm or angry feelings. Some mothers find that D-MER gets less severe as the baby gets older. However, for some mothers D-MER will be harder to handle if she also has PPD or an anxiety disorder as well.
How can D-MER be treated?
Mothers with severe D-MER can work with their practitioners to find a medication that is right for them that will increase their dopamine levels. Mothers with more moderate or mild D-MER can work with their lactation consultant regarding natural treatments and lifestyle changes. Some mothers find it helpful simply to know what is happening to them and knowing that it will quickly go away once their milk starts flowing.
So how have I decided to handle this new development in my breastfeeding journey? I am one of those mothers who feels better knowing what is happening and that it will go away. I can handle the surge of sadness if I know it will disappear within minutes. Hell, I fought that sadness for months on end after Munchkin was born; I can certainly deal with it for a couple of minutes. And despite this new hiccup, I still plan to continue to feed my daughter until she’s at least a year old. Even now, I still can’t find it in me to take that away from her. I know what good it will do her for the rest of her life and I’m not willing to sacrifice it.
If you are a mother with D-MER, or you suspect you have D-MER, I write this for you. I want to shed light on this condition, just like I wanted to be open and honest about my PPD. This is not something to be ashamed about. It is not something you can control. It is a hormonal issue that can be treated. If you are like me and choose to ride it out, more power to you. But if you feel that you need help getting past these overwhelming feelings of sadness or anxiety, please don’t be embarrassed or ashamed to ask for it! Most importantly, don’t let these feelings stop you from continuing your breastfeeding journey if it is important to you as it is to me. But if you decide that your journey needs to end, that’s okay too. Your choice to breastfeed is just that: YOUR CHOICE. Don’t let anyone tell you different. The decision to breastfeed belongs to you and I know that, as a mama, you will make the best choice for you and your baby.
For more information about D-MER, please visit www.D-MER.org, and please pass along this information to other lactating mamas you know.
(Photos of me and Munchkin on her birth day are copyright of Wisner Photo.)