Just-Identified Breastfeeding Disorder Gives New Meaning To "Letdown"

Earlier this week, I wrote a blog post over at Baby’s First Year, exploring the pros and cons of breastfeeding and formula feeding, from my personal perspective. One of the things I mentioned in the post was how bizarrely agitated and unhappy I felt every time I used a breastpump. I described the feeling as being close to a low grade panic attack.

One of the commenters on that post left a link to a website about something called “Dysphoric Milk Ejection Reflex” or “D-MER.” I’d never heard of this, so I went and checked the site out, and what I found is truly fascinating, and has the potential to help a whole lot of women.

The site was started by a mother who found herself experiencing sudden and painful  feelings of sadness and disappointment every time she started to nurse her baby. She made the connection between her milk letdown (ejection reflex) and the onset of these feelings, and started trying to track down information and resources about this condition, which obviously has the potential to make it very hard for a woman to breastfeed her baby, and could also lead to more serious problems, like depression.

To make a long story short, this resourceful mother, named Alia Macria Heise gave the condition a name, and by starting a blog in which she discussed her experiences, she found many, many other moms who had also been dealing with this mysterious, very real complication of breastfeeding that wasn’t officially recognized by medical science.

Soon, Heise tracked down a few nationally-known Board Certified Lactation Consultants, including Diane Wiessinger, MS, IBCLC who were interested in clearly identifying the symptoms and diagnosis of D-MER, and in creating a research project around the topic. And that’s what they’ve done. They plan to publish their first scientific study of Dysphoric Milk Ejection Research soon.

From the D-MER website:

Simply put: D-MER is physiological, not psychological. It is hormones, not past experience or repressed memories, that cause it.
We’re quite sure now that D-MER is linked to a drop in dopamine that seems to occur whenever milk is released. In a mother with D-MER at the time of letdown dopamine falls inappropriately, causing negative feelings. All of the suggestions made for treating D-MER are based on our belief that transiently inadequate dopamine is responsible.
Milk release itself isn’t caused by dopamine dropping; it’s caused by oxytocin rising. In D-MER, the MER (milk ejection reflex) is a result of rising oxytocin (needed to move the milk out of the breast) but the D (dysphoria) is a result of inappropriately falling dopamine. Dopamine gets involved because it inhibits prolactin (which is what makes the milk,) so dopamine levels need to drop for prolactin levels to rise in order to make more milk. Normally, dopamine drops properly and breastfeeding mothers never knew it even happened, in D-MER mothers however, it doesn’t drop properly and causes a negative emotional reaction.

I have personally known several mothers over the years who have described what I now believe to have been D-MER to me with regard to their personal breastfeeding experiences. These women recounted that they began to feel inexplicably empty and hopeless whenever they breastfed their babies; one friend told me that she had a sudden and powerful pang of what felt like homesickness when the baby would begin to nurse. Another explained that nursing her baby made her feel very anxious and agitated, like she was going to jump out of her own skin.

According to the researchers now looking into the causes and treatment for D-MER, all of these feelings fall within their well-defined spectrum of symptoms for diagnosis.

This is truly fascinating stuff. It’s real medical research on an under-explored but important aspect of women’s health, and the push to get the research going was completely grassroots in nature, started by one mom with a problem to solve and a motivation to find answers in order to help others.

Have you ever experienced D-MER, or known anyone who did? What was your experience? Did you ever try to explain it to a doctor or other medical professional? What kind of response did you get? Tell me in the comments below.

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